Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 8.627
Filtrar
1.
BMC Public Health ; 21(1): 1781, 2021 10 02.
Artículo en Inglés | MEDLINE | ID: mdl-34600498

RESUMEN

BACKGROUND: During the COVID-19 pandemic, multiple countries have taken measures, such as isolation and quarantine, to prevent person-to-person spread of disease. These actions forced many physicians to adopt new techniques, such as telemedicine, to continue patient care, which has proven to be useful in continued care for those with non-COVID-19 pathologies. Various factors, such as security, confidentiality, cost-effectiveness, comfort, and the risk of malpractice, influence the perception of telemedicine among medical practitioners. The aim of this study was to adapt an existing instrument and validate it into a new Spanish version. The instrument is about the perceptions and knowledge of telemedicine in healthcare professionals. METHODS: The original questionnaire surveyed 6 domains with 40 questions, and each question was measured with a five-point Likert scale ranging from very high [5] to very low [1]. The survey was translated to Spanish using machine translation. The translation was reviewed independently, and then, a consensus was achieved regarding minor changes in the syntax of the survey to facilitate understanding. After expert feedback and questionnaire review, the research team members proposed reducing the instrument to 13 items in 4 domains due to the similarity of some questions. The sample was divided into 2randomly selected groups. Eligibility criteria included physicians providing private or public services with active medical/clinical practice. RESULTS: In total, 382 surveys were collected and separated into two random samples, S1 and S2 (198 and 184, respectively). In exploratory factor analysis (EFA), the 13 items were grouped into four theoretical domains, and item 7 presented cross loading between factors and was removed. Confirmatory factor analysis was performed to assess the scale reliability and interscale associations; three models were tested. Global Cronbach's alpha for internal consistency was 0.76 for the EFA. The goodness of fit measures root mean square error of approximation and comparative fit index were 0.009 and 0.999, respectively, for the best model. CONCLUSIONS: The translated instrument was clear, with adequate internal consistency, readability, and appropriate for application in the physician setting. This validated questionnaire made it possible to evaluate physicians' knowledge of telemedicine to increase its use, especially during the COVID-19 pandemic.


Asunto(s)
COVID-19 , Médicos , Telemedicina , Ecuador , Humanos , Pandemias , Percepción , Psicometría , Reproducibilidad de los Resultados , SARS-CoV-2 , Encuestas y Cuestionarios
2.
PLoS One ; 16(9): e0257661, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34551016

RESUMEN

BACKGROUND: The effects of the COVID 19 pandemic on the mental health of citizens from Asia, Europe, or North America begin to be known, but there are fewer publications on its effects in Latin American countries. In this study, its impact in Ecuador is described, with data collected during the first phase of the pandemic. The objective of this study was to analyse the level of psychological distress in the population of Ecuador during the first phase of the COVID-19 pandemic. METHODS AND FINDINGS: Cross-sectional observational study. The questionnaires were collected through an online self-developed questionnaire, between April 2 and May 17, 2020, using the non-probabilistic sampling methodology: snowball method. The variables considered were sociodemographic variables, physical symptoms, health status, COVID-19 contact history, preventive measures, and the General Health Questionnaire (GHQ-12). The percentage with high psychological distress (PD) (GHQ-12 ≥ 3) has been somewhat lower than that found in Europe, being women, young people, people with higher level of education, living without a partner, not living with children or children under 16 years of age, and with worse perception of health the groups with the highest PD. Differences have been observed with European studies regarding common symptoms, preventive measures to avoid contagion, percentage of infected relatives, or diagnostic tests performed. CONCLUSIONS: The use of the same research instrument, validated in Europe and adapted to Ecuador, has facilitated the comparison of the found results and differences, which can be explained by socio-economic or cultural variables, the health system, level of information, or by preventive measures put in place to prevent the pandemic.


Asunto(s)
COVID-19/epidemiología , COVID-19/psicología , Pandemias/estadística & datos numéricos , Distrés Psicológico , Adolescente , Adulto , Niño , Estudios Transversales , Ecuador/epidemiología , Femenino , Humanos , Masculino , Encuestas y Cuestionarios , Adulto Joven
3.
BMJ Glob Health ; 6(9)2021 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-34583975

RESUMEN

Latin America has struggled to control the transmission of COVID-19. Comparison of excess death (ED) rates during the pandemic reveals that Ecuador is among the highest impacted countries. In this analysis, we update our previous findings with the most complete all-cause mortality records available for 2020, disaggregated by sex, age, ethnicity and geography. Our study shows that in 2020, Ecuador had a 64% ED rate (95% CI 63% to 65%) or 64% more deaths than expected. Men had a higher ED rate, 75% (95% CI 73% to 76%), than women's 51% (95% CI 49% to 52%), and this pattern of higher EDs for men than women held for most age groups. The only exception was the 20-29 age group, where women had 19% more deaths, compared to 10% more deaths for men, but that difference is not statistically significant. The analysis provides striking evidence of the lack of COVID-19 diagnostic testing in Ecuador: the confirmed COVID-19 deaths in 2020 accounted for only 21% of total EDs. Our significant finding is that indigenous populations, who typically account for about 5% of the deaths, show almost four times the ED rate of the majority mestizo group. Indigenous women in each age group have higher ED rates than the general population and, in ages between 20 and 49 years, they have higher ED rates than indigenous men. Indigenous women in the age group 20-29 years had an ED rate of 141%, which is commensurate to the ED rate of indigenous women older than 40 years.


Asunto(s)
COVID-19 , Adulto , Prueba de COVID-19 , Ecuador/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pandemias , SARS-CoV-2 , Adulto Joven
4.
Rev Colomb Psiquiatr (Engl Ed) ; 50(3): 166-175, 2021.
Artículo en Inglés, Español | MEDLINE | ID: mdl-34481796

RESUMEN

INTRODUCTION: Since the emergence of the novel coronavirus disease (COVID-19), the world has faced a pandemic with consequences at all levels. In many countries, the health systems collapsed and healthcare professionals had to be on the front line of this crisis. The adverse effects on the mental health of healthcare professionals have been widely reported. This research focuses on identifying the main factors associated with adverse psychological outcomes. METHODS: Descriptive, cross-sectional study based on surveys, applying the PHQ-9, GAD-7, ISI and EIE-R tests to healthcare professionals from Ecuador during the COVID-19 pandemic. RESULTS: 1028 participants, distributed in: 557 physicians (54.18%), 349 nurses (33.94%), 29 laboratory workers (2.82%), 27 paramedics (2.62%), 52 psychologists (5.05%) and 14 respiratory therapists (1.36%), from 16 of the 24 provinces of Ecuador. Of these, 27.3% presented symptoms of depression, 39.2% anxiety symptoms, 16.3% insomnia and 43.8% symptoms of PTSD, with the 4 types of symptoms ranging from moderate to severe. The most relevant associated factors were: working in Guayas (the most affected province) (OR = 2.18 for depressive symptoms and OR = 2.59 for PTSD symptoms); being a postgraduate doctor (OR = 1.52 for depressive symptoms and OR = 1.57 for insomnia), perception of not having the proper protective equipment (OR = 1.71 for symptoms of depression and OR = 1.57 for symptoms of anxiety) and being a woman (OR = 1.39 for anxiety). CONCLUSIONS: Healthcare professionals can suffer a significant mental condition that may require psychiatric and psychological intervention. The main associated factors are primarily related to living and working in cities with a higher number of cases and the characteristics of the job, such as being a postgraduate doctor, as well as the perception of security. The main risk factors are primarily related to geographical distribution and job characteristics, such as being a resident physician and self-perception of safety. Further studies are required as the pandemic evolves.


Asunto(s)
COVID-19/psicología , Personal de Salud/psicología , Trastornos Mentales/etiología , Enfermedades Profesionales/etiología , Adolescente , Adulto , COVID-19/epidemiología , COVID-19/prevención & control , Estudios Transversales , Ecuador/epidemiología , Femenino , Encuestas Epidemiológicas , Humanos , Modelos Logísticos , Masculino , Trastornos Mentales/diagnóstico , Trastornos Mentales/epidemiología , Persona de Mediana Edad , Enfermedades Profesionales/diagnóstico , Enfermedades Profesionales/epidemiología , Pandemias/prevención & control , Pruebas Psicológicas , Factores de Riesgo , Adulto Joven
5.
Cad Saude Publica ; 37(8): e00164520, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34550179

RESUMEN

The tendency to live alone is a relatively recent phenomenon in Ecuador, but it is expanding rapidly. This study aims to identify factors associated with financial distress/well-being according to living situation (living alone vs. living with a partner) in Ecuadorian health workers. This study examined the construct of financial distress/well-being in a sample of 800 Ecuadorian health workers using cross-sectional data. Living situation was compared using generalized linear model analyses including income, age, children living at home, self-perception of health, depression, anxiety and stress, perceived social support, positive mental health, and hedonistic and austere profiles. Regarding financial well-being, workers living alone ranked lower and workers living with a partner ranked higher. In workers living alone the main sources of financial distress/well-being were income, children living at home, perceived social support, positive mental health, and hedonistic attitude towards indebtedness. In workers living with a partner the main sources of financial distress/well-being were income, age, self-perception of health, depression, anxiety and stress, perceived social support, positive mental health, and austere attitude towards indebtedness. Based on our results, we discuss potential public policy interventions that can be used to improve workers' financial well-being.


Asunto(s)
Ansiedad , Salud Mental , Ansiedad/epidemiología , Brasil , Niño , Estudios Transversales , Ecuador , Humanos
6.
Quito; OPS; 2021-09-29. (OPS/ECU/21-0001).
No convencional en Español | PAHO-IRIS | ID: phr2-54919

RESUMEN

Establecida en 1902 como el organismo independiente especializado en salud del sistema interamericano, la Organización Panamericana de la Salud (OPS) ha desarrollado competencias y experiencia ampliamente reconocidas al brindar cooperación técnica a sus Estados Miembros para combatir las enfermedades transmisibles y no transmisibles y sus causas, fortalecer los sistemas de salud y responder a situaciones de emergencia y desastres en toda la Región de las Américas. Asimismo, en su calidad de oficina regional de la Organización Mundial de la Salud, la OPS participa activamente en los equipos de las Naciones Unidas en los países, colaborando con otros organismos, fondos y programas del sistema de las Naciones Unidas para contribuir al logro de los Objetivos de Desarrollo Sostenible (ODS) a nivel de país. En este informe anual se presenta la cooperación técnica de la OPS a nivel de país en el 2020, mediante la aplicación de la estrategia de cooperación con el país, la respuesta a las necesidades y prioridades nacionales, y el desarrollo de las actividades en el marco de los mandatos regionales y mundiales de la Organización y los ODS. En consonancia con el tema general de "la salud universal y la pandemia: sistemas de salud resilientes", se pone de relieve la respuesta de la OPS a la pandemia de COVID-19, así como sus esfuerzos continuos en esferas prioritarias como las enfermedades transmisibles, las enfermedades no transmisibles, la salud mental, la salud a lo largo del curso de vida y las emergencias de salud. También se presenta un resumen financiero del ejercicio examinado.


Asunto(s)
Cooperación Técnica , Prioridades en Salud , Políticas, Planificación y Administración en Salud , Programas Nacionales de Salud , Enfermedades no Transmisibles , Enfermedades Transmisibles , Cobertura de los Servicios de Salud , Cobertura Universal de Salud , Salud Mental , Factores de Riesgo , Factores Socioeconómicos , Sistemas de Salud , Sistemas de Información en Salud , Administración en Salud Pública , América del Sur , Ecuador
7.
Recurso de Internet en Portugués | LIS - Localizador de Información en Salud | ID: lis-48311

RESUMEN

O Ministério de Saúde Pública (MSP) do Equador realizou um encontro virtual para debater os diversos aspectos envolvidos na proteção, promoção e suporte à amamentação, em celebração à Semana Mundial de Aleitamento Materno. Estavam presentes representantes do MSP, instituições de saúde e da sociedade civil. A Rede Brasileira de Bancos de Leite Humano (rBLH-BR) apresentou sua experiência no enfrentamento da pandemia de Covid-19.


Asunto(s)
Lactancia Materna , COVID-19 , Bancos de Leche , Leche Humana , Ecuador
8.
Molecules ; 26(15)2021 Jul 29.
Artículo en Inglés | MEDLINE | ID: mdl-34361766

RESUMEN

Hedyosmum racemosum (Ruiz & Pav.) G. is a native species of Ecuador used in traditional medicine for treatment of rheumatism, bronchitis, cold, cough, asthma, bone pain, and stomach pain. In this study, fresh H. racemosum leaves of male and female specimens were collected and subjected to hydrodistillation for the extraction of the essential oil. The chemical composition of male and female essential oil was determined by gas chromatography-gas chromatography equipped with a flame ionization detector and coupled to a mass spectrometer using a non-polar and a polar chromatographic column. The antibacterial activity was assayed against five Gram-positive and two Gram-negative bacteria, and two dermatophytes fungi. The scavenging radical properties of the essential oil were evaluated by DPPH and ABTS assays. The chemical analysis allowed us to identify forty-three compounds that represent more than 98% of the total composition. In the non-polar and polar column, α-phellandrene was the principal constituent in male (28.24 and 25.90%) and female (26.47 and 23.90%) essential oil. Other main compounds were methyl chavicol, germacrene D, methyl eugenol, and α-pinene. Female essential oil presented a strong activity against Klebsiella pneumoniae (ATCC 9997) with an minimum inhibitory concentration (MIC) of 500 µg/mL and a scavenging capacity SC50 of 800 µg/mL.


Asunto(s)
Antibacterianos/química , Antioxidantes/química , Monoterpenos Ciclohexánicos/química , Magnoliopsida/química , Aceites Volátiles/química , Derivados de Alilbenceno/química , Derivados de Alilbenceno/aislamiento & purificación , Anisoles/química , Anisoles/aislamiento & purificación , Antibacterianos/aislamiento & purificación , Antibacterianos/farmacología , Antioxidantes/aislamiento & purificación , Antioxidantes/farmacología , Arthrodermataceae/efectos de los fármacos , Arthrodermataceae/crecimiento & desarrollo , Benzotiazoles/antagonistas & inhibidores , Monoterpenos Bicíclicos/química , Monoterpenos Bicíclicos/aislamiento & purificación , Compuestos de Bifenilo/antagonistas & inhibidores , Monoterpenos Ciclohexánicos/aislamiento & purificación , Ecuador , Eugenol/análogos & derivados , Eugenol/química , Eugenol/aislamiento & purificación , Femenino , Bacterias Gramnegativas/efectos de los fármacos , Bacterias Gramnegativas/crecimiento & desarrollo , Bacterias Grampositivas/efectos de los fármacos , Bacterias Grampositivas/crecimiento & desarrollo , Humanos , Magnoliopsida/metabolismo , Masculino , Pruebas de Sensibilidad Microbiana , Picratos/antagonistas & inhibidores , Hojas de la Planta/química , Plantas Medicinales , Sesquiterpenos de Germacrano/química , Sesquiterpenos de Germacrano/aislamiento & purificación , Factores Sexuales , Ácidos Sulfónicos/antagonistas & inhibidores
9.
Cir Cir ; 89(4): 476-483, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34352874

RESUMEN

Antecedentes: En una cesárea se puede emplear analgesia epidural con bupivacaína 0.125% and lidocaína 1.5% ó bupivacaína 0.25% and lidocaína 1.0%. Una concentración mayor de bupivacaína alcanza mayor analgesia con más eventos adversos. OBJETIVO: evaluar la analgesia y seguridad de bupivacaína 0.125% and lidocaína 1.5% ó bupivacaína 0.25% and lidocaína 1.0%. MATERIALES Y MÉTODOS: Cohorte prospectivo estratificado según ambas concentraciones de bupivacaína. RESULTADOS: Se recuperó cien gestantes a término (cincuenta por cohorte). A los 20 y 30 minutos tras la administración epidural hubo más casos con mayor bloqueo motor en quienes se empleó bupivacaína 0.125% and lidocaína 1.5% (p = 0.0229 y p = 0.0006, respectivamente). No hubo diferencia significativa respecto al bloqueo sensitivo. Bupivacaína 0.25% and lidocaína 1.5% mostró una tencencia a la hipotensión (p < 0.001) y a la bradicardia (p = 0.4100). De la cohorte de bupivacaína 0.125% and lidocaína 1.5%, 25 casos (50%) presentaron cuando menos un evento adverso, en contraste con 44/50 (88%) de la cohorte de bupivacaína 0.25% and lidocaína 1.0% (p < 0.001). CONCLUSIÓN: En la analgesia epidural durante cesárea, bupivacaína 0.125% and lidocaína 1.5% está asociado con un efecto analgésico similar a bupivacaína 0.25% and lidocaína 1.0%. Sin embargo, mayores concentraciones están significativamente relacionadas con mayor tasa de eventos adversos (especialmente hipotensión). BACKGROUND: In a cesarean section, epidural analgesia with 0.125% bupivacaine and 1.5% lidocaine or 0.25% bupivacaine with 1.0% lidocaine concentrations can be used. A higher concentration of bupivacaine reaches better analgesia but with a higher rate of drug-related adverse events. AIM: The aim of the study was to assess analgesia and safety of 0.125% bupivacaine and 1.5% lidocaine or 0.25% bupivacaine with 1.0% lidocaine during cesarean. MATERIALS AND METHODS: Prospective cohort stratified following both bupivacaine concentrations. RESULTS: One hundred women with full-term pregnancies were selected (fifty per cohort). At 20 and 30 min after epidural administration, there was a higher proportion of motor blockade cases from the 0.125% bupivacaine and 1.5% lidocaine cohort (p = 0.0229 and p = 0.0006, respectively). There was no significant difference among sensitive blockage. A 0.25% bupivacaine and 1.0% lidocaine concentration showed a tendency to hypotension (p < 0.001) and bradycardia (p = 0.4100). From 0.125% bupivacaine and 1.5% lidocaine cohort, 25 cases (50%) presented at least one adverse event; in contrast with 44/50 (88%) from 0.25% bupivacaine and 1.0% lidocaine cohort (p < 0.001). CONCLUSION: In epidural analgesia during cesarean, using 0.125% bupivacaine and 1.5% lidocaine presented similar analgesia than 0.25% bupivacaine and 1.0% lidocaine. However, a higher bupivacaine concentration is significantly related to more frequent drug-related adverse events (especially hypotension).


Asunto(s)
Anestesia Epidural , Cesárea , Bupivacaína , Ecuador , Femenino , Humanos , Embarazo , Estudios Prospectivos
10.
Environ Pollut ; 289: 117955, 2021 Nov 15.
Artículo en Inglés | MEDLINE | ID: mdl-34435567

RESUMEN

Mangroves are unique coastal ecosystems, located in tropical and subtropical regions. Yet, the functioning of these essential ecosystems is threatened by the presence of pollutants, including pesticides originating from agricultural activities. We investigated pesticide residues in the Guayas estuarine environment, since agricultural activities rapidly increased in the Guayas river basin over the past decades. A multi-residue analysis involving a selection of 88 pesticides was performed on the white meat and the hepatopancreas of the red mangrove crab (Ucides Occidentalis) at 15 sampling sites within the Guayas estuary along with water, sediment, and leaves samples. We found that 35 active compounds were present in the Guayas estuary, of which pyrimethanil was most commonly detected and had the highest concentrations in almost all compartments. Also, cadusafos was present in all studied compartments of the Guayas mangrove system and several prohibited pesticides (including carbendazim, carbofuran, and parathion) were detected. An ecotoxicological and probabilistic consumer risk assessment pointed out that current butachlor, carbendazim, and fludioxonil concentrations can cause adverse effects in aquatic organisms in the long term. Moreover, high potential acute and chronic risks of cadusafos residues on aquatic invertebrates and of diuron on algae in the Guayas wetlands were observed. Still, the exposure results indicated that the health risk for the consumers of the commercial red mangrove crab is low concerning cadusafos, chlorpyrifos, diuron, linuron, and pyrimethanil residues in crab tissues. The findings presented in this research can provide a useful basis for local water managers and environmental conservation groups to act and reduce the usage of pesticides, to avoid threatening aquatic and human health.


Asunto(s)
Braquiuros , Plaguicidas , Contaminantes Químicos del Agua , Animales , Ecosistema , Ecuador , Monitoreo del Ambiente , Estuarios , Humanos , Plaguicidas/análisis , Medición de Riesgo , Ríos , Contaminantes Químicos del Agua/análisis
11.
Nutrients ; 13(8)2021 Jul 30.
Artículo en Inglés | MEDLINE | ID: mdl-34444800

RESUMEN

Low-grade systemic inflammation is implicated in metabolic syndrome (MetS) and cardiometabolic diseases. Diet is hypothesized to be an important low-grade inflammation modifier. However, few studies have examined the association of dietary inflammation with MetS and cardiometabolic risk in Latin American populations and their findings are inconsistent. Our cross-sectional study examined the association of dietary inflammatory potential with MetS and cardiometabolic risk components in 276 urban Ecuadorian women. Dietary inflammation was evaluated using an energy-adjusted Dietary Inflammatory Index (E-DII), divided into quartiles (Q). E-DII scores ranged from -4.89 (most anti-inflammatory) to 4.45 (most pro-inflammatory). Participants in the most pro-inflammatory (Q4) compared to the least inflammatory E-DII quartile (Q1) had a 4.4 increased adjusted odds for MetS (95% C.I. = 2.0, 9.63; p < 0.001). Every one-unit increase in E-DII was associated with a 1.4 increase in MetS (95% CI = 1.22, 1.52; p < 0.001). In other adjusted models, the most pro-inflammatory E-DII quartile (Q4) was positively associated with total blood cholesterol and triglycerides (p < 0.001), LDL-c (p = 0.007), diastolic blood pressure (p< 0.002), mean arterial pressure (p < 0.006), waist circumference (p < 0.008), and Framingham risk score (p < 0.001). However, the previously identified associations with pulse wave velocity and BMI were no longer evident in the models. These findings suggest that more pro-inflammatory diets may contribute to poorer cardiometabolic health. Promoting healthier diets with a lower inflammatory potential may help to prevent or slow development of cardiometabolic disorders.


Asunto(s)
Factores de Riesgo Cardiometabólico , Enfermedades Cardiovasculares , Dieta , Adulto , Presión Sanguínea , Estudios Transversales , Dieta Saludable , Ingestión de Alimentos , Ecuador , Femenino , Humanos , Renta , Inflamación , Síndrome Metabólico , Factores de Riesgo , Encuestas y Cuestionarios , Circunferencia de la Cintura
12.
Health Qual Life Outcomes ; 19(1): 189, 2021 Jul 31.
Artículo en Inglés | MEDLINE | ID: mdl-34332613

RESUMEN

INTRODUCTION: The Diabetes Health Profile (DHP-18), structured in three dimensions (psychological distress (PD), barriers to activity (BA) and disinhibited eating (DE)), assesses the psychological and behavioural burden of living with type 2 diabetes. The objectives were to adapt the DHP-18 linguistically and culturally for use with patients with type 2 DM in Ecuador, and to evaluate its psychometric properties. METHODS: Participants were recruited using purposive sampling through patient clubs at primary health centres in Quito, Ecuador. The DHP-18 validation consisted in the linguistic validation made by two Ecuadorian doctors and eight patient interviews. And in the psychometric validation, where participants provided clinical and sociodemographic data and responded to the SF-12v2 health survey and the linguistically and culturally adapted version of the DHP-18. The original measurement model was evaluated with confirmatory factor analysis (CFA). Reliability was assessed through internal consistency using Cronbach's alpha and test-retest reproducibility by administering DHP-18 in a random subgroup of the participants two weeks after (n = 75) using intraclass correlation coefficient (ICC). Convergent validity was assessed by establishing previous hypotheses of the expected correlations with the SF12v2 using Spearman's coefficient. RESULTS: Firstly, the DHP-18 was linguistically and culturally adapted. Secondly, in the psychometric validation, we included 146 participants, 58.2% female, the mean age was 56.8 and 31% had diabetes complications. The CFA indicated a good fit to the original three factor model (χ2 (132) = 162.738, p < 0.001; CFI = 0.990; TLI = 0.989; SRMR = 0.086 and RMSEA = 0.040. The BA dimension showed the lowest standardized factorial loads (λ) (ranging from 0.21 to 0.77), while λ ranged from 0.57 to 0.89 and from 0.46 to 0.73, for the PD and DE dimensions respectively. Cronbach's alphas were 0.81, 0.63 and 0.74 and ICCs 0.70, 0.57 and 0.62 for PD, BA and DE, respectively. Regarding convergent validity, we observed weaker correlations than expected between DHP-18 dimensions and SF-12v2 dimensions (r > -0.40 in two of three hypotheses). CONCLUSIONS: The original three factor model showed good fit to the data. Although reliability parameters were adequate for PD and DE dimensions, the BA presented lower internal consistency and future analysis should verify the applicability and cultural equivalence of some of the items of this dimension to Ecuador.


Asunto(s)
Diabetes Mellitus Tipo 2/diagnóstico , Calidad de Vida/psicología , Encuestas y Cuestionarios/normas , Estudios Transversales , Diabetes Mellitus Tipo 2/psicología , Diabetes Mellitus Tipo 2/terapia , Ecuador , Femenino , Humanos , Hipoglucemiantes/uso terapéutico , Masculino , Psicometría , Reproducibilidad de los Resultados
13.
J Environ Qual ; 50(5): 1233-1245, 2021 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-34350988

RESUMEN

The behavior of trace metals may vary strongly in the course of volcanic soil development. Cadmium retention in soils is specifically important for some Galápagos islands where agriculture is leading to anthropogenic Cd contamination. To assess the influence of soil development factors on soil Cd retention and toxicity, we performed Cd sorption-desorption experiments with volcanic topsoils from the Galápagos Islands sampled along gradients of (a) substrate age (chronosequence, 1.5-1,070 ka) and (b) climate (elevation sequence, 47-866 m asl) ranging from arid lowland areas to humid highland areas. Additionally, the effects of Cd toxicity on the soil microbial community composition were evaluated for two soils of the chronosequence. In young volcanic soils, the sorption capacity was very high but decreased rapidly with soil age and increasing elevation. These trends were coupled with decreases in soil weathering indicators (e.g., electrical conductivity, pH, and effective cation exchange capacity) as well as changes in soil mineralogy. Cadmium addition did not influence total phospholipid fatty acids and basal respiration in most soils. However, with increasing Cd concentration, a pronounced reduction in the Gram-negative/Gram-positive bacteria ratio (from 0.32 to 0.12) occurred in an old, highly weathered soil with low Cd retention capacity. Our results show that up to 60% of added Cd was only weakly sorbed in old volcanic soils. As a consequence, the old volcanic soils of Galápagos bear the potential risk that the mobile Cd fraction is taken up by soil microorganisms, transferring this element into the food chain.


Asunto(s)
Contaminantes del Suelo , Suelo , Cadmio/análisis , Clima , Ecuador , Contaminantes del Suelo/análisis
14.
Artículo en Inglés | MEDLINE | ID: mdl-34444455

RESUMEN

Adherence to preventive measures is influenced by people's knowledge, attitudes and practices towards a disease; therefore, assessing knowledge of COVID-19 is critical in the overall effort to contain the outbreak. This cross-sectional study was conducted among undergraduates (n = 3621) of different programs and different levels of education associated with universities in north-central Ecuador. The form consisted of 32 questions covering demographics, symptoms, detection, treatment, transmission, prevention and knowledge of the virus. The rate of correct answers was 75.5% (21.1 ± 5 out of 28), with differences observed regarding program of study, educational level and location of institution (α = 0.05), although effect size analyses showed that these differences could not be considered large. Multiple linear regression analyses showed that lower scores were associated with initial stages of education, careers related to social sciences and location of institution. Participants possessed sufficient knowledge about detection, transmission and prevention, although they overestimated fatality rate and were less confident about the characteristics of the virus and the effectiveness of traditional medicine. Consequently, future educational programs must place emphasis on addressing deficient knowledge. Certainly, improving COVID-19 literacy will promote the appropriate application of protective measures aimed at preventing the virus' spread.


Asunto(s)
COVID-19 , Estudios Transversales , Ecuador/epidemiología , Conocimientos, Actitudes y Práctica en Salud , Humanos , SARS-CoV-2 , Estudiantes , Encuestas y Cuestionarios
16.
Am J Trop Med Hyg ; 105(3): 600-610, 2021 07 19.
Artículo en Inglés | MEDLINE | ID: mdl-34280150

RESUMEN

Extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL), a family of bacteria that includes Escherichia coli, have emerged as a global health threat. This study examined risks associated with carriage of third-generation cephalosporin-resistant (3GC-R) E. coli, including ESBL-producing, multidrug-resistant, and extensively drug-resistant (XDR) strains in children living in semirural parishes of Quito, Ecuador. We conducted a longitudinal study with two cycles of sampling (N = 374, N = 366) that included an analysis of child fecal samples and survey questions relating to water, sanitation, and hygiene, socioeconomic status, household crowding, and animal ownership. We used multivariate regression models to assess risk factors associated with a child being colonized. Across the two cycles, 18.4% (n = 516) of the 3GC-R isolates were ESBL-producing E. coli, and 40.3% (n = 516) were XDR E. coli. Children living in households that owned between 11 and 20 backyard animals had an increased odds of being colonized with XDR E. coli (odds ratio [OR] = 1.94, 95% confidence interval [CI]: 1.05-3.60) compared with those with no animals. Households that reported smelling odors from commercial poultry had increased odds of having a child positive for XDR E. coli (OR = 1.72, 95% CI: 1.11-2.66). Our results suggest that colonization of children with antimicrobial-resistant E. coli is influenced by exposure to backyard and commercial livestock and poultry. Future studies should consider community-level risk factors because child exposures to drug-resistant bacteria are likely influenced by neighborhood and regional risk factors.


Asunto(s)
Infecciones Comunitarias Adquiridas/epidemiología , Farmacorresistencia Bacteriana , Infecciones por Escherichia coli/epidemiología , Agricultura , Animales , Preescolar , Infecciones Comunitarias Adquiridas/microbiología , Agua Potable , Farmacorresistencia Bacteriana Múltiple , Ecuador/epidemiología , Escolaridad , Exposición a Riesgos Ambientales , Escherichia coli , Infecciones por Escherichia coli/microbiología , Composición Familiar , Femenino , Humanos , Lactante , Ganado , Masculino , Pruebas de Sensibilidad Microbiana , Determinantes Sociales de la Salud , Cuartos de Baño
17.
Int J Equity Health ; 20(1): 169, 2021 07 22.
Artículo en Inglés | MEDLINE | ID: mdl-34294109

RESUMEN

BACKGROUND: In 2008, Ecuador started a national health reform based on the principles of Alma Ata to achieve Universal Health Coverage. While coverage indicators have increased, a systematic assessment of the impact of the reform on the delivery of health services at primary level is lacking. The aim of this study was to assess the impact of the 2008 health reform on the performance of primary health care services in Ecuador. METHODS: Ambulatory Care Sensitive Conditions (ACSC) are a subset of diseases where hospital admission is potentially avoidable by high quality well-functioning primary care. Thus, observing the behaviour of ACSC hospitalizations can serve as an indicator of how the primary health care level is performing. Crude and adjusted rates, stratified by sex, were calculated from ten selected ACSC hospitalization discharges during 22 years of data representing 11 years before and after the health reform. An interrupted time series analysis was then conducted by applying a negative binomial regression and adjusting for overdispersion and autocorrelation. RESULTS: Overall higher crude and adjusted rates for ACSC hospitalizations were observed in women compared to men; both increased gradually since the start of the observation, reaching a peak around 2010, and then started a downwards trend. In men, the incidence rate ratio increased significantly by 3 % per year during the period before the intervention. During the first year after intervention, an increase (13 %) was detected, and then a statistically significant 1 % decrease (IRR = 0.99; 95 % CI: 0.98, 0.99) was observed in the ACSC rate ratio per year in the period after the intervention. Similar trends and effect sizes were found for women. CONCLUSIONS: The study revealed significant decreasing trends of the ACSC hospitalization rates in both sexes, indicating an improvement of the performance of the primary health care services following the 2008 national health reform. A continuous strengthening of the primary care model as well as a regular monitoring of ACSC hospitalization rates in the country is recommended. A health economic evaluation considering hospitalizations avoided and associated costs is also advisable.


Asunto(s)
Atención Ambulatoria , Reforma de la Atención de Salud , Hospitalización , Atención Primaria de Salud , Atención Ambulatoria/estadística & datos numéricos , Ecuador , Femenino , Investigación sobre Servicios de Salud , Hospitalización/estadística & datos numéricos , Humanos , Análisis de Series de Tiempo Interrumpido , Masculino , Atención Primaria de Salud/organización & administración
18.
Artículo en Inglés | MEDLINE | ID: mdl-34281059

RESUMEN

This study aimed to adapt and show evidence of validity for the Ecuadorian version of the Burnout Assessment Tool (BAT) considering only its "core" dimensions. The adaptation process included its translation and back translation. For content validation, expert reviews and focus groups were carried out. A confirmatory factor analysis was used to identify the psychometric properties and dimensionality of the scale. The reliability of the scale was assessed through the alpha, omega and composite reliability indices. To carry out the study, the questionnaire was applied to a sample of workers with a high level of education in Ecuador. In total, 2237 respondents were considered in the analysis. The results showed that the hierarchical model for BAT-23 and its short version, the BAT-12 scale, is the most adequate structure for analysis of the construct in the Ecuadorian context. The reliability of the general factor of burnout and its dimensions, evaluated by composite reliability, omega and Cronbach's alpha, showed satisfactory indices. The findings obtained provide support for the reliability and validity of the Burnout Assessment Tool for the Ecuadorian context.


Asunto(s)
Agotamiento Psicológico , Traducciones , Ecuador , Humanos , Psicometría , Reproducibilidad de los Resultados , Encuestas y Cuestionarios
19.
J Fish Biol ; 99(4): 1158-1189, 2021 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-34235726

RESUMEN

Freshwater fish communities in Ecuador exhibit some of the highest levels of diversity and endemism in the Neotropics. Unfortunately, aquatic ecosystems in the country are under serious threat and conditions are deteriorating. In 2018-19, the government of Ecuador sponsored a series of workshops to examine the conservation status of Ecuador's freshwater fishes. Concerns were identified for 35 species, most of which are native to the Amazon region, and overfishing of Amazonian pimelodid catfishes emerged as a major issue. However, much of the information needed to make decisions across fish groups and regions was not available, hindering the process and highlighting the need for a review of the conservation threats to Ecuador's freshwater fishes. Here, we review how the physical alteration of rivers, deforestation, wetland and floodplain degradation, agricultural and urban water pollution, mining, oil extraction, dams, overfishing, introduced species and climate change are affecting freshwater fishes in Ecuador. Although many of these factors affect fishes throughout the Neotropics, the lack of data on Ecuadorian fish communities is staggering and highlights the urgent need for more research. We also make recommendations, including the need for proper enforcement of existing environmental laws, restoration of degraded aquatic ecosystems, establishment of a national monitoring system for freshwater ecosystems, investment in research to fill gaps in knowledge, and encouragement of public engagement in citizen science and conservation efforts. Freshwater fishes are an important component of the cultural and biological legacy of the Ecuadorian people. Conserving them for future generations is critical.


Asunto(s)
Conservación de los Recursos Naturales , Ecosistema , Animales , Biodiversidad , Ecuador , Explotaciones Pesqueras , Peces , Agua Dulce
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA
...