Perception about vaccines and level of knowledge, attitudes and practices towards COVID-19 in older adults in Lima, Peru. / Percepción sobre las vacunas y nivel de conocimientos, actitudes y prácticas hacia la COVID-19 en adultos mayores de Lima, Perú.

This study aimed to describe the perception about vaccines and the level of knowledge, attitudes and practices towards COVID-19 in older adults from a hospital in Lima, Peru. Descriptive and cross-sectional study carried out from March to November 2021. An instrument was adapted and validated to measure the level of knowledge, attitudes and practices; the perception about vaccines was evaluated with an exploratory questionnaire. Eighty-three older adults were surveyed, the mean age was 74.0 years and 62.7% were women. Most of the participants knew the cause and symptoms, and 50.6% believed that it could be transmitted by contaminated food. Additionally, 61.7% used traditional medicine to prevent it, and 65.4% considered that the level of social awareness was insufficient; 91.5% were vaccinated against COVID-19, and 65.4% considered these vaccines to be safe. In conclusion, most older adults showed a high level of knowledge, attitudes and practices and a positive perception about the vaccine against COVID-19.

El objetivo fue describir la percepción sobre las vacunas y el nivel de conocimientos, actitudes y prácticas hacia la COVID-19 en adultos mayores que acuden a un hospital en Lima, Perú. Estudio descriptivo y transversal de marzo a noviembre del 2021. Se adaptó y validó un instrumento para medir el nivel de conocimientos, actitudes y prácticas, y se evaluó la percepción sobre vacunas con un cuestionario exploratorio. Se encuestaron a 83 adultos mayores, la media de edad fue 74,0 años y el 62,7% fueron mujeres. La mayoría conoce la causa y síntomas, y el 50,6% cree que puede transmitirse por alimentos contaminados. El 61,7% usa medicina tradicional para prevenirla, y el 65,4% considera insuficiente el nivel de conciencia social. El 91,5% se vacunó contra la COVID-19, y el 65,4% considera que estas vacunas son seguras. En conclusión, la mayoría de los adultos mayores presenta un alto nivel de conocimientos, actitudes y prácticas y una percepción positiva sobre la vacuna contra la COVID-19.

Identification of Probable sarcopenia based on SARC-F and SARC-CalF in older adults from a low-resource setting.

Objectives: We aimed to investigate the frequency of probable sarcopenia and to compare the performance of SARC-F and SARC-CalF for detecting this condition in outpatient older adults from a low-resource setting. Methods: We conducted a retrospective, cross-sectional study in outpatient older adults aged ≥60 years attending a hospital in Peru, between August 2019 and February 2020. Probable sarcopenia was defined as low handgrip strength (<27 kg in men and <16 in women). We used SARC-F and SARC-CalF with their standard cut-off points (≥4 and ≥11, respectively). Low calf circumference was defined as ≤33 cm in women and ≤34 cm in men. We performed sensitivity and specificity analyses. Results: We included 206 older adults, 102 (49.5%) aged ≥75 years old and 140 (67.9%) females. Probable sarcopenia was present in 36.40% of the participants. SARC-F ≥4 was observed in 29.61% and SARC-CalF ≥11 in 41.26% of the population. SARC-F≥4 showed 41.33% sensitivity and 77.10% specificity, whereas SARC-Calf ≥11 had 50.67% sensitivity and 64.12% specificity. Conclusion: We found that one out of three of the population had probable sarcopenia. SARC-Calf showed superior but still low sensitivity than SARC-F, while both had moderate specificity and thus may be useful for ruling out the disease in clinical practice.

Percepción sobre las vacunas y nivel de conocimientos, actitudes y prácticas hacia la COVID-19 en adultos mayores de Lima, Perú / Perception about vaccines and level of knowledge, attitudes and practices towards COVID-19 in older adults in Lima, Peru

RESUMEN El objetivo fue describir la percepción sobre las vacunas y el nivel de conocimientos, actitudes y prácticas hacia la COVID-19 en adultos mayores que acuden a un hospital en Lima, Perú. Estudio descriptivo y transversal de marzo a noviembre del 2021. Se adaptó y validó un instrumento para medir el nivel de conocimientos, actitudes y prácticas, y se evaluó la percepción sobre vacunas con un cuestionario exploratorio. Se encuestaron a 83 adultos mayores, la media de edad fue 74,0 años y el 62,7% fueron mujeres. La mayoría conoce la causa y síntomas, y el 50,6% cree que puede transmitirse por alimentos contaminados. El 61,7% usa medicina tradicional para prevenirla, y el 65,4% considera insuficiente el nivel de conciencia social. El 91,5% se vacunó contra la COVID-19, y el 65,4% considera que estas vacunas son seguras. En conclusión, la mayoría de los adultos mayores presenta un alto nivel de conocimientos, actitudes y prácticas y una percepción positiva sobre la vacuna contra la COVID-19.

ABSTRACT This study aimed to describe the perception about vaccines and the level of knowledge, attitudes and practices towards COVID-19 in older adults from a hospital in Lima, Peru. Descriptive and cross-sectional study carried out from March to November 2021. An instrument was adapted and validated to measure the level of knowledge, attitudes and practices; the perception about vaccines was evaluated with an exploratory questionnaire. Eighty-three older adults were surveyed, the mean age was 74.0 years and 62.7% were women. Most of the participants knew the cause and symptoms, and 50.6% believed that it could be transmitted by contaminated food. Additionally, 61.7% used traditional medicine to prevent it, and 65.4% considered that the level of social awareness was insufficient; 91.5% were vaccinated against COVID-19, and 65.4% considered these vaccines to be safe. In conclusion, most older adults showed a high level of knowledge, attitudes and practices and a positive perception about the vaccine against COVID-19.

Cancer screening risk literacy of physicians in training: An experimental study.

We investigated what factors may foster or hinder physicians' cancer screening risk literacy-specifically the ability to understand evidence regarding screening effectiveness and make evidence-based recommendations to patients. In an experiment, physicians in training (interns and residents) read statistical information about outcomes from screening for cancer, and had to decide whether to recommend it to a patient. We manipulated the effectiveness of the screening (effective vs. ineffective at reducing mortality) and the demand of the patient to get screened (demand vs. no demand). We assessed participants' comprehension of the presented evidence and recommendation to the patient, as well as a-priori screening beliefs (e.g., that screening is always a good choice), numeracy, science literacy, knowledge of screening statistics, statistical education, and demographics. Stronger positive a-priori screening beliefs, lower knowledge of screening statistics, and lower numeracy were related to worse comprehension of the evidence. Physicians recommended against the ineffective screening but only if they showed good comprehension of the evidence. Physicians' recommendations were further based on the perceived benefits from screening but not on perceived harms, nor the patient's demands. The current study demonstrates that comprehension of cancer screening statistics and the ability to infer the potential benefits for patients are essential for evidence-based recommendations. However, strong beliefs in favor of screening fostered by promotion campaigns may influence how physicians evaluate evidence about specific screenings. Fostering physician numeracy skills could help counteract such biases and provide evidence-based recommendations to patients.

Graphical and numerical skills in pre- and postgraduate medical students from a private university. / Habilidad gráfica y numérica en estudiantes de medicina de pre y posgrado de una universidad privada.

Introduction: Physicians and medical students need to understand numerical and graphical health data in order to provide patients with correct information. Objective: The graphical and numerical skills of medical students and residents from a private university in Lima, Peru, were determined in this investigation. Method: Cross-sectional, descriptive study. The Objective Numeracy, Subjective Numeracy and Graph Literacy Scales were applied to medical students at their two final years of medical school and to medical residents. Results: Of 169 participants, 52.07% were sixth-year and 18.34% were seventh-year students and 29.58% were residents. Mean objective numeracy score was 7.34, mean subjective numeracy was 34.12 and mean graph literacy was 10.35. A multiple linear regression analysis showed that Subjective and Objective Numeracy Scales highest means were associated with the male gender and training on research methodology (p < 0.05). Graph Literacy Scale highest means were associated with the male gender and younger age (p-value < 0.05). Conclusion: Numeracy and Graph Literacy Scales mean scores were high in medical students.

Introducción: Los médicos y estudiantes de medicina necesitan comprender los datos numéricos y gráficos sobre salud para proveer información correcta a los pacientes. Objetivo: Determinar las habilidades gráficas y numéricas en estudiantes y residentes de medicina de una universidad privada de Lima, Perú. Método: Estudio descriptivo, transversal. Se aplicaron las escalas de Habilidad Numérica Objetiva, de Habilidad Numérica Subjetiva y de Habilidad Gráfica a estudiantes de medicina de los dos últimos años de la carrera de medicina y a residentes de medicina. Resultados: De 169 participantes, 52.07 % fueron estudiantes de sexto año, 18.34 % de séptimo y 29.58 % residentes. La media en la habilidad numérica objetiva fue de 7.34, en la subjetiva de 34.12 y en la habilidad gráfica de 10.35. De la regresión lineal múltiple se obtuvo que las medias más altas en las escalas de Habilidad Numérica Subjetiva y Objetiva estuvieron asociadas con el sexo masculino y la capacitación sobre metodología en investigación (p < 0.05). En la Escala de Habilidad Gráfica, las medias más altas estuvieron asociadas con el sexo masculino y menor edad (p < 0.05). Conclusión: Las medias de las escalas de Habilidad Gráfica y Habilidad Numérica en estudiantes de medicina fueron altas.

Higher prevalence of unrecognized kidney disease at high altitude.

BACKGROUND: High altitude renal syndrome has been described in populations with excessive erythrocytosis. We evaluated whether high altitude (HA) dwellers might be at increased risk for kidney disease. METHODS: We performed a cross-sectional study to investigate differences in prevalence of kidney function and metabolic syndrome in healthy subjects living at HA vs. sea level (SL) without any known history of hypertension, diabetes or chronic kidney disease. RESULTS: We examined 293 subjects, aged 40 to 60 years: 125 SL (154 m) and 168 HA (3640 m) dwellers. HA dwellers had higher serum creatinine, lower estimated glomerular function rate (eGFR) (69.5 ± 15.2 vs. 102.1 ± 17.8 ml/min/1.73 m2, p < 0.0001), more proteinuria and higher hemoglobin concentrations compared to SL subjects. HA subjects had a lower prevalence of metabolic syndrome. Hemoglobin concentrations correlated inversely with eGFR in female (p = 0.001) and male (p = 0.03) HA dwellers. Using logistic regression analysis to compare subjects with eGFR < 90 vs. > 90 ml/min/1.73 m2, a lower eGFR was associated with female gender (odds ratio adjusted: 5.65 [95% confidence interval: 2.43-13.13]; p = 0.001), high altitude (14.78 [6.46-33.79]; p = 0.001), hemoglobin (1.68 [1.16-2.43]; p = 0.001) and uric acid (1.93 [1.36-2.72]; p = 0.001). CONCLUSIONS: Dwellers at high altitude who are considered healthy have worse kidney function, a higher prevalence of proteinuria and a lower prevalence of metabolic syndrome compared to people living at SL.