Morbimortality Associated with Liver Cirrhosis in Peru: An Ecological Analysis for the Period of 2004-2016.

Liver cirrhosis (LC) is an irreversible, chronic disease and constitutes the last clinical stage of many different liver diseases. The main cause of death is upper gastrointestinal bleeding caused by esophageal variceal rupture. We aim to depict the trend and estimate the morbimortality. For this, we conducted an ecological study and analyzed data from 2004-2016 using the public information provided by the Peruvian Ministry of Health (Ministerio de Salud del Perú, MINSA). Morbidity and mortality were presented according to 5-year groups. Regions were divided according to age quintiles for each studied year, and standardized morbidity and mortality rates were calculated for each natural geographic region; we found that LC-related morbidity per 100,000 people was 52.3 in 2004 and 117.9 in 2016. LC-related mortality had increased from 13.6 deaths per 100,000 people in 2004-2005 to 16.8 deaths per 100,000 people in 2015-2016. Morbidity showed an upward trend in Peru, especially in the departments of Callao, Ica, and Tumbes, whereas mortality showed an upward trend in the departments of Lambayeque, Ica, and Callao.

Blended learning y predisposición al aprendizaje autodirigido en un programa de especialización dental / Blended learning and self-directed learning in a dental specialization program

INTRODUCCIÓN: Uno de los retos de la educación superior es formar un profesional capaz de mantener un aprendizaje permanente. Para ello, la integración de TIC mediante estrategias que involucran el aprendizaje en línea es esencial. Sin embargo, el éxito de su implementación depende de la capacidad que tenga el estudiante de autogestionar su proceso de aprendizaje. Por ello, el objetivo de este estudio fue relacionar los niveles de predisposición al aprendizaje autodirigido de los alumnos de un programa de especialización al iniciar un taller en comunicación científica con el grado de satisfacción con la metodología implementada y con su efectividad sobre el desarrollo de competencias en comunicación científica. MATERIALES Y MÉTODOS: Se aplicaron 3 instrumentos: Escala de Fisher, King y Tague para la medición de la predisposición al aprendizaje autodirigido, Cuestionario de satisfacción con metodología b-learning y Cuestionario de autopercepción en competencias de comunicación científica. Se evaluó la relación entre los resultados de la medición de la predisposición al aprendizaje autodirigido y los resultados de los otros cuestionarios. RESULTADOS: Se observaron correlaciones positivas entre los niveles de deseo de aprender y las dimensiones actividades presenciales (p < 0,01), interacción en actividades presenciales (p < 0,05) y actividades de enseñanza aprendizaje (p < 0,05); entre los niveles de deseos de aprender y la dimensión lectura de artículos científicos (p < 0,01) y entre los niveles de autoconfianza y la dimensión lectura del artículo científico (p < 0,05). CONCLUSIONES: La autodirección en el aprendizaje cumplió un papel importante en la implementación de la estrategia educativa en esta cohorte en particular

INTRODUCTION: One of the challenges in higher education is to train professionals capable of maintaining lifelong learning. Because of it, the incorporation of ICT through strategies that involve online learning is essential. However, the success of its implementation depends on the ability of the student to self-manage their learning process. Therefore, the aim of this study was to relate levels of self-directed learning readiness of a specialization program students at the beginning of a scientific communication course with their satisfaction with the methodology implemented and it effectiveness on developing scientific communication competencies. MATERIALS AND METHODS: Three instruments were applied: Fisher, King & Tague's self-directed learning readiness scale B-learning strategy satisfaction questionnaire and Self-perceived scientific communication skills questionnaire. The relation between self-directed learning readiness and the results of the other questionnaires was evaluated. RESULTS: Positive correlations were observed between levels of willingness to learn and the dimensions of classroom activities (P < .01), interaction in face-to-face activities (P < .05) and teaching-learning activities (P < .05); between the levels of willingness to learn and the reading dimension of scientific articles (P < .01) and between the levels of self-confidence and the reading dimension of the scientific article (P < .05). CONCLUSIONS: Self-direction in learning played an important role in the implementation of the educational strategy for these particular students

Validity and reliability of SISCO inventory of academic stress among health students in Chile.

OBJECTIVE: To evaluate the factorial structure and internal consistency of SISCO inventory of academic stress in medical students.. METHODS: The cross-sectional study was conducted at the School of Medicine, University of Concepcion, Chile, in 2014, and comprised second and third year students.Exploratory factor analysis was carried out to determine the reliability of each of the dimensions of SISCO inventory. Descriptive and correlational analyses were also conducted. RESULTS: Of the 155 students, 121(78.1%)were female. The overall mean age was 20.5+/- 1.55 years (range: 18.9-32.2 years). Of the total, 61(39.4%) students were in the nursing programme, 10(6.5%) in speech therapy, 16(10.3%) in kinesiology, 10(6.5%) in medicine, 20(12.9%) in midwifery and 38(24.4%) in medical technology.For stressor, somatisation and coping dimensions, a factor was identified, with Cronbach's alpha values of 0.76, 0.86 and 0.52, respectively. Correlation could only be established between the first two dimensions. CONCLUSIONS: Stressors and somatisation dimensions of the SISCO inventory of academic stress were found to be validity and reliabile.

Relationship among academic engagement, burnout and student perceptions of curriculum delivery in Speech and Language Therapy Students from University of Concepcion, Chile.

OBJECTIVE: To relate engagement and academic burnout with curriculum evaluation among speech therapy students. METHODS: This observational, cross-sectional study was conducted at the end of the first academic semester for each level and at the end of a theoretical class in order to ensure the maximum participation rate at the University of Concepción, Concepción, Chile, and comprised students of a speech and language therapy programme.Curriculum evaluation scale, academic engagement and academic burnout questionnaires were used. STATA SE 11 was used for statistical analysis. RESULTS: Of the 200 participants, 157(78.50%) were women and 43(21.50%) men. The overall mean age was 20.81±2.15 years (range: 18-30 years). Emotional burnout was inversely correlated with the evaluation of teaching and evaluation methods, distribution of fields, teaching team and achievement of objectives (p<0.05 each). Depersonalisation was inversely associated with the distribution of teaching and learning activities (r=-0.13; p<0.05). Lack of personal accomplishment was also significantly and statistically associated with seven out of the eight factors of the curriculum evaluation scale (p<0.05 each). Involvement in studies was statistically and significantly related to all factors (p<0.05 each), except the achievement of objectives. Finally, satisfaction with studies was directly, statistically and significantly related to six of the eight factors (p<0.05 each). CONCLUSIONS: A more positive evaluation of the academic curriculum was associated with lower levels of burnout and higher levels of academic engagement.

Estructura factorial y confiabilidad de una escala de autoeficacia académica en estudiantes chilenos de Fonoaudiología / Factorial structure and reliability of an academic self-efficacy scale in Chilean Phonoaudiology students

Introducción: las expectativas de autoeficacia son un predictor importante del éxito académico en todos los niveles formativos, incluyendo las carreras de la salud. El diagnóstico temprano de los niveles de autoeficacia de los alumnos y una oportuna intervención puede ser una estrategia útil para favorecer los procesos formativos. Esto hace necesario contar con instrumentos psicométricamente adecuados que permitan su evaluación en los estudiantes. Objetivo: evaluar la estructura factorial y la consistencia interna de la Escala de Autoeficacia Percibida Específica de Situaciones Académicas de Palenzuela en estudiantes de Fonoaudiología de Chile. Métodos: esta escala se aplicó a 282 estudiantes elegidos por muestreo no probabilístico por cuotas.Se realizó un análisis factorial exploratorio y se evaluó la confiabilidad con alfa de Cronbach. Resultados: presentaban entre 19 y 33 años de edad y 84,59 % eran mujeres. Se identificó una estructura unifactorial. Su consistencia interna fue adecuada según un alfa de Cronbach de 0,87. Conclusiones: existe evidencia psicométrica de la validez de constructo de la escala como medida unifactorial de autoeficacia académica en estudiantes de Fonoaudiología de Chile; además, muestra una adecuada confiabilidad(AU)

Introduction: Self-efficacy expectations are an important predictor for academic success at all levels of education, including the health-related majors. Early diagnosis of students' self-efficacy levels and timely intervention can be a useful strategy to favor the training processes. This makes it necessary to have psychometrically adequate instruments that allow students to evaluate themselves. Objective: To evaluate the factorial structure and internal consistency of the Scale of Specific Perceived Self-efficacy of Academic Situations of Palenzuela in Phonoaudiology students in Chile. Methods: This scale was applied to 282 students chosen by non-probabilistic sampling by rates. They were at ages between 19 and 33 years and 84.59% were women. An exploratory factorial analysis was performed and reliability was evaluated with Cronbach's alpha. Results: A unifactorial structure was identified. Its internal consistency was adequate according to Cronbach alpha of 0.87. Conclusions: There is psychometric evidence on the validity of the scale construction as a unifactorial measure of academic self-efficacy in Phonoaudiology students in Chile. In addition, it shows an adequate reliability(AU)

Translation and validation of a Spanish version of the xerostomia inventory.

OBJECTIVE: The aim of this study was to validate a Spanish cross-cultural adaptation of the xerostomia inventory (XI). MATERIALS AND METHODS: The original English version of XI was translated into Spanish, cross-culturally adapted and field tested. The Spanish version of XI (XI-Sp) was tested with a sample of 41 patients with xerostomia. The reliability of the XI-Sp was determined through internal consistency and test-retest methods. The construct validity of XI-Sp was determined by means of correlation between XI-Sp scores and salivary flow measurements. RESULTS: Overall XI-Sp scores were 40.8 (SD = 10) for the first application and 40.2 (SD = 9.5) for the second. Cronbach's alpha value for the XI-Sp was 0.89 and 0.87, respectively, while interitem correlation averages were r = 0.44 and r = 0.39 for each application. Interitem correlation and corrected total was rc ≥0.30. The test-retest intraclass correlation coefficient value for the XI-Sp score was 0.59 and 0.91. Convergent validity for construct validity correlation with salivary flow showed a medium effect size (r2  = 0.10) for the first application but did not make a statistically significant prediction for the second (r2  = 0.7). CONCLUSIONS: This study provides evidence concerning the reliability of the XI-Sp, showing that it may be a useful tool for Spanish-speaking xerostomia patients for both clinical and epidemiologic research.

Relación de antecedentes académicos y expectativas iniciales con el bienestar académico de alumnos de primer año de medicina / Relationship between previous academics background and initial expectations with academic well-being of first year of medical students

Introducción: Los estudiantes de primer año de medicina deben afrontar altas exigencias académicas y personales que influyen en el bienestar y el desempeño académico. Esta investigación analiza la relación de los antecedentes académicos y las expectativas académicas iniciales con el bienestar académico de alumnos de primer año de medicina. Sujetos y métodos: Estudio cuantitativo, transversal y correlacional. Se aplicaron los cuestionarios UWES-S17, MBI-HSS e involucramiento académico, versión expectativas. Se obtienen los antecedentes académicos y sociodemográficos de una base de datos oficial. Resultados: Se encontró una relación directa entre las notas de enseñanza media y la dimensión de involucramiento en los estudios del compromiso académico (engagement), una relación inversa con la falta de realización personal del desgaste académico (burnout) y relaciones directas entre las tres dimensiones de las expectativas académicas y el compromiso académico e inversas con la dimensión falta de realización personal del desgaste académico. Conclusión: Tanto los antecedentes académicos previos como las expectativas académicas iniciales se relacionan con el bienestar académico tras el primer semestre

Introduction: First year medical students face personal and high academic standards impacting the well-being and academic performance. This research examines the relationship of the academic background and the initial academic expectations with the academic well-being of first year medical students. Subjects and methods: Quantitative, transversal and correlational study. Applied the questionnaire UWES-S17, MBI-HSS and Academic Involvement, version Expectations. Academic and socio-demographic basis of official data are obtained. Results: We found direct relationships between the high school grades and dimension of involvement in studies of the academic engagement and inverse with the lack of fulfillment of academic burnout and direct relationships between the three dimensions of the academic expectations and academic engagement and reverse with the lack of personal fulfillment dimension of academic burnout. Conclusion: Both the previous academic background and initial academic expectations relate to the academic well-being after the first semester

[Development of a professional social responsibility questionnaire for physicians]. / Construcción y análisis psicométrico de un cuestionario para evaluar el comportamiento médico socialmente responsable.

BACKGROUND: Professional Social Responsibility is now imperative for the practice of medicine. However, there are no instruments to assess it among physicians. AIM: To construct and evaluate the factorial structure and reliability of a questionnaire designed to measure socially responsible behavior in physicians. MATERIAL AND METHODS: The Questionnaire on Medical Socially Responsible Behavior, consisting of 34 items, was constructed. It was applied to 284 physicians and medical students. After eliminating respondents who omitted questions, a valid sample of 214 individuals aged 23 to 67 years (51.4% males) was obtained. We assessed the factorial structure, reliability, discriminative ability of the items and correlation between factors. RESULTS: Exploratory factorial analysis, conducted using the principal axis method, identified the presence of three factors and considered 30 items. The reliability of the factors, assessed using Cronbach's alpha, ranged from 0.73 to 0.89. Only one item had a low correlation of 0.3. Correlations between the three factors were direct and high. CONCLUSIONS: The developed questionnaire presents a definite factorial structure, with internally consistent and correlated factors and with adequate psychometric properties.

[Relationship between self-directed learning and value profile in Chilean medical students]. / Aprendizaje autodirigido y su relación con el perfil valórico en estudiantes de medicina.

BACKGROUND: Medical education should prepare students to face a dynamic environment, through competencies that allow them to learn independently. AIM: To evaluate the relationship between self-directed learning and value profile of undergraduate first year students in a medical school in Chile. MATERIAL AND METHODS: Self-Directed Learning Scale and Schwartz's Values Questionnaire were applied to 235 medical students from the University of Concepción, Chile. RESULTS: Self-direction and Security are value types that correlate directly and significantly with the overall scale and with the five subscales of Self-Directed Learning. CONCLUSIONS: In first year medical students ofUniversity of Concepcion, Chile, Self-direction and Security are values that facilitate Self-directed Learning.

Aprendizaje autodirigido y su relación con el perfil valórico en estudiantes de medicina / Relationship between self-directed learning and value profile in Chilean medical students

Background: Medical education should prepare students to face a dynamic environment, through competencies that allow them to learn independently. Aim: To evaluate the relationship between self-directed learning and value profile of undergraduate first year students in a medical school in Chile. Material and Methods: Self-Directed Learning Scale and Schwartz's Values Questionnaire were applied to 235 medical students from the University of Concepción, Chile. Results: Self-direction and Security are value types that correlate directly and significantly with the overall scale and with the five subscales of Self-Directed Learning. Conclusions: In first year medical students ofUniversity of Concepcion, Chile, Self-direction and Security are values that facilitate Self-directed Learning.

[Knowledge and practices about the prevention and the control of the influenza A H1N1 in the community of Floridablanca, Santander]. / Conocimientos y prácticas sobre la prevención y el control de la influenza AH1N1 en una comunidad de Floridablanca, Santander.

INTRODUCTION: The influenza A H1N1 generated a pandemic during 2009; governments around the world developed mitigation and control strategies to contain its spread. In Santander prevention plans in a local community were put into practice. OBJECTIVES: The knowledge and practices of the population were assessed with respect to the prevention and control of pandemic influenza A H1N1. MATERIALS AND METHODS: A cross-sectional study of a random sample of processed survey designed by one of the investigators, was conducted by personnel experienced with the survey method. Analysis was by univariate, bivariate and logistic regression methods. RESULTS: The sample obtained was of 340 inhabitants. Nearly the entire population (97.4%) were aware of the pandemic. Hand washing and use of surgical masks were the best known preventative actions. An association was seen between gender and level of knowledge, and between knowledge of preventative action and the media exposure. The educational level was related to symptom control measures. Age was related with the duration of hand washing and the use of quarantine. CONCLUSIONS: The community appeared to have acceptable levels of knowledge and practices for the prevention of influenza A H1N1. Continued mitigation plans at government level were recommended to prevent the spread of influenza.

Conocimientos y prácticas sobre la prevención y el control de la influenza AH1N1 en una comunidad de Floridablanca, Santander / Knowledge and practices about the prevention and the control of the influenza A H1N1 in the community of Floridablanca, Santander

Introducción. La influenza AH1N1 generó una pandemia durante el año 2009, para la cual los gobiernos de todo el mundo desarrollaron medidas de mitigación y control de la propagación. En el departamento de Santander se pusieron en práctica planes de prevención orientados a la comunidad. Objetivo. Evaluar los conocimientos y prácticas de la población sobre la prevención y control de la pandemia de influenza AH1N1. Materiales y métodos. Se trató de un estudio transversal con muestreo no probabilístico de encuesta diseñada por los investigadores y diligenciada por personal capacitado sobre el tema. Se realizaron análisis univariado, bivariado y regresión logística. Resultados. La muestra obtenida fue de 340 habitantes, los cuales se encontraban en su domicilio el día de la encuesta; de ellos, 97,4 % de la población conocía sobre la pandemia. El lavado de manos y el uso de tapabocas fueron las medidas más escuchadas. Se encontró relación entre el sexo y el nivel de conocimientos, las medidas escuchadas y los medios de difusión. El nivel de escolaridad está relacionado con las medidas de control de síntomas. La edad está relacionada con la duración del lavado de manos y el uso de la cuarentena. Conclusión. La población estudiada presenta niveles aceptables de conocimientos y prácticas de prevención de la influenza AH1N1. Se recomienda continuar con los planes de mitigación a nivel gubernamental para evitar la expansión de la influenza.

Introduction. The influenza A H1N1 generated a pandemic during 2009; governments around the world developed mitigation and control strategies to contain its spread. In Santander prevention plans in a local community were put into practice. Objectives. The knowledge and practices of the population were assessed with respect to the prevention and control of pandemic influenza A H1N1. Materials and methods. A cross-sectional study of a random sample of processed survey designed by one of the investigators, was conducted by personnel experienced with the survey method. Analysis was by univariate, bivariate and logistic regression methods. Results. The sample obtained was of 340 inhabitants. Nearly the entire population (97.4%) were aware of the pandemic. Hand washing and use of surgical masks were the best known preventative actions. An association was seen between gender and level of knowledge, and between knowledge of preventative action and the media exposure. The educational level was related to symptom control measures. Age was related with the duration of hand washing and the use of quarantine. Conclusions. The community appeared to have acceptable levels of knowledge and practices for the prevention of influenza A H1N1. Continued mitigation plans at government level were recommended to prevent the spread of influenza.