Motivación en 3 escuelas de medicina de Ecuador / Motivation in three Medical Schools in Ecuador

INTRODUCCIÓN: La motivación como elemento en el proceso formal de planificación, desarrollo o evaluación, no es considerada formalmente, a pesar de que hay evidencia de su papel en el proceso enseñanza-aprendizaje. El presente estudio busca describir los perfiles motivacionales de estudiantes de la carrera de medicina en 3 universidades de Ecuador. MATERIAL Y MÉTODOS: Se realizó un análisis transversal de los perfiles motivacionales de los estudiantes de 3 facultades de medicina de Ecuador. La motivación se identificó a través de la Escala de motivación educativa validada en español a través de un formulario en línea autosuministrado, utilizando la herramienta Formularios de Google®. RESULTADOS: Previo una prueba piloto que evaluaba la claridad de la herramienta virtual, se enviaron entre las 3 universidades un total de 538 invitaciones, obteniéndose 124 respuestas (tasa de respuesta de 23,04%). De las variables evaluadas se encontraron asociaciones entre tener motivación extrínseca y el nivel de instrucción, el tener hijos, así como la asociación en el deseo de intentar nuevamente ingresar en la carrera de medicina y motivación intrínseca. Se encontró además una asociación entre más horas de estudio reportadas y estados de motivación intrínseca. CONCLUSIÓN: Es conveniente profundizar el estudio de la motivación estudiantil universitaria, tanto en su descripción como en posibles intervenciones incluidas dentro de las actividades curriculares formales. La asociación entre horas de estudio y motivación intrínseca sugiere la inclusión de actividades formales de fomento de la motivación para obtener mayor adherencia a los programas académicos

INTRODUCTION: Motivation has an obvious role in the teaching-learning process, which unfortunately has not been considered formally in planning, developing, or evaluation processes. The aim of the present study is to describe motivational profiles of medical students in three universities of Ecuador. MATERIAL AND METHODS: A cross-sectional analytical study was performed on the motivational profiles of medical students in three Medical Schools of Ecuador. Motivation was assessed using Academic Motivation Scale validated in Spanish and applied using Google Forms®. RESULTS: A pilot test was performed first to evaluate clarity of the virtual tool used. After which, a total of 538 invitations were sent to the three universities. There were 124 responses (response rate of 23.04%). During the analysis, an association was found between extrinsic motivation, instructional level, and having children. Intrinsic motivation was associated with trying to enter to the university and number of hours dedicated to study. CONCLUSION: More detailed studies need to be conducted on motivation in university students, both on descriptions and interventions in curricula. The association between hours dedicated to study and intrinsic motivation suggests the reinforcement of motivation activities to obtain adherence to academic programs

The burden of acute respiratory infections in Ecuador 2011-2015.

BACKGROUND: Burden of disease studies intend to improve public health decision-making and to measure social and economic impact in population. The objective of this study was to describe the burden of acute respiratory infections (ARI) in Ecuador between 2011 and 2015. METHODS: Five-year period morbidity and mortality data available from national agencies of statistics was analyzed to estimate the burden of disease attributable to acute respiratory infections. Cases and deaths registered were grouped according to their ICD-10 code into three diagnostic groups: Acute upper respiratory infections (J00-J06), Influenza and pneumonia (J09-J18), and Bronchitis and other acute lower respiratory infections (J20-J22, J85, J86). Disability-adjusted life years stratified by diagnostic and age group were calculated using the "DALY" package for R. The productivity loss in monetary terms was estimated using the human capital method. RESULTS: Over the 5-year period studied there were a total of 14.84 million cases of acute respiratory infections, with 17 757 deaths reported (0.12%). The yearly burden of disease ranged between 98 944 to 118 651 disability-adjusted life years, with an estimated average loss of productivity of US$152.16 million (±19.6) per year. Approximately 99% of the burden can be attributed to years life lost due to premature mortality in population under 5 years old and over 60 years-old. CONCLUSIONS: The burden of acute respiratory infections remained steady during the analyzed period. Evidence-based prevention and control policies to tackle acute respiratory infections in Ecuador should focus on the population at extreme ages of life.

Descripción de la experiencia de endoscopia digestiva alta en el Centro de Medicina Familiar Vozandes Carapungo / Description of the experience in upper digestive endoscopy at the Medical Family Center Vozandes-Carapungo

La realización de procedimientos en centros de atención primaria juegan un rol importante en la resolución de problemas de salud especialmente en comunidades de bajos ingresos. Objetivo Describir los resultados de endoscopias digestivas altas y bajas realizadas en el Centro de Medicina Familiar Vozandes Carapungo. Diseño Estudio transversal de prevalencia. Mediciones principales Revisión de registros clínicos y reportes histopatológicos de las endoscopías digestivas realizadas entre enero de 2010 a agosto de 2015. Resultados Se estudiaron 1035 pacientes (edad media 44.3 ± 17.1 años; 33.8% hombres y 66.2% mujeres). Los motivos de consulta principales fueron dolor epigástrico (78.5%), dolor abdominal difuso (6.1%) y dispepsia (5.3%). Indicaciones adecuadas para el procedimiento endoscópico se encontraron en 90.4% pacientes, pero no hubo criterios reportados para endoscopia en 80% de los pacientes con dispepsia. Los hallazgos endoscópicos más frecuentes fueron gastropatía (85.2%), esofagitis (6.1%) y hernia hiatal (5.2%). De 1021 reportes histológicos, 95.6% fueron positivos para algún grado de gastritis y 0.5% presentaron malignidad. 78.9% de los reportes fueron positivos para Helicobacter pylori. Finalmente, la tasa de complicaciones durante el período observado fue de 0.48%. Conclusiones A fn de optimizar las indicaciones para realizar las endoscopias se necesita establecer un consenso preciso defnido previamente. La tasa de complicaciones es comparable con otros estándares, pero la selección de pacientes debe ser revisada. Finalmente recomendamos estandarizar los reportes histopatológicos y las descripciones macroscópicas

Procedures performed in primary care settings play an important role in solving healthcare needs especially in low income communities. Objective To describe the results of upper digestive endoscopy performed at Centro de Medicina Familiar Vozandes Carapungo. Design Cross sectional study. Main measurements Clinical data and histopathological reports from endoscopies performed between January 2010 to August 2015. Results 1035 patients (33.8% male, 66.2% female; 44.3 ± 17.2 years old) were studied. Main consult complains were epigastric pain (78.5%), diffuse abdominal pain (6.1%) and dyspepsia (5.3%). Appropriate indications for the procedure were found in 90.41% of the individuals, but there was not reported criteria for endoscopy in 80% of patients with dyspepsia. The most frequent endoscopic fndings include gastropathy (85.2%), esophagitis (6.1%) and hiatus herniation (5.2%). Out of 1021 histopathological reports, 95.6% were positive for gastritis (diverse grade) and 0.5% for malignancy. 78.9% were Helicobacter Pylori positive. Finally, complications rate was 0.48% in all period of time observed. Conclusion In order to optimize endoscopic procedures indications, it is needed to establish precise consensus previously defned. Complications rate is comparable with other standards, but the selection of patients to perform the procedure should be revised. Finally, we recommend to standardize histopathological and macroscopic reports

Sentinel surveillance of influenza-like-illness in two cities of the tropical country of Ecuador: 2006-2010.

BACKGROUND: Tropical countries are thought to play an important role in the global behavior of respiratory infections such as influenza. The tropical country of Ecuador has almost no documentation of the causes of acute respiratory infections. The objectives of this study were to identify the viral agents associated with influenza like illness (ILI) in Ecuador, describe what strains of influenza were circulating in the region along with their epidemiologic characteristics, and perform molecular characterization of those strains. METHODOLOGY/FINDINGS: This is a prospective surveillance study of the causes of ILI based on viral culture of oropharyngeal specimens and case report forms obtained in hospitals from two cities of Ecuador over 4 years. Out of 1,702 cases of ILI, nine viral agents were detected in 597 patients. During the time of the study, seven genetic variants of influenza circulated in Ecuador, causing six periods of increased activity. There appeared to be more heterogeneity in the cause of ILI in the tropical city of Guayaquil when compared with the Andean city of Quito. CONCLUSIONS/SIGNIFICANCE: This was the most extensive documentation of the viral causes of ILI in Ecuador to date. Influenza was a common cause of ILI in Ecuador, causing more than one outbreak per year. There was no well defined influenza season although there were periods of time when no influenza was detected alternating with epidemics of different variant strains.