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1.
Crit Care Explor ; 2(9): e0210, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-33063043

RESUMEN

Importance: Management of severe coronavirus disease 2019 relies on advanced respiratory support modalities including invasive mechanical ventilation, continuous positive airway pressure, and noninvasive ventilation, all of which are associated with the development of subcutaneous emphysema, pneumomediastinum, and pneumothorax (herein collectively termed barotrauma). Objectives: To assess the occurrence rate of barotrauma in severe coronavirus disease 2019 and to explore possible associated factors. Design Setting and Participants: A retrospective, single-center cohort study with nested case series, conducted at University Hospital Lewisham: a 450-bed general hospital in London, United Kingdom. All patients with confirmed coronavirus disease 2019 admitted to the critical care department from March 12, to April 12, 2020, were included. Main Outcomes and Measures: Patients were retrospectively screened for radiological evidence of barotrauma. Admission characteristics, modalities of respiratory support, and outcomes were compared between barotrauma and nonbarotrauma groups. Respiratory parameters in the period preceding barotrauma identification were recorded. Results: Of 83 admissions with coronavirus disease 2019, eight suffered barotrauma (occurrence rate 9.6%; 95% CI 4.3%-18.1%). Barotrauma cases had longer illness duration prior to critical care admission (10 vs 7 d; interquartile range, 8-14 and 6-10, respectively; p = 0.073) and were more often treated with continuous positive airway pressure or noninvasive ventilation as the initial modality of advanced respiratory support (87.5% vs 36.0%; p = 0.007). Patients managed with continuous positive airway pressure or noninvasive ventilation prior to the development of barotrauma had median minute ventilation of 16.2-19.9 and 21.3-22.7 L/min, respectively. Compared with the nonbarotrauma group, a higher proportion of patients with barotrauma had died (62.5% vs 43.2%), and a lower proportion of patients had been discharged (25.0% vs 53.3%) at 3-month follow-up. Conclusions and Relevance: Barotrauma appears to be a common complication of severe coronavirus disease 2019. Determining whether high minute ventilation while using continuous positive airway pressure or noninvasive ventilation predisposes patients to barotrauma requires further investigation.

2.
Clin Epidemiol ; 12: 1045-1057, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33116899

RESUMEN

Background: In the interrupted time series (ITS) approach, it is common to average the outcome of interest at each time point and then perform a segmented regression (SR) analysis. In this study, we illustrate that such 'aggregate-level' analysis is biased when data are missing at random (MAR) and provide alternative analysis methods. Methods: Using electronic health records from the UK, we evaluated weight change over time induced by the initiation of antipsychotic treatment. We contrasted estimates from aggregate-level SR analysis against estimates from mixed models with and without multiple imputation of missing covariates, using individual-level data. Then, we conducted a simulation study for insight about the different results in a controlled environment. Results: Aggregate-level SR analysis suggested a substantial weight gain after initiation of treatment (average short-term weight change: 0.799kg/week) compared to mixed models (0.412kg/week). Simulation studies confirmed that aggregate-level SR analysis was biased when data were MAR. In simulations, mixed models gave less biased estimates than SR analysis and, in combination with multilevel multiple imputation, provided unbiased estimates. Mixed models with multiple imputation can be used with other types of ITS outcomes (eg, proportions). Other standard methods applied in ITS do not help to correct this bias problem. Conclusion: Aggregate-level SR analysis can bias the ITS estimates when individual-level data are MAR, because taking averages of individual-level data before SR means that data at the cluster level are missing not at random. Avoiding the averaging-step and using mixed models with or without multilevel multiple imputation of covariates is recommended.

3.
J Psychopharmacol ; 34(1): 79-85, 2020 01.
Artículo en Inglés | MEDLINE | ID: mdl-31724905

RESUMEN

BACKGROUND: Antipsychotics are often prescribed for long-term periods, however, most evidence of their impact on body weight comes from short-term clinical trials. Particularly, impact associated with dosage has been barely studied. AIMS: The aim of this study was to describe the short- and long-term change in body weight of people initiated on high or low doses of the three most commonly prescribed second-generation antipsychotics. METHODS: Retrospective cohorts of individuals with a diagnosed psychotic disorder observed from 2005 to 2015 in the UK primary care. The exposure was the first prescription of olanzapine, quetiapine or risperidone. The main outcome was change in body weight four years before and four years after initiation of antipsychotic treatment, stratified on sex and 'low' or 'high' dose. RESULTS: In total, 22,306 women and 16,559 men were observed. Olanzapine treatment was associated with the highest change in weight, with higher doses resulting in more weight gain. After 4 years, given a high dose of olanzapine (> 5 mg), women gained on average +6.1 kg; whereas given a low dose (⩽ 5 mg), they gained +4.4 kg. During the first six weeks of olanzapine treatment, they gained on average +3.2 kg on high dose and +1.9 kg on low dose. The trends were similar for men. Individuals prescribed risperidone and quetiapine experienced less weight gain in both the short- and long-term. CONCLUSIONS: Olanzapine treatment was associated with the highest increase in weight. Higher doses were associated with more weight gain. Doctors should prescribe the lowest effective dose to balance mental-health benefits, weight gain and other adverse effects.

4.
Liberabit ; 25(2): 139-158, jul.-dic. 2019. ilus, tab
Artículo en Español | LILACS-Express | LILACS | ID: biblio-1143221

RESUMEN

Objetivo: evaluar la estructura interna, invarianza de medida, validez de criterio y confiabilidad del CASM-85 en estudiantes de secundaria peruanos. Materiales y Métodos: se evaluaron 2075 estudiantes de ambos sexos, entre 11 y 18 años, provenientes de colegios nacionales y particulares de Arequipa, Chimbote, Lima y Pucallpa. Se realizó un análisis de la correlación ítem-ítem e ítemresto para cada dimensión del CASM-85, un análisis factorial confirmatorio y modelos MIMIC (Multiple Indicator, Multiple Cause) para evaluar la invarianza de medida a través de grupos según sexo, edad, colegio y ciudad. La confiabilidad fue estimada mediante los coeficientes Alpha y Omega. La validez de criterio entre el CASM-85 y el rendimiento académico se revisó a través de la r de Pearson y modelos de regresión. Resultados: se eliminaron ítems heterogéneos y se obtuvo una forma reducida de 45 ítems a compararse con su original de 53 ítems. Para la forma original el CFI y TLI fue < .9 en todas las ciudades, mientras que para la forma reducida fue < . 9 solo en Chimbote. Los SRMR y RMSEA fueron ≤ .10 y ≤ .09 para las formas original y reducida respectivamente. Los modelos MIMIC confirmaron invarianza para todas las variables excepto para la variable ciudad con la forma original (│ΔCFI│ = .09, │ΔTLI│ = .08). La confiabilidad fue moderada tanto para la forma original (Ω ≥ .68; α ≥ .81) como para la reducida (Ω ≥ .77; α ≥ .84). La r de Pearson mostró una relación positiva y de fuerza débil para la forma original (r = .17) y reducida (r = .18). Conclusión: la forma reducida del CASM-85 (45 ítems) ha mostrado mejores propiedades psicométricas que su forma original.


Objective: To assess the internal structure, measurement invariance, criterion validity and reliability of the CASM-85 in Peruvian high school students. Materials and methods: Two thousand seventy-five (2075) students of both sexes, aged 11 to 18 years, from public and private high schools of Arequipa, Chimbote, Lima and Pucallpa were evaluated. An item-item and item-rest correlation analysis for each dimension of the CASM- 85, a confirmatory factorial analysis and MIMIC (Multiple Indicator, Multiple Cause) models were used to evaluate the measurement invariance across the groups according to their sex, age, school and city. Reliability was estimated using alpha and omega coefficients. The criterion validity between the CASM-85 and academic performance was determined using Pearson’s r and regression models. Results: The heterogeneous items were removed, obtaining a 45-item short form compared to the original 53-item form. In the original form, CFI and TLI were < .9 in all the cities, whereas in the short form, CFI and TLI were < .9 only in Chimbote. SRMR and RMSEA were ≤ .10 and ≤ .09 in the original and short forms, respectively. The MIMIC models confirmed the measurement invariance in all variables, with the exception of the original form between cities (│ΔCFI│ = .09, │ΔTLI│= .08). Reliability was moderate for both the original (Ω ≥ .68; α ≥ .81) and short forms (Ω ≥ .77; α ≥ .84). Pearson’s r showed a positive and weak correlation in the original (r = .17, p < .001) and short (r = .18, p < .001) forms. Conclusion: The CASM-85 short form (45 items) has shown better psychometric properties than its original full form.

5.
PLoS One ; 14(9): e0221717, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31498796

RESUMEN

OBJECTIVE: Analyze the measurement invariance and the factor structure of the Patient Health Questionnaire-9 (PHQ-9) in the Peruvian population. METHOD: Secondary data analysis performed using cross-sectional data from the Health Questionnaire of the Demographic and Health Survey in Peru. Variables of interest were the PHQ-9 and demographic characteristics (sex, age group, level of education, socioeconomic status, marital status, and area of residence). Factor structure was evaluated by standard confirmatory factor analysis (CFA), and measurement invariance by multi-group CFA, using standard goodness-of-fit indices criteria for interpreting results from both CFAs. Analysis of the internal consistency (α and ω) was also pursued. RESULTS: Data from 30,449 study participants were analyzed, 56.7% were women, average age was 40.5 years (standard deviation (SD) = 16.3), 65.9% lived in urban areas, 74.6% were married, and had 9 years of education on average (SD = 4.6). From standard CFA, a one-dimensional model presented the best fit (CFI = 0.936; RMSEA = 0.089; SRMR = 0.039). From multi-group CFA, all progressively restricted models had ΔCFI<0.01 across almost all groups by demographic characteristics. PHQ-9 reliability was optimal (α = ω = 0.87). CONCLUSIONS: The evidence presents support for the one-dimensional model and measurement invariance of the PHQ-9 measure, allowing for reliable comparisons between sex, age groups, education level, socioeconomic status, marital status, and residence area, and recommends its use within the Peruvian population.


Asunto(s)
Demografía/estadística & datos numéricos , Cuestionario de Salud del Paciente/estadística & datos numéricos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Análisis de Varianza , Escolaridad , Femenino , Humanos , Masculino , Estado Civil/estadística & datos numéricos , Persona de Mediana Edad , Reproducibilidad de los Resultados , Población Rural/estadística & datos numéricos , Clase Social , Población Urbana/estadística & datos numéricos , Adulto Joven
6.
Rev Peru Med Exp Salud Publica ; 35(3): 456-464, 2018.
Artículo en Español | MEDLINE | ID: mdl-30517506

RESUMEN

OBJECTIVE.: To assess the reliability and validity of the translated and culturally-adapted Institutional Review Board Researcher Assessment Tool (IRB-RAT) for Peruvian research ethics committees (RECs). MATERIALS AND METHODS.: The IRB-RAT is an instrument that determines how RECs are perceived by researchers based on eight factors, using two formats: 1) importance in the work of the researcher and 2) descriptive of the REC being evaluated. Its original English version was translated and culturally adapted into Spanish, with the support of experts and representatives of the target population. Then, according to the responses of 113 users, the heterogeneous items were identified and eliminated until a final version of 29 items was obtained. The reliability of this version was reviewed using Cronbach's α and omega coefficient, its internal structure validity through a confirmatory factor analysis with the unweighted least squares method. RESULTS.: Translation and cultural adaptation complied with internationally recommended steps. Reliability at the level of the eight factors was moderate for format 1 (0.67<α<0.89; 0.71<ω<0.89) and high for format 2 (0.83<α<0.92; 0.85<ω<0.92). Content validity was high at item level and moderate for factors. Internal structure validity was good for format 1 (AGFI=0.97, GFI=0.97, NFI=0.97, RMR=0.04) and moderately good for format 2 (AGFI=0.99, GFI=0.99, NFI=0.99, RMR=0.10). CONCLUSIONS.: Our Spanish adaptation of the IRB-RAT has sufficient reliability and validity to assist in the continuous improvement of the RECs in Peru and other Spanish-speaking countries.


Asunto(s)
Actitud del Personal de Salud , Comités de Ética en Investigación , Autoinforme , Adulto , Características Culturales , Femenino , Humanos , Masculino , Perú , Psicometría , Traducciones
7.
Sage Open ; 8(1)2018.
Artículo en Inglés | MEDLINE | ID: mdl-30221033

RESUMEN

Over the past decade, data have identified male sex work as a potentially viable economic decision; despite this, male sex workers (MSWs) continue to be perceived as group with access to few assets and resources. Using data from a pilot skills- building intervention for MSWs in Lima, Peru, an analysis of the economic characteristics of 209 MSWs is presented. The majority reported livable incomes with median earnings of US$250 per month, 83% earning above the urban poverty line. Interestingly, non-sex work was also an important source of income, especially for the high-earning MSWs. Spending data revealed that a large portion of income went to necessities (55%), luxuries (11%), and gifts (11%), with less toward savings (5%) and studies (1%). Such data on MSWs' earnings and spending, which suggest that a lack of overall income is not the MSW's main impediment to escaping poverty, could direct future poverty alleviation and health improvement programs in this key population.

8.
Rev. peru. med. exp. salud publica ; 35(3): 456-464, jul.-sep. 2018. tab, graf
Artículo en Español | LILACS-Express | LILACS | ID: biblio-978893

RESUMEN

RESUMEN Objetivo. Evaluar la confiabilidad y validez del Institutional Review Board Researcher Assessment Tool (IRB-RAT) traducido y adaptado culturalmente para los comités de ética en investigación (CEI) peruanos. Materiales y métodos. El IRB-RAT es un instrumento que determina como son percibidos los CEI por los investigadores en función a ocho factores, mediante dos formatos: 1) importancia en el trabajo del investigador y 2) descriptivo del CEI evaluado. Su versión original en inglés se tradujo y adaptó culturalmente al español, con el apoyo de expertos y representantes de la población objetivo. Luego, según las respuestas de 113 usuarios, se identificaron y eliminaron los ítems heterogéneos hasta obtener una versión final de 29 ítems. La confiabilidad de esta versión se revisó mediante α de Cronbach y coeficiente omega, su validez de estructura interna mediante un análisis factorial confirmatorio con el método de mínimos cuadrados no ponderados. Resultados. La traducción y adaptación cultural cumplió con los pasos recomendados internacionalmente. La confiabilidad a nivel de los ocho factores fue moderada para el formato 1 (0,67<α<0,89; 0,71<ω<0,89) y alta para el formato 2 (0,83<α<0,92; 0,85<ω<0,92). La validez de contenido fue alta a nivel de ítems y moderada para los factores. La validez de estructura interna fue buena para el formato 1 (AGFI=0,97, GFI=0,97, NFI=0,97, RMR=0,04) y moderadamente buena para el formato 2 (AGFI=0,99, GFI=0,99, NFI=0,99, RMR=0,10). Conclusión. Nuestra adaptación al español del IRB-RAT tiene confiabilidad y validez suficientes para asistir en la mejora continua de los CEI del medio peruano y otros similares de habla hispana.


ABSTRACT Objective. To assess the reliability and validity of the translated and culturally-adapted Institutional Review Board Researcher Assessment Tool (IRB-RAT) for Peruvian research ethics committees (RECs). Materials and Methods. The IRB-RAT is an instrument that determines how RECs are perceived by researchers based on eight factors, using two formats: 1) importance in the work of the researcher and 2) descriptive of the REC being evaluated. Its original English version was translated and culturally adapted into Spanish, with the support of experts and representatives of the target population. Then, according to the responses of 113 users, the heterogeneous items were identified and eliminated until a final version of 29 items was obtained. The reliability of this version was reviewed using Cronbach's α and omega coefficient, its internal structure validity through a confirmatory factor analysis with the unweighted least squares method. Results. Translation and cultural adaptation complied with internationally recommended steps. Reliability at the level of the eight factors was moderate for format 1 (0.67<α<0.89; 0.71<ω<0.89) and high for format 2 (0.83<α<0.92; 0.85<ω<0.92). Content validity was high at item level and moderate for factors. Internal structure validity was good for format 1 (AGFI=0.97, GFI=0.97, NFI=0.97, RMR=0.04) and moderately good for format 2 (AGFI=0.99, GFI=0.99, NFI=0.99, RMR=0.10). Conclusions. Our Spanish adaptation of the IRB-RAT has sufficient reliability and validity to assist in the continuous improvement of the RECs in Peru and other Spanish-speaking countries.

9.
PLoS One ; 13(6): e0199820, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29953501

RESUMEN

INTRODUCTION: Instrumental activities of daily living (IADL) are cognitively complex activities related to independent living in the community. Robust IADL scales are needed, however the psychometric properties of instruments have been little evaluated. There is no validated instrument for Sri Lankan older populations. Sri Lanka has the highest proportion of older people in South Asia with rapid population ageing. Therefore, it is essential to have standard instruments to assess activity limitations. We aimed to cross-culturally adapt the original Lawton Instrumental Activities of Daily Living Scale from English to Sinhala and evaluate the psychometric properties of the Sinhala version. METHODS: Cross-cultural adaptation of the instrument was performed. The instrument was validated in a sample of 702 community-dwelling older adults aged 60 years and above in Sri Lanka. Reliability (internal consistency and inter-rater reliability) was assessed. Construct validity of the scale was evaluated by performing exploratory and confirmatory factor analysis and testing convergent and divergent validity. RESULTS: The Lawton IADL scale was successfully adapted to Sri Lankan context. Internal consistency of the scale was very high (Cronbach's alpha = 0.91). Very good inter-rater reliability was observed with very good agreement for all items. Inter-class correlations for overall IADL score ranged from 0.57 to 0.91. Results of the exploratory and confirmatory factor analyses supported the unidimensionality of the scale. Goodness of fit indices in confirmatory factor analysis were in acceptable range (CFI = 0.98, SRMR = 0.06, NNFI = 0.97). Strength of associations were significant and in the expected direction. Results of the known group validity were also significant, confirming the convergent and divergent validity. CONCLUSION: The Lawton IADL scale was successfully translated and culturally adapted to Sinhala language. The Sinhala version demonstrated excellent reliability and construct validity. Given good psychometric properties, this scale would be recommended for use in future research.


Asunto(s)
Actividades Cotidianas/psicología , Adaptación Psicológica , Envejecimiento/psicología , Cognición , Cultura , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Psicometría , Sri Lanka
11.
Eur J Paediatr Neurol ; 22(5): 763-773, 2018 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-29778429

RESUMEN

BACKGROUND: Hand, foot and mouth disease (HFMD) caused by enterovirus A71 (EV-A71) is associated with acute neurological disease in children. This study aimed to estimate the burden of long-term sequelae and death following severe HFMD. METHODS: This systematic review and meta-analysis pooled all reports from English and Chinese databases including MEDLINE and Wangfang on outbreaks of clinically diagnosed HFMD and/or laboratory-confirmed EV-A71 with at least 7 days' follow-up published between 1st January 1966 and 19th October 2015. Two independent reviewers assessed the literature. We used a random effects meta-analysis to estimate cumulative incidence of neurological sequelae or death. Studies were assessed for methodological and reporting quality. PROSPERO registration number: 10.15124/CRD42015021981. FINDINGS: 43 studies were included in the review, and 599 children from 9 studies were included in the primary analysis. Estimated cumulative incidence of death or neurological sequelae at maximum follow up was 19.8% (95% CI:10.2%, 31.3%). Heterogeneity (Iˆ2) was 88.57%, partly accounted for by year of data collection and reporting quality of studies. Incidence by acute disease severity was 0.00% (0.00, 0.00) for grade IIa; 17.0% (7.9, 28.2) for grade IIb/III; 81.6% (65.1, 94.5) for grade IV (p = 0.00) disease. CONCLUSIONS: HFMD with neurological involvement is associated with a substantial burden of long-term neurological sequelae. Grade of acute disease severity was a strong predictor of outcome. Strengths of this study include its bilingual approach and clinical applicability. Future prospective and interventional studies must use rigorous methodology to assess long-term outcomes in survivors. FUNDING: There was no specific funding for this study. See below for researcher funding.


Asunto(s)
Enfermedades del Sistema Nervioso Central/virología , Enfermedad de Boca, Mano y Pie/complicaciones , Animales , Enfermedades del Sistema Nervioso Central/epidemiología , Niño , Preescolar , Progresión de la Enfermedad , Enterovirus , Infecciones por Enterovirus/complicaciones , Humanos , Lactante , Masculino , Estudios Prospectivos
13.
Prev Chronic Dis ; 14: E102, 2017 10 19.
Artículo en Inglés | MEDLINE | ID: mdl-29072986

RESUMEN

INTRODUCTION: The rise in noncommunicable diseases and their risk factors in developing countries may have changed or intensified the effect of parity on obesity. We aimed to assess this association in Peruvian women using data from a nationally representative survey. METHODS: We used data from Peru's Demographic and Health Survey, 2012. Parity was defined as the number of children ever born to a woman. We defined overweight as having a body mass index (BMI, kg/m2) of 25.0 to 29.9 and obesity as a BMI ≥30.0. Generalized linear models were used to evaluate the association between parity and BMI and BMI categories, by area of residence and age, adjusting for confounders. RESULTS: Data from 16,082 women were analyzed. Mean parity was 2.25 (95% confidence interval [CI], 2.17-2.33) among rural women and 1.40 (95% CI, 1.36-1.43) among urban women. Mean BMI was 26.0 (standard deviation, 4.6). We found evidence of an association between parity and BMI, particularly in younger women; BMI was up to 4 units higher in rural areas and 2 units higher in urban areas. An association between parity and BMI categories was observed in rural areas as a gradient, being highest in younger women. CONCLUSION: We found a positive association between parity and overweight/obesity. This relationship was stronger in rural areas and among younger mothers.


Asunto(s)
Obesidad/epidemiología , Paridad , Adulto , Distribución por Edad , Índice de Masa Corporal , Estudios Transversales , Países en Desarrollo , Femenino , Mapeo Geográfico , Encuestas Epidemiológicas , Humanos , Modelos Lineales , Persona de Mediana Edad , Perú/epidemiología , Vigilancia de la Población , Prevalencia , Factores de Riesgo , Factores Socioeconómicos
16.
Rev Peru Med Exp Salud Publica ; 33(3): 462-470, 2016.
Artículo en Español | MEDLINE | ID: mdl-27831609

RESUMEN

Objetives.: Our aim was to evaluate the psychometric properties of the FACES-III among Peruvian high school students. Materials and Methods.: This is a psychometric cross-sectional study. A probabilistic sampling was applied, defined by three stages: stratum one (school), stratum two (grade) and cluster (section). The participants were 910 adolescent students of both sexes, between 11 and 18 years of age. The instrument was also the object of study: the Olson's FACES-III. The analysis included a review of the structure / construct validity of the measure by factor analysis and assessment of internal consistency (reliability). Results.: The real-cohesion scale had moderately high reliability (Ω=.85) while the real-flexibility scale had moderate reliability (Ω=.74). The reliability found for the ideal-cohesion was moderately high (Ω=.89) like for the scale of ideal-flexibility (Ω=.86). Construct validity was confirmed by the goodness of fit of a two factor model (cohesion and flexibility) with 10 items each [Adjusted goodness of fit index (AGFI) = 0.96; Expected Cross Validation Index (ECVI) = 0.87; Normed fit index (NFI) = 0.93; Goodness of fit index (GFI) = 0.97; Root mean square error of approximation (RMSEA) = 0.06]. Conclusions.: FACES-III has sufficient reliability and validity to be used in Peruvian adolescents for the purpose of group or individual assessment.


Asunto(s)
Psicometría , Adolescente , Niño , Estudios Transversales , Femenino , Humanos , Masculino , Perú , Reproducibilidad de los Resultados , Encuestas y Cuestionarios
17.
Rev. peru. med. exp. salud publica ; 33(3): 462-470, jul.-sep. 2016. tab, graf
Artículo en Español | LILACS-Express | LILACS, LIPECS | ID: lil-798207

RESUMEN

RESUMEN Objetivos. Evaluar las propiedades psicométricas del FACES-III en una población de estudiantes adolescentes peruanos. Materiales y métodos. El presente estudio es transversal, de tipo psicométrico. El muestreo aplicado fue probabilístico, definido en tres etapas: primer estrato (colegio), segundo estrato (grado), conglomerado (sección). Los participantes fueron 910 estudiantes adolescentes de ambos sexos, entre los 11 y 18 años. El instrumento es, a la vez, el objeto de estudio: el FACES-III de Olson. El análisis incluyó la revisión de la validez de estructura/constructo mediante análisis factorial y de la confiabilidad por consistencia interna (índices alpha, theta y omega). Resultados. La escala cohesión-real tiene confiabilidad moderadamente alta (Ω=0,85) mientras que la escala flexibilidad-real tiene confiabilidad moderada (Ω=0,74). Para la escala cohesión-ideal la confiabilidad es moderadamente alta (Ω=0,89), lo mismo que para la escala de flexibilidad-ideal (Ω=0,86). La validez de constructo se confirmó en la bondad de ajuste del modelo de dos factores (cohesión y flexibilidad) con 10 ítems cada uno [índice ajustado de bondad de ajuste (AGFI)=0,96; índice de validación cruzada esperada (ECVI)=0,87; índice de ajuste normado (NFI)=0,93; índice de bondad de ajuste (GFI)=0,97; raíz del error cuadrático medio de aproximación (RMSEA)=0,06]. Conclusiones. El FACES-III tiene confiabilidad y validez suficientes como para ser utilizado en población adolescente peruana con fines de evaluación grupal o individual.


ABSTRACT Objetives. Our aim was to evaluate the psychometric properties of the FACES-III among Peruvian high school students. Materials and Methods. This is a psychometric cross-sectional study. A probabilistic sampling was applied, defined by three stages: stratum one (school), stratum two (grade) and cluster (section). The participants were 910 adolescent students of both sexes, between 11 and 18 years of age. The instrument was also the object of study: the Olson's FACES-III. The analysis included a review of the structure / construct validity of the measure by factor analysis and assessment of internal consistency (reliability). Results. The real-cohesion scale had moderately high reliability (Ω=.85) while the real-flexibility scale had moderate reliability (Ω=.74). The reliability found for the ideal-cohesion was moderately high (Ω=.89) like for the scale of ideal-flexibility (Ω=.86). Construct validity was confirmed by the goodness of fit of a two factor model (cohesion and flexibility) with 10 items each [Adjusted goodness of fit index (AGFI) = 0.96; Expected Cross Validation Index (ECVI) = 0.87; Normed fit index (NFI) = 0.93; Goodness of fit index (GFI) = 0.97; Root mean square error of approximation (RMSEA) = 0.06]. Conclusions. FACES-III has sufficient reliability and validity to be used in Peruvian adolescents for the purpose of group or individual assessment.

18.
BMC Psychol ; 4: 22, 2016 May 04.
Artículo en Inglés | MEDLINE | ID: mdl-27142187

RESUMEN

BACKGROUND: Positive mental health (PMH) is much more than the absence of mental illnesses. For example, PMH explains that to be happy or resilient can drive us to live a full life, giving us a perception of well-being and robustness against everyday problems. Moreover, PMH can help people to avoid risky behaviours like tobacco consumption (TC). Our hypothesis was that PMH is negatively associated with TC, and this association differs across rural, urban and migrant populations. METHODS: A cross-sectional study was conducted using the PERU MIGRANT Study's dataset, including rural population from the Peruvian highlands (n = 201), urban population from the capital city Lima (n = 199) and migrants who were born in highlands but had to migrated because of terrorism (n = 589). We used an adapted version of the 12-item Global Health Questionnaire to measure PMH. The outcome was TC, measured as lifetime and recent TC. Log-Poisson robust regression, performed with a Maximum Likelihood method, was used to estimate crude prevalence ratios (PR) and 95 % confidence intervals (95%CI), adjusted by sex, age, family income and education which were the confounders. The modelling procedure included the use of LR Test, Akaike information criteria (AIC) and Bayesian information criteria (BIC). RESULTS: Cumulative occurrence of tobacco use (lifetime TC) was 61.7 % in the rural group, 78 % in the urban group and 76.2 % in rural-to-urban migrants. Recent TC was 35.3 % in the rural group, 30.7 % in the urban group and 20.5 % in rural-to-urban migrants. After adjusting for confounders, there was evidence of a negative association between PMH and lifetime TC in the rural group (PR = 0.93; 95%CI: 0.87-0.99), and a positive association between PMH and recent TC in migrants (PR = 1.1; 95%CI: 1.0-1.3). CONCLUSIONS: PMH was negatively associated with TC in rural participants only. Urbans exhibited just a similar trend, while migrants exhibited the opposite one. This evidence represents the first step in the route of knowing the potential of PMH for fighting against TC. For rural populations, this study supplies new information that could support decisions about prevention programmes and psychotherapy for smoking cessation. However, more research in the topic is needed.


Asunto(s)
Salud Mental , Uso de Tabaco/psicología , Adulto , Anciano , Anciano de 80 o más Años , Teorema de Bayes , Estudios Transversales , Estudios Epidemiológicos , Femenino , Humanos , Funciones de Verosimilitud , Masculino , Persona de Mediana Edad , Satisfacción Personal , Perú , Prevalencia , Factores de Riesgo , Población Rural/estadística & datos numéricos , Factores Socioeconómicos , Encuestas y Cuestionarios , Migrantes/psicología , Población Urbana/estadística & datos numéricos
19.
Glob Heart ; 11(1): 121-130.e2, 2016 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-27102029

RESUMEN

BACKGROUND: Variations in the distribution of cardiovascular disease and risk factors by socioeconomic status (SES) have been described in affluent societies, yet a better understanding of these patterns is needed for most low- and middle-income countries. OBJECTIVE: This study sought to describe the relationship between cardiovascular risk factors and SES using monthly family income, educational attainment, and assets index, in 4 Peruvian sites. METHODS: Baseline data from an age- and sex-stratified random sample of participants, ages ≥35 years, from 4 Peruvian sites (CRONICAS Cohort Study, 2010) were used. The SES indicators considered were monthly family income (n = 3,220), educational attainment (n = 3,598), and assets index (n = 3,601). Behavioral risk factors included current tobacco use, alcohol drinking, physical activity, daily intake of fruits and vegetables, and no control of salt intake. Cardiometabolic risk factors included obesity, elevated waist circumference, hypertension, insulin resistance, diabetes mellitus, low high-density lipoprotein cholesterol, and high triglyceride levels. RESULTS: In the overall population, 41.6% reported a monthly family income

Asunto(s)
Enfermedades Cardiovasculares/epidemiología , Hipertrigliceridemia/epidemiología , Resistencia a la Insulina , Obesidad/epidemiología , Pobreza/estadística & datos numéricos , Clase Social , Adulto , Anciano , Consumo de Bebidas Alcohólicas/epidemiología , HDL-Colesterol , Estudios de Cohortes , Diabetes Mellitus/epidemiología , Dieta/estadística & datos numéricos , Dislipidemias/epidemiología , Escolaridad , Ejercicio Físico , Femenino , Humanos , Hipertensión/epidemiología , Renta/estadística & datos numéricos , Masculino , Persona de Mediana Edad , Perú/epidemiología , Factores de Riesgo , Fumar/epidemiología , Circunferencia de la Cintura
20.
J Am Heart Assoc ; 4(8): e002112, 2015 Aug 07.
Artículo en Inglés | MEDLINE | ID: mdl-26254303

RESUMEN

BACKGROUND: Short-term risk assessment tools for prediction of cardiovascular disease events are widely recommended in clinical practice and are used largely for single time-point estimations; however, persons with low predicted short-term risk may have higher risks across longer time horizons. METHODS AND RESULTS: We estimated short-term and lifetime cardiovascular disease risk in a pooled population from 2 studies of Peruvian populations. Short-term risk was estimated using the atherosclerotic cardiovascular disease Pooled Cohort Risk Equations. Lifetime risk was evaluated using the algorithm derived from the Framingham Heart Study cohort. Using previously published thresholds, participants were classified into 3 categories: low short-term and low lifetime risk, low short-term and high lifetime risk, and high short-term predicted risk. We also compared the distribution of these risk profiles across educational level, wealth index, and place of residence. We included 2844 participants (50% men, mean age 55.9 years [SD 10.2 years]) in the analysis. Approximately 1 of every 3 participants (34% [95% CI 33 to 36]) had a high short-term estimated cardiovascular disease risk. Among those with a low short-term predicted risk, more than half (54% [95% CI 52 to 56]) had a high lifetime predicted risk. Short-term and lifetime predicted risks were higher for participants with lower versus higher wealth indexes and educational levels and for those living in urban versus rural areas (P<0.01). These results were consistent by sex. CONCLUSIONS: These findings highlight potential shortcomings of using short-term risk tools for primary prevention strategies because a substantial proportion of Peruvian adults were classified as low short-term risk but high lifetime risk. Vulnerable adults, such as those from low socioeconomic status and those living in urban areas, may need greater attention regarding cardiovascular preventive strategies.


Asunto(s)
Enfermedades Cardiovasculares/epidemiología , Adulto , Factores de Edad , Anciano , Algoritmos , Enfermedades Cardiovasculares/diagnóstico , Escolaridad , Femenino , Humanos , Renta , Masculino , Persona de Mediana Edad , Perú/epidemiología , Prevalencia , Características de la Residencia , Medición de Riesgo , Factores de Riesgo , Salud Rural , Factores Sexuales , Factores de Tiempo , Salud Urbana
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