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Cruz-Ausejo L, Copez-Lonzoy A, Vilela-Estrada AL, Valverde JJ, Bohórquez M, Moscoso-Porras M. Can working at home be a hazard? Ergonomic factors associated with musculoskeletal disorders among teleworkers during the COVID-19 pandemic: a scoping review. Int J Occup Saf Ergon 2023; 29:1335-1344. [PMID: 36217607 DOI: 10.1080/10803548.2022.2127246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Objectives. The improvised and massive adoption of remote work in the context of COVID-19 has forced us to adapt homes as workspaces, which could promote development of musculoskeletal disorders (MSDs). This review explores the evidence for ergonomic factors associated with MSDs in teleworkers. Methods. A literature search was conducted in MEDLINE, Embase, Scopus, SciELO and EBSCO. We included observational studies published between March 2020 and October 2021 that included teleworking personnel due to the restrictions of the pandemic. Results. A total of 212 studies were identified, 14 were chosen for complete review. Associated factors were change of work modality (on-site work to telework), use of home environments as workspaces (areas not adapted for work and with low lighting), working furniture (non-ergonomic chairs and desks), use of electronic devices (tablets, cell phones and laptops), organizational factors (working hours, active breaks, sitting time) and individual factors (physical activity practice). Conclusion. Various ergonomic home factors and the characteristics of teleworking - mainly furniture, the environment of work and physical activity - are associated with MSDs. This evidence suggests that the norms and regulation of telework can consider the adaptation of workspace and conditions at home to prevent health problems in the medium and long term.
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Affiliation(s)
- Liliana Cruz-Ausejo
- Centro Nacional de Salud Ocupacional y Protección del Ambiente para la Salud (CENSOPAS), Instituto Nacional de Salud, Perú
- Tecnólogo Médico, Instituto Nacional de Salud, Perú
| | - Anthony Copez-Lonzoy
- Centro Nacional de Salud Ocupacional y Protección del Ambiente para la Salud (CENSOPAS), Instituto Nacional de Salud, Perú
- Psicólogo, Instituto Nacional de Salud, Perú
| | - Ana Lucía Vilela-Estrada
- Centro Nacional de Salud Ocupacional y Protección del Ambiente para la Salud (CENSOPAS), Instituto Nacional de Salud, Perú
- Psicólogo, Instituto Nacional de Salud, Perú
| | - Juan José Valverde
- Tecnólogo Médico, Instituto Nacional de Salud, Perú
- Facultad de Ingeniería Ambiental, Universidad Nacional de Ingeniería, Perú
| | - Melissa Bohórquez
- Facultad de Ingeniería Ambiental, Universidad Nacional de Ingeniería, Perú
- Ingeniera de Higiene y Seguridad Industrial, Universidad Nacional de Ingeniería, Perú
| | - Miguel Moscoso-Porras
- Centro Nacional de Salud Ocupacional y Protección del Ambiente para la Salud (CENSOPAS), Instituto Nacional de Salud, Perú
- Tecnólogo Médico, Instituto Nacional de Salud, Perú
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Mendoza-Quispe D, Chambergo-Michilot D, Moscoso-Porras M, Bernabe-Ortiz A. Hypertension prevalence by degrees of urbanization and altitude in Peru: pooled analysis of 186 906 participants. J Hypertens 2023; 41:1142-1151. [PMID: 37071440 DOI: 10.1097/hjh.0000000000003444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
Abstract
OBJECTIVE Few studies, using countrywide data, examined how hypertension prevalence varies at diverse degrees of urbanization and altitude. This study examined the association between urbanization and altitude, including the potential interaction between those variables, with hypertension prevalence in Peru. METHODS Cross-sectional analysis of the Peruvian Demographic and Health Survey (2014-2019). Hypertension (SBP ≥140 mmHg or DBP ≥90 mmHg or self-reported diagnosis) was the outcome. Exposures were altitude levels, and urbanization assessed with four indicators (urban/rural; type of place of residence; population density level; and population size level). RESULTS Among 186 906 participants (mean age ± standard deviation: 40.6 ± 17.9; 51.1% women), pooled hypertension prevalence was 19% [95% confidence interval (CI) 18.7-19.3], which was higher in urban compared with rural areas (prevalence ratio: 1.09; 95% CI 1.05-1.15). Compared with countryside, hypertension was higher in towns (prevalence ratio: 1.09; 95% CI 1.04-1.15), small cities (prevalence ratio: 1.07; 95% CI 1.02-1.13) and large cities (prevalence ratio: 1.19; 95% CI 1.12-1.27). Compared with least density settings (1-500 inhabitants/km 2 ), hypertension was higher in the highest density (≥10 001 inhabitants/km 2 ) settings (prevalence ratio: 1.12; 95% CI 1.07-1.18). Population size was not associated with hypertension. Compared with low altitude, hypertension was lower above 2500 m (prevalence ratio 0.91; 95% CI 0.87-0.94) and above 3500 m (prevalence ratio 0.89; 95% CI 0.84-0.95). Interaction between exposures had varying patterning. CONCLUSION Hypertension in Peru is more prevalent at urban than rural areas, especially in large cities and in more densely populated areas above 10 001 inhabitants/km 2 , and less prevalent at altitudes above 2500 m.
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Affiliation(s)
- Daniel Mendoza-Quispe
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia
| | | | - Miguel Moscoso-Porras
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia
- Escuela de Medicina Humana, Universidad Continental, Huancayo, Perú
| | - Antonio Bernabe-Ortiz
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia
- Universidad Científica del Sur, Lima
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Rojas-Mezarina L, Escobar-Agreda S, Chahuara-Rojas M, Silva-Valencia J, Espinoza-Herrera DH, Reátegui-Rivera CM, Moscoso-Porras M, Quispe-Gamarra J, Ronceros G. Usability and perceptions of a one-on-one telementoring program for young physicians in rural settings of Peru: a mixed method study. BMC Med Educ 2023; 23:175. [PMID: 36949455 PMCID: PMC10031997 DOI: 10.1186/s12909-023-04142-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 03/07/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Telementoring seems to be a promising strategy to deliver training and counselling to physicians in remote areas. In Peru, early graduated physicians must work for the Rural and Urban-Edge Health Service Program where they face important training needs. The aim of this study was to describe the usage of a one-on-one telementoring program for rural physicians and evaluate the aspects related to the perceptions of acceptability and usability. METHODS Mixed methods study on recently graduated physicians who work in rural areas and participate in the telementoring program. The program used a mobile application to connect these young doctors with specialized mentors to answer queries about real-life problems raised by working in a rural area. We summarize administrative data to assess participant characteristics and their participation in the program. Additionally, we conducted in-depth interviews to explore the perceived usability, ease of use, and reason for non-use of the telementoring program. RESULTS Of 74 physicians (mean age 25, 51.4% women) enrolled, 12 (16.2%) actively used the program and performed a total of 27 queries, which received response in an average time of 5.4 ± 6.3 h. In the interviews, the main reasons for non-use were connectivity issues, feelings of shame, and self-efficacy. For those who used the telementoring program they referred it was easy to use and solve their inquiries timely. CONCLUSIONS The implementation of a telementoring program sought to provide guidance to recently graduated physicians working in rural areas. Low use rates show that administrative and process-related deficiencies in the program implementation need to be improved.
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Affiliation(s)
- Leonardo Rojas-Mezarina
- Unidad de Telesalud, Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Av. Grau 755, Cercado de Lima, 15001, Peru.
| | - Stefan Escobar-Agreda
- Unidad de Telesalud, Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Av. Grau 755, Cercado de Lima, 15001, Peru
- Asociación Para El Desarrollo de La Investigación Estudiantil en Ciencias de La Salud (ADIECS), Jr. Sergio Bernales 771, Cercado de Lima, 15001, Peru
| | - Max Chahuara-Rojas
- Unidad de Telesalud, Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Av. Grau 755, Cercado de Lima, 15001, Peru
| | - Javier Silva-Valencia
- Unidad de Telesalud, Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Av. Grau 755, Cercado de Lima, 15001, Peru
- Asociación Para El Desarrollo de La Investigación Estudiantil en Ciencias de La Salud (ADIECS), Jr. Sergio Bernales 771, Cercado de Lima, 15001, Peru
| | - Daniel Hector Espinoza-Herrera
- Unidad de Telesalud, Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Av. Grau 755, Cercado de Lima, 15001, Peru
| | - C Mahony Reátegui-Rivera
- Unidad de Telesalud, Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Av. Grau 755, Cercado de Lima, 15001, Peru
- Asociación Para El Desarrollo de La Investigación Estudiantil en Ciencias de La Salud (ADIECS), Jr. Sergio Bernales 771, Cercado de Lima, 15001, Peru
| | - Miguel Moscoso-Porras
- Escuela de Medicina Humana, Universidad Continental, Av. San Carlos 1980, Huancayo, 12001, Peru
| | - Juan Quispe-Gamarra
- Unidad de Telesalud, Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Av. Grau 755, Cercado de Lima, 15001, Peru
| | - Gerardo Ronceros
- Unidad de Telesalud, Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Av. Grau 755, Cercado de Lima, 15001, Peru
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Silva-Valencia J, Soto-Becerra P, Escobar-Agreda S, Fernandez-Navarro M, Moscoso-Porras M, Solari L, Mayta-Tristán P. Effectiveness of the BBIBP-CorV vaccine in preventing infection and death in health care workers in Peru 2021. Travel Med Infect Dis 2023; 53:102565. [PMID: 36933851 PMCID: PMC10019038 DOI: 10.1016/j.tmaid.2023.102565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 01/03/2023] [Accepted: 03/09/2023] [Indexed: 03/18/2023]
Abstract
BACKGROUND During 2021, Peru started the vaccination against SARS-CoV-2 using the BBIBP-CorV inactivated virus vaccine for health care workers (HCW). We aim to evaluate the effectiveness of the BBIBP-CorV vaccine to prevent SARS-CoV-2 infection and deaths among HCWs. METHODS Retrospective cohort study, from February 9 to June 30, 2021, using national registries of health care workers, laboratory tests for SARS-CoV-2 and deaths. We calculated the vaccine effectiveness for preventing laboratory-confirmed SARS-CoV-2 infection, COVID-19-mortality, and all-cause mortality among partially immunized and fully immunized HCWs. An extension of Cox proportional hazards regression was used to model the mortality results, and Poisson regression was used to model SARS-CoV-2 infection. RESULTS The study included 606,772 eligible HCWs, the mean age was 40 (IQR: 33.0, 51.0). In fully immunized HCW, the effectiveness for preventing all-cause mortality was 83.6 (95% CI: 80.2 to 86.4), 88.7 (95% CI: 85.1 to 91.4) for preventing COVID-19 mortality, and 40.3 (95% CI 38.9 to 41.6) for preventing SARS-CoV-2 infection. CONCLUSION The BBIBP-CorV vaccine showed high levels of effectiveness for preventing all-cause and COVID-19 deaths among fully immunized HCW. These results were consistent within different subgroups and sensitivity analyses. However, the effectiveness for preventing infection was suboptimal in this particular setting.
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Affiliation(s)
| | - Percy Soto-Becerra
- Universidad Continental, Av San Carlos 1980, Huancayo, 12000, Peru; Seguro Social en Salud (EsSalud), Instituto de Evaluación de Tecnologías Sanitarias e Investigación - IETSI, EsSalud, Domingo Cueto 109, Jesus Maria, Lima, Peru
| | | | | | - Miguel Moscoso-Porras
- Instituto Nacional de Salud (INS), Jr. Capac Yupanqui 1400, Jesus Maria, Lima, Peru; Universidad Continental, Av San Carlos 1980, Huancayo, 12000, Peru
| | - Lely Solari
- Instituto Nacional de Salud (INS), Jr. Capac Yupanqui 1400, Jesus Maria, Lima, Peru.
| | - Percy Mayta-Tristán
- Universidad Científica del Sur, Dirección General de Investigación, Desarrollo e Innovación, Antigua panamericana Sur Km19, Lima, Peru
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Saavedra-Garcia L, Moscoso-Porras M, Diez-Canseco F. An Experimental Study Evaluating the Influence of Front-of-Package Warning Labels on Adolescent’s Purchase Intention of Processed Food Products. IJERPH 2022; 19:ijerph19031094. [PMID: 35162126 PMCID: PMC8833989 DOI: 10.3390/ijerph19031094] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 01/12/2022] [Accepted: 01/17/2022] [Indexed: 01/27/2023]
Abstract
Front-of-package warning labels (WLs) are among the public health policies adopted by some countries, mainly in Latin-America, to tackle childhood obesity; however, their impact is still under review. The aim of this study was to assess, using an experimental design, whether WLs influence purchase intention of processed foods and identification of the healthiest products among adolescents in Peru, in May 2019, just before WLs mandatory implementation. Four hundred forty-nine adolescents from two public schools were randomly assigned to an experimental group (received three different processed products with either zero, one or two WLs, informing if they were high in sugar, sodium and/or saturated fats) or a control group (received the same products but unlabeled). Participants chose which product they would buy, and which they considered to be the healthiest. No differences between groups were found neither in purchase intention (p = 0.386) nor in the identification of the healthiest product (p = 0.322). In both groups, the most-selected product was always the healthiest of the triad (>40% in purchase intention and >80% in identification of the healthiest). Front-of-package WLs did not influence purchase intention, or identification of healthier products among adolescents from public schools in Peru. Mass media and educational campaigns should accompany the WLs implementation to help achieve the policy objective.
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Yaria J, Gil A, Makanjuola A, Oguntoye R, Miranda JJ, Lazo-Porras M, Zhang P, Tao X, Ahlgren JÁ, Bernabe-Ortiz A, Moscoso-Porras M, Malaga G, Svyato I, Osundina M, Gianella C, Bello O, Lawal A, Temitope A, Adebayo O, Lakkhanaloet M, Brainin M, Johnson W, Thrift AG, Phromjai J, Mueller-Stierlin AS, Perone SA, Varghese C, Feigin V, Owolabi MO. Quality of stroke guidelines in low- and middle-income countries: a systematic review. Bull World Health Organ 2021; 99:640-652E. [PMID: 34475601 PMCID: PMC8381090 DOI: 10.2471/blt.21.285845] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 05/27/2021] [Accepted: 05/28/2021] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE To identify gaps in national stroke guidelines that could be bridged to enhance the quality of stroke care services in low- and middle-income countries. METHODS We systematically searched medical databases and websites of medical societies and contacted international organizations. Country-specific guidelines on care and control of stroke in any language published from 2010 to 2020 were eligible for inclusion. We reviewed each included guideline for coverage of four key components of stroke services (surveillance, prevention, acute care and rehabilitation). We also assessed compliance with the eight Institute of Medicine standards for clinical practice guidelines, the ease of implementation of guidelines and plans for dissemination to target audiences. FINDINGS We reviewed 108 eligible guidelines from 47 countries, including four low-income, 24 middle-income and 19 high-income countries. Globally, fewer of the guidelines covered primary stroke prevention compared with other components of care, with none recommending surveillance. Guidelines on stroke in low- and middle-income countries fell short of the required standards for guideline development; breadth of target audience; coverage of the four components of stroke services; and adaptation to socioeconomic context. Fewer low- and middle-income country guidelines demonstrated transparency than those from high-income countries. Less than a quarter of guidelines encompassed detailed implementation plans and socioeconomic considerations. CONCLUSION Guidelines on stroke in low- and middle-income countries need to be developed in conjunction with a wider category of health-care providers and stakeholders, with a full spectrum of translatable, context-appropriate interventions.
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Affiliation(s)
- Joseph Yaria
- Department of Medicine, University College Hospital, Ibadan, Nigeria
| | - Artyom Gil
- Division of Country Health Programme, WHO European Office for the Prevention and Control of Noncommunicable Diseases, Moscow, Russia
| | | | - Richard Oguntoye
- Department of Medicine, University College Hospital, Ibadan, Nigeria
| | - J Jaime Miranda
- School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Maria Lazo-Porras
- CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Puhong Zhang
- The George Institute for Global Health, Beijing, China
| | - Xuanchen Tao
- The George Institute for Global Health, Beijing, China
| | | | - Antonio Bernabe-Ortiz
- CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | | | - German Malaga
- School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Irina Svyato
- Moscow School of Management SKOLKOVO, Moscow, Russia
| | - Morenike Osundina
- Department of Medicine, University College Hospital, Ibadan, Nigeria
| | - Camila Gianella
- Department of Psychology, Pontificia Universidad Católica del Perú, Lima, Peru
| | - Olamide Bello
- Department of Medicine, University College Hospital, Ibadan, Nigeria
| | - Abisola Lawal
- Department of Medicine, University College Hospital, Ibadan, Nigeria
| | - Ajagbe Temitope
- Department of Medicine, University College Hospital, Ibadan, Nigeria
| | | | | | - Michael Brainin
- Department of Neurosciences and Preventive Medicine, Danube University, Krems, Austria
| | - Walter Johnson
- Department of Neurosurgery, Loma Linda University, California, United States of America
| | - Amanda G Thrift
- School of Clinical Sciences, Monash University, Melbourne, Australia
| | | | | | | | - Cherian Varghese
- Noncommunicable Disease Department, World Health Organization, Geneva, Switzerland
| | - Valery Feigin
- National Institute for Stroke and Applied Neurosciences, Auckland University of Technology, Auckland, New Zealand
| | - Mayowa O Owolabi
- Department of Medicine, University College Hospital, 200001 Ibadan, Oyo State, Nigeria.Correspondence to Mayowa O Owolabi ()
| | - on behalf of the Stroke Experts Collaboration Group
- Department of Medicine, University College Hospital, Ibadan, Nigeria
- Division of Country Health Programme, WHO European Office for the Prevention and Control of Noncommunicable Diseases, Moscow, Russia
- School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
- CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
- The George Institute for Global Health, Beijing, China
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden
- Moscow School of Management SKOLKOVO, Moscow, Russia
- Department of Psychology, Pontificia Universidad Católica del Perú, Lima, Peru
- Thung Chang Hospital, Thung Chang District, Nan, Thailand
- Department of Neurosciences and Preventive Medicine, Danube University, Krems, Austria
- Department of Neurosurgery, Loma Linda University, California, United States of America
- School of Clinical Sciences, Monash University, Melbourne, Australia
- Health System Research Institute, Nonthaburi, Thailand
- Institute for Epidemiology and Medical Biometry, University of Ulm, Ulm, Germany
- Division of Tropical and Humanitarian Medicine, Geneva University Hospitals, Geneva, Switzerland
- Noncommunicable Disease Department, World Health Organization, Geneva, Switzerland
- National Institute for Stroke and Applied Neurosciences, Auckland University of Technology, Auckland, New Zealand
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Bernabé-Ortiz A, Zafra-Tanaka JH, Moscoso-Porras M, Sampath R, Vetter B, Miranda JJ, Beran D. Diagnostics and monitoring tools for noncommunicable diseases: a missing component in the global response. Global Health 2021; 17:26. [PMID: 33750391 PMCID: PMC7941936 DOI: 10.1186/s12992-021-00676-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 02/25/2021] [Indexed: 11/15/2022] Open
Abstract
A key component of any health system is the capacity to accurately diagnose individuals. One of the six building blocks of a health system as defined by the World Health Organization (WHO) includes diagnostic tools. The WHO’s Noncommunicable Disease Global Action Plan includes addressing the lack of diagnostics for noncommunicable diseases, through multi-stakeholder collaborations to develop new technologies that are affordable, safe, effective and quality controlled, and improving laboratory and diagnostic capacity and human resources. Many challenges exist beyond price and availability for the current tools included in the Package of Essential Noncommunicable Disease Interventions (PEN) for cardiovascular disease, diabetes and chronic respiratory diseases. These include temperature stability, adaptability to various settings (e.g. at high altitude), need for training in order to perform and interpret the test, the need for maintenance and calibration, and for Blood Glucose Meters non-compatible meters and test strips. To date the issues surrounding access to diagnostic and monitoring tools for noncommunicable diseases have not been addressed in much detail. The aim of this Commentary is to present the current landscape and challenges with regards to guidance from the WHO on diagnostic tools using the WHO REASSURED criteria, which define a set of key characteristics for diagnostic tests and tools. These criteria have been used for communicable diseases, but so far have not been used for noncommunicable diseases. Diagnostic tools have played an important role in addressing many communicable diseases, such as HIV, TB and neglected tropical diseases. Clearly more attention with regards to diagnostics for noncommunicable diseases as a key component of the health system is needed.
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Affiliation(s)
- Antonio Bernabé-Ortiz
- CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Jessica H Zafra-Tanaka
- CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Miguel Moscoso-Porras
- CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru.,School of Medicine "Alberto Hurtado", Universidad Peruana Cayetano Heredia, Lima, Peru
| | | | - Beatrice Vetter
- Foundation for Innovative and New Diagnostics, Geneva, Switzerland
| | - J Jaime Miranda
- CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru.,The George Institute for Global Health, UNSW, Sydney, Australia
| | - David Beran
- Division of Tropical and Humanitarian Medicine, University of Geneva and Geneva University Hospitals, Geneva, Switzerland.
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Urrunaga N, Montoya-Medina JE, Miranda JJ, Moscoso-Porras M, Cárdenas MK, Diez-Canseco F, Gilman RH, Bernabe-Ortiz A. Attitudes, health lifestyle behaviors and cardiometabolic risk factors among relatives of individuals with type 2 diabetes mellitus. Prim Care Diabetes 2021; 15:101-105. [PMID: 32739222 DOI: 10.1016/j.pcd.2020.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 07/13/2020] [Accepted: 07/14/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To describe and compare attitudes, lifestyle behaviors, and cardiometabolic risk factors between individuals with and without a relative with type 2 diabetes mellitus (T2DM) living in the same household. METHODS A secondary analysis of baseline data from an implementation study in Peru was conducted. The outcomes were attitudes towards changing lifestyle behaviors (e.g. intentions towards losing weight, increasing physical activity, reducing salt consumption, etc), profiles of health lifestyle behaviors (e.g. daily smoking, heavy drinking, and physical activity), and cardiometabolic risk factors (e.g., overweight [body mass index ≥25 kg/m2] and hypertension); whereas the exposure was the presence of at least one relative with known diagnosis of T2DM living in the same household. Multilevel logistic mixed effect regression models were used to estimate odds ratios (OR) and 95% confidence intervals (95% CI). RESULTS A total of 2298 records, 1134 (49.4%) males, mean age 43.3 (SD: 17.2) years, were analyzed. There was no evidence of a difference in lifestyle-changing attitudes, smoking, alcohol drinking, physical activity levels, and hypertension between individuals with and without relatives with T2DM. Overweight was 63% more common among individuals having a relative with a T2DM in multivariable model (OR = 1.63; 95% CI: 1.03-2.61). CONCLUSIONS Individuals with relatives with T2DM have higher probabilities of being overweight compared to those who did not have relatives with T2DM in the same household. The absence of differences on lifestyle-related attitudes and behaviors highlight the need of involving relatives of patients with T2DM on intervention strategies to further enhance diabetes prevention and management efforts.
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Affiliation(s)
- Nicole Urrunaga
- Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas (UPC), Lima, Peru
| | - José E Montoya-Medina
- Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas (UPC), Lima, Peru
| | - J Jaime Miranda
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru; Department of Medicine, School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Miguel Moscoso-Porras
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - María K Cárdenas
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Francisco Diez-Canseco
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Robert H Gilman
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA
| | - Antonio Bernabe-Ortiz
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru; Universidad Científica del Sur, Lima, Peru.
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Moscoso-Porras M, Fuhs AK, Carbone A. Access barriers to medical facilities for people with physical disabilities: the case of Peru. CAD SAUDE PUBLICA 2019; 35:e00050417. [PMID: 31800781 DOI: 10.1590/0102-311x00050417] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Accepted: 06/03/2019] [Indexed: 11/22/2022] Open
Abstract
People with disabilities (PWD) face several challenges accessing medical services. However, the extent to which architectural and transportation barriers impede access to healthcare is unknown. In Peru, despite laws requiring that buildings be accessible for PWD, no report confirms that medical facilities comply with such regulations. Thus, we aim to provide an association between these barriers and access to medical facilities. Data from a Peruvian disability survey were analyzed. Participants were 18 years of age and older people who reported having a physical disability. Accessibility was defined by reported struggles accessing medical facilities (health or rehabilitation centers). Absence of ramps, handrails, elevators, adapted bathrooms, and information counters in medical facilities were reported as architectural barriers. The transportation barriers analyzed included struggles using buses or trains. Poisson regression models with robust variance were used to estimate prevalence ratios (PR) and to control for confounding variables. 20,663 participants were included, their mean age was 66.5 years and 57.5% were females. Architectural and transportation barriers reported were 40% and 61%, respectively. All barriers reported were more prevalent in rural compared to urban areas (p < 0.001). Inadequacy of ramps, handrails, and adapted elevators and bathrooms were associated with limited use of rehabilitation centers (p < 0.001) but not of health centers (p > 0.05). Architectural and transportation barriers represent a hindrance to seeking treatment at rehabilitation centers. Actions to improve this situation are needed.
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Affiliation(s)
- Miguel Moscoso-Porras
- Cronicas - Centro de Excelencia en Enfermedades Crónicas, Universidad Peruana Cayetano Heredia, Lima, Perú.,Asociación para el Desarrollo de Investigación Estudiantil en Ciencias de la Salud, Lima, Perú
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10
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Lazo-Porras M, Ortiz-Soriano V, Moscoso-Porras M, Runzer-Colmenares FM, Málaga G, Jaime Miranda J. Cognitive impairment and hypertension in older adults living in extreme poverty: a cross-sectional study in Peru. BMC Geriatr 2017; 17:250. [PMID: 29073885 PMCID: PMC5659043 DOI: 10.1186/s12877-017-0628-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Accepted: 10/08/2017] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Previous studies have shown that hypertension is a risk factor for cognitive impairment, but whether this association is also present in extremely poor populations in Low Middle Income Countries settings remains to be studied. Understanding other drivers of cognitive impairment in this unique population also merits attention. METHODS We performed a secondary analysis using data from the "Encuesta de Salud y Bienestar del Adulto Mayor", a regional survey conducted in an extremely poor population of people older than 65 years old from 12 Peruvian cities in 2012. The outcome variable was cognitive impairment, determined by a score of ≤7 in the modified Mini-Mental State Examination. The exposure was self-reported hypertension status. Variables such as age, gender, controlled hypertension, education level, occupation, depression and area of living (rural/urban) were included in the adjusted analysis. We used Poisson regression with robust variance to calculate prevalence ratios (PR) and 95% confidence interval (95% CI) adjusting for confounders. RESULTS Data from 3842 participants was analyzed, 51.8% were older than 70 years, and 45.6% were females. The prevalence of cognitive impairment was 1.7% (95% CI 1.3%-2.1%). There was no significant difference on the prevalence of cognitive impairment between the group of individuals with hypertension in comparison with those without hypertension (PR = 0.64, 95% CI 0.33-1.23). CONCLUSIONS The association described between hypertension and cognitive impairment was not found in a sample of extremely poor Peruvian older adults.
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Affiliation(s)
- Maria Lazo-Porras
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Av. Armendariz 497, Miraflores, 241 69 78, Lima, Peru. .,Unidad de Conocimiento y Evidencia (CONEVID), Universidad Peruana Cayetano Heredia, Av. Armendariz 497, Miraflores, 241 69 78, Lima, Peru.
| | - Victor Ortiz-Soriano
- Unidad de Conocimiento y Evidencia (CONEVID), Universidad Peruana Cayetano Heredia, Av. Armendariz 497, Miraflores, 241 69 78, Lima, Peru
| | - Miguel Moscoso-Porras
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Av. Armendariz 497, Miraflores, 241 69 78, Lima, Peru
| | | | - German Málaga
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Av. Armendariz 497, Miraflores, 241 69 78, Lima, Peru.,Unidad de Conocimiento y Evidencia (CONEVID), Universidad Peruana Cayetano Heredia, Av. Armendariz 497, Miraflores, 241 69 78, Lima, Peru.,School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru.,Medicine Service, Hospital Cayetano Heredia, Lima, Peru
| | - J Jaime Miranda
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Av. Armendariz 497, Miraflores, 241 69 78, Lima, Peru.,School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
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11
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Miranda JJ, Bernabé-Ortiz A, Diez-Canseco F, Málaga G, Cárdenas MK, Carrillo-Larco RM, Lazo-Porras M, Moscoso-Porras M, Pesantes MA, Ponce V, Araya R, Beran D, Busse P, Boggio O, Checkley W, García PJ, Huicho L, León-Velarde F, Lescano AG, Mohr DC, Pan W, Peiris D, Perel P, Rabadán-Diehl C, Rivera-Chira M, Sacksteder K, Smeeth L, Trujillo AJ, Wells JCK, Yan LL, García HH, Gilman RH. Towards sustainable partnerships in global health: the case of the CRONICAS Centre of Excellence in Chronic Diseases in Peru. Global Health 2016; 12:29. [PMID: 27255370 PMCID: PMC4890274 DOI: 10.1186/s12992-016-0170-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 05/18/2016] [Indexed: 11/10/2022] Open
Abstract
Human capital requires opportunities to develop and capacity to overcome challenges, together with an enabling environment that fosters critical and disruptive innovation. Exploring such features is necessary to establish the foundation of solid long-term partnerships. In this paper we describe the experience of the CRONICAS Centre of Excellence in Chronic Diseases, based at Universidad Peruana Cayetano Heredia in Lima, Peru, as a case study for fostering meaningful and sustainable partnerships for international collaborative research. The CRONICAS Centre of Excellence in Chronic Diseases was established in 2009 with the following Mission: "We support the development of young researchers and collaboration with national and international institutions. Our motivation is to improve population's health through high quality research." The Centre's identity is embedded in its core values - generosity, innovation, integrity, and quality- and its trajectory is a result of various interactions between multiple individuals, collaborators, teams, and institutions, which together with the challenges confronted, enables us to make an objective assessment of the partnership we would like to pursue, nurture and support. We do not intend to provide a single example of a successful partnership, but in contrast, to highlight what can be translated into opportunities to be faced by research groups based in low- and middle-income countries, and how these encounters can provide a strong platform for fruitful and sustainable partnerships. In defiant contexts, partnerships require to be nurtured and sustained. Acknowledging that all partnerships are not and should not be the same, we also need to learn from the evolution of such relationships, its key successes, hurdles and failures to contribute to the promotion of a culture of global solidarity where mutual goals, mutual gains, as well as mutual responsibilities are the norm. In so doing, we will all contribute to instil a new culture where expectations, roles and interactions among individuals and their teams are horizontal, the true nature of partnerships.
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Affiliation(s)
- J Jaime Miranda
- CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Av. Armendáriz 497, Miraflores, Lima 18, Peru.
- School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru.
| | - Antonio Bernabé-Ortiz
- CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Av. Armendáriz 497, Miraflores, Lima 18, Peru
- School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Francisco Diez-Canseco
- CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Av. Armendáriz 497, Miraflores, Lima 18, Peru
| | - Germán Málaga
- CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Av. Armendáriz 497, Miraflores, Lima 18, Peru
- School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
- Division of Internal Medicine, Hospital Nacional Cayetano Heredia, Lima, Peru
| | - María K Cárdenas
- CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Av. Armendáriz 497, Miraflores, Lima 18, Peru
| | - Rodrigo M Carrillo-Larco
- CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Av. Armendáriz 497, Miraflores, Lima 18, Peru
- School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - María Lazo-Porras
- CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Av. Armendáriz 497, Miraflores, Lima 18, Peru
| | - Miguel Moscoso-Porras
- CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Av. Armendáriz 497, Miraflores, Lima 18, Peru
| | - M Amalia Pesantes
- CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Av. Armendáriz 497, Miraflores, Lima 18, Peru
| | - Vilarmina Ponce
- CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Av. Armendáriz 497, Miraflores, Lima 18, Peru
| | - Ricardo Araya
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - David Beran
- Division of Tropical and Humanitarian Medicine, Geneva University Hospitals, Geneva, Switzerland
- University of Geneva, Geneva, Switzerland
| | | | - Oscar Boggio
- Division of Non-Communicable Diseases, Dirección General de Salud de las Personas, Ministerio de Salud, Lima, Peru
| | - William Checkley
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Patricia J García
- School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Luis Huicho
- School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
- Department of Pediatrics, Instituto Nacional de Salud del Niño, Lima, Peru
- School of Medicine, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | | | - Andrés G Lescano
- School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
- Department of Parasitology, and Public Health Training Program, USA Naval Medical Research Unit No. 6 (NAMRU-6), Lima, Peru
| | - David C Mohr
- Center for Behavioral Intervention Technologies, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - William Pan
- Division of Environmental Science and Policy, Nicholas School of the Environment, Duke University, Durham, NC, USA
| | - David Peiris
- The George Institute for Global Health, University of Sydney, Sydney, New South Wales, Australia
| | - Pablo Perel
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
- World Heart Federation, Geneva, Switzerland
| | - Cristina Rabadán-Diehl
- Office of Global Affairs, U.S. Department of Health & Human Services, Washington, DC, USA
| | | | - Katherine Sacksteder
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Liam Smeeth
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Antonio J Trujillo
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jonathan C K Wells
- Childhood Nutrition Research Centre, UCL Institute of Child Health, University College London, London, UK
| | - Lijing L Yan
- Global Health Research Center, Duke Kunshan University, Kunshan, Jiangsu, China
| | - Héctor H García
- School of Medicine, Universidad Nacional Mayor de San Marcos, Lima, Peru
- Center for Global Health - Tumbes, Universidad Peruana Cayetano Heredia, Tumbes, Peru
- Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
| | - Robert H Gilman
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
- Asociación Benéfica PRISMA, Lima, Peru
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