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Objetivo: analizar cuáles son las variables tecnológicas, derivadas del uso de dispositivo electrónico, predicen el estrés académico, y sus dimensiones en estudiantes de enfermería. Método: estudio transversal de tipo analítico, realizado en 796 estudiantes de seis universidades de Perú. Se empleó la escala SISCO y para el análisis se estimaron cuatro modelos de regresión logística, con selección de variables por pasos. Resultados: entre los participantes, 87,6% presentaron un nivel alto de estrés académico; el tiempo de uso del dispositivo electrónico, el brillo de la pantalla, la edad y el sexo, estuvieron asociados con el estrés académico y sus tres dimensiones; la posición de uso del dispositivo electrónico estuvo asociada con la escala total y con las dimensiones estresores y reacciones. Finalmente, la distancia entre el rostro y el dispositivo electrónico estuvo asociada con la escala total y la dimensión reacciones. Conclusión: las variables tecnológicas y las características sociodemográficas predicen el estrés académico en estudiantes de enfermería. Se sugiere optimizar el tiempo de uso de las computadoras, regular el brillo de la pantalla, evitar sentarse en posiciones inadecuadas y vigilar la distancia, con la finalidad de reducir el estrés académico durante la enseñanza a distancia.

Objective: to analyze which technological variables, derived from the use of electronic devices, predict academic stress and its dimensions in Nursing students. Method: analytical cross-sectional study carried out with a total of 796 students from six universities in Peru. The SISCO scale was used and four logistic regression models were estimated for the analysis, with selection of variables in stages. Results: among the participants, 87.6% had a high level of academic stress; time using the electronic device, screen brightness, age and sex were associated with academic stress and its three dimensions; the position of using the electronic device was associated with the total scale and the stressors and reactions dimensions. Finally, the distance between the face and the electronic device was associated with the total scale and size of reactions. Conclusion: technological variables and sociodemographic characteristics predict academic stress in nursing students. It is suggested to optimize the time of use of computers, regulate the brightness of the screen, avoid sitting in inappropriate positions and pay attention to the distance, in order to reduce academic stress during distance learning.

RESUMEN Objetivo: Analizar la Teleorientación como una estrategia costo efectivo para la atención de personas con Hipertensión Arterial (HTA) en el contexto Covid -19. Materiales y Métodos: Artículo de reflexión sobre el análisis crítico de la teleorientación de personas con hipertensión arterial en contexto COVID-19, que resalta aspectos del marco normativo, ventajas y beneficios para los usuarios y los servicios de salud.Resultados: La teleorientación representó una estrategia costo efectiva beneficiosa en países de Sudamérica ya que permitió brindar educación, seguimiento y atención de salud oportuna al paciente con HTA, disminuyó el costo farmacológico mensual de S/. 5.76, mejoraría la calidad de vida al identificar signos y síntomas de alerta de la HTA, disminuyó la demanda laboral y costos en hospitales para el personal de salud reduciendo tiempo de espera y riesgos de contagio con enfermedades concomitantes Conclusión: Resulta adecuado considerar a la teleorientación como una medida costo efectiva en el seguimiento, tratamiento, atención y educación de las personas con HTA, debido a que podría incrementar la esperanza de vida de estos pacientes, evitar la exposición innecesaria a otras enfermedades durante la asistencia a los establecimientos de salud, disminuir la carga laboral del profesional de salud y reduciría costos del sistema de atención en salud orientados a gastos farmacológicos y horarios prolongados de espera; asimismo, constituye uno de los primeros pasos hacia la transformación digital en salud, en la cual Sudamérica aún se encuentra en proceso de desarrollo. Palabras Claves: Teleorientación; hipertensión arterial, COVID-19.

RESUMEN Objetivo: Identificar los factores asociados a las actitudes hacia la violencia (AHV) en escolares de instituciones educativas (IE) públicas ubicadas en zonas urbano-marginales de Lima Metropolitana en 2019. Materiales y métodos: Estudio observacional, descriptivo y transversal. Los participantes fueron adolescentes de diez IE mixtas del sexto grado de primaria al tercer año de secundaria. Se empleó el cuestionario de actitudes hacia la violencia (CAHV25). En el análisis bivariado se empleó la prueba de coeficiente de correlación de Spearman, la U de Mann-Whitney y la H de KruskalWallis con post hoc de Dunn, ajustado por método de Bonferroni. Para determinar los factores asociados se realizó el análisis multivariado mediante un modelo de regresión binomial negative. Resultados: El 45,1% de escolares fueron de sexo femenino y el 87,3% recibió información sobre acoso escolar. En el análisis bivariado, se encontraron diferencias estadísticamente significativas entre los puntajes de las AHV con la edad (p=0,003), el sexo (p

Resumen Objetivo: analizar la relación entre la preocupación y el miedo al COVID-19 con el fatalismo, en lo cotidiano laboral de los enfermeros. Método: estudio transversal tipo analítico, realizado en 449 enfermeros. La recolección de datos se realizó mediante instrumentos validados en Perú. En el análisis se utilizó la prueba de Shapiro-Wilk, el coeficiente de correlación de Spearman y se estimaron dos modelos de regresión múltiple, con selección de variables por pasos. Resultados: los enfermeros presentaron un nivel moderado de fatalismo y un nivel bajo de miedo y preocupación por la COVID-19. El primer modelo estadístico que incluyó las variables sociodemográficas apenas explica un 3% de la varianza de fatalismo; sin embargo, un segundo modelo que incluye el miedo y la percepción explica el 33%. Conclusión: la preocupación, el miedo y el haber sido diagnosticado con COVID-19 fueron factores predictores de fatalismo. Se sugiere implementar intervenciones psicoemocionales en el cotidiano laboral - focalizadas en profesionales de Enfermería que presenten altos niveles de miedo o preocupación - para reducir el fatalismo y de esta manera prevenir consecuencias fatales de la pandemia y promover la salud.

Objective: To identify the factors associated with the use of the N95 respirator in Nursing and Medical students in the daily life of the covid-19 pandemic. Methods: Descriptive-analytical cross-sectional study carried out in 2020. A total of 830 students from three universities in Peru participated in the study. Associations were evaluated using Pearson’s Chi-Square and multivariate Poisson modeling with log linkage. Results: Statistically significant differences were found between the preference to use the N95 respirator in relation to masks according to the activity they perform (p=0.001) and where they live (p=0.005). The multivariate analysis reported that the associated characteristics were age, activity performed, perception and fear of being infected by covid-19. Conclusion: The choice of N95 respirator is influenced by individual factors and perceptions. Spaces are needed to discuss daily life, the way of living, caring and educating, considering the socioeconomic dimensions and beliefs.

There has been a high prevalence of digital eye strain (DES) among students who have received distance-learning lessons due to COVID-19. However, in low- and middle-income countries, there are few studies that have analyzed its associated factors. This study aimed to determine the prevalence of DES and its associated factors among nursing students during COVID-19 distance learning. This was a cross-sectional analytical study conducted between May and June 2021 in six Peruvian universities. The sample comprised 796 nursing students. DES was measured using the Computer Vision Syndrome Questionnaire (CVS-Q). A bivariate logistic regression analysis was performed. DES was found in 87.6% of nursing students. Sitting upright (OR, 0.47; 95% IC, 0.30–0.74), using electronic devices for more than four hours a day (OR, 1.73; 95% IC, 1.02–2.86), not following the 20-20-20 rule (OR, 2.60; 95% IC, 1.25–5.20), having the screen brightness very high (OR, 3.36; 95% IC, 1.23–11.8), and not wearing glasses (OR, 0.59; 95% IC, 0.37–0.93) are factors associated with DES. The prevalence of DES among nursing students is high. Improving the ergonomics of study environments, reducing the time of exposure to electronic devices, adjusting the screen brightness, and taking eye-care measures are key to controlling computer vision syndrome in virtual learning.

Objetivo:analizar la relación entre la preocupación y el miedo al COVID-19 con el fatalismo, en lo cotidiano laboral de los enfermeros.Método:estudio transversal tipo analítico, realizado en 449 enfermeros. La recolección de datos se realizó mediante instrumentos validados en Perú. En el análisis se utilizó la prueba de Shapiro-Wilk, el coeficiente de correlación de Spearman y se estimaron dos modelos de regresión múltiple, con selección de variables por pasos.Resultados:los enfermeros presentaron un nivel moderado de fatalismo y un nivel bajo de miedo y preocupación por la COVID-19. El primer modelo estadístico que incluyó las variables sociodemográficas apenas explica un 3% de la varianza de fatalismo; sin embargo, un segundo modelo que incluye el miedo y la percepción explica el 33%.Conclusión:la preocupación, el miedo y el haber sido diagnosticado con COVID-19 fueron factores predictores de fatalismo. Se sugiere implementar intervenciones psicoemocionales en el cotidiano laboral - focalizadas en profesionales de Enfermería que presenten altos niveles de miedo o preocupación - para reducir el fatalismo y de esta manera prevenir consecuencias fatales de la pandemia y promover la salud. Objective:to analyze the relationship between the concern and fear of COVID-19 with fatalism in the daily work of nurses.Method:analytical cross-sectional study carried out with a total of 449 nurses. Data collection was performed using instruments validated in Peru. In the analysis, the Shapiro-Wilk test and the Spearman correlation coefficient were used, and two multiple regression models were estimated, with variable selection in stages. Results:nurses had a moderate level of fatalism and a low level of fear and concern about COVID-19. The first statistical model, which included sociodemographic variables, explains only 3% of the fatalism variance. However, a second model that includes fear and perception explains 33% of it. Conclusion:Worry, fear and having been diagnosed with COVID-19 were predictors of fatalism. It is suggested the implementation of psycho-emotional interventions in daily work - aimed at Nursing professionals who present high levels of fear or concern - to reduce fatalism and prevent fatal consequences of the pandemic and promote health. Objetivo:analisar a relação entre a preocupação e o medo da COVID-19 com o fatalismo no cotidiano de trabalho dos enfermeiros.Método:estudo transversal analítico, realizado com 449 enfermeiros. A coleta de dados foi realizada por meio de instrumentos validados no Peru. Na análise, foram utilizados o teste de Shapiro-Wilk e o coeficiente de correlação de Spearman, sendo estimados dois modelos de regressão múltipla, com seleção de variáveis por etapas.Resultados:os enfermeiros apresentaram nível moderado de fatalismo e baixo nível de medo e preocupação com a COVID-19. O primeiro modelo estatístico, que incluiu variáveis sociodemográficas, explica apenas 3% da variância de fatalismo. No entanto, um segundo modelo que inclui medo e percepção explica 33%.Conclusão:a preocupação, o medo e ter sido diagnosticado com COVID-19 foram fatores preditores de fatalismo. Sugere-se a implementação de intervenções psicoemocionais no cotidiano de trabalho, voltadas para profissionais de Enfermagem que apresentem altos níveis de medo ou preocupação, para reduzir o fatalismo e, assim, prevenir consequências fatais da pandemia e promover a saúde.

Background We determined the frequency of genetic polymorphisms in three anti‐TB drug metabolic proteins previously reported: N‐acetyltransferase 2 (NAT2), cytochrome P450 2E1 (CYP2E1), and arylacetamide deacetylase (AADAC) within a Peruvian population in a cohort of TB patients. Methods We genotyped SNPs rs1041983, rs1801280, rs1799929, rs1799930, rs1208, and rs1799931 for NAT2; rs3813867 and rs2031920 for CYP2E1; and rs1803155 for AADAC in 395 participants completed their antituberculosis treatment. Results Seventy‐four percent of the participants are carriers of slow metabolizer genotypes: NAT2*5, NAT2*6, and NAT2*7, which increase the sensitivity of INH at low doses and increase the risk of drug‐induced liver injuries. Sixty‐four percent are homozygous for the wild‐type CYP2E1*1A allele, which could increase the risk of hepatotoxicity. However, 16% had a NAT2 fast metabolizer phenotype which could increase the risk of acquiring resistance to INH, thereby increasing the risk of multidrug‐resistant (MDR) or treatment failure. The frequency of rs1803155 (AADAC*2 allele) was higher (99.9%) in Peruvians than in European American, African American, Japanese, and Korean populations. Conclusions This high prevalence of slow metabolizers for isoniazid in the Peruvian population should be further studied and considered to help individualize drug regimens, especially in countries with a great genetic diversity like Peru. These data will help the Peruvian National Tuberculosis Control Program develop new strategies for therapies., High prevalence of slow metabolizers for isoniazid in the Peruvian population should be further studied and considered to help individualize drug regimens, especially in countries with a great genetic diversity like Peru.

Background Tuberculosis (TB) prevention through the use of preventive treatment is a critical activity in the elimination of TB. In multiple settings, limited staffing has been identified as a barrier to managing preventive treatment for TB contacts. This study aims to determine how health center staffing, service type, and TB caseload affects implementation of isoniazid preventive therapy (IPT) for TB contacts in southern Lima. Methods We conducted an ecological study in 2019 in southern Lima, Peru. Through the review of medical records, we identified contacts of TB patients who initiated IPT during 2016–2018, and who were 0–19 years old, the age group eligible for IPT according to Peruvian guidelines. We assessed bivariate associations between health center characteristics (numbers of physicians and nurses, types of services available, annual TB caseload) and IPT initiation and completion using binomial logistic regression. Results Among 977 contacts, 69% took more than a week to start IPT and 41% did not complete IPT. For those who successfully completed IPT, 58% did not complete full medical follow-up. There was no significant difference in IPT completion or adherence based on whether health centers had more physicians and nurses, more comprehensive services, or higher TB caseloads. Among contacts, female sex was associated with delay in initiating IPT (P = 0.005), age 5–19 years old was associated with completion of IPT (P = 0.025) and age P = 0.041). Conclusions There are significant gaps in IPT implementation in health centers of southern Lima, Peru, but insufficient staffing of health centers may not be responsible. Further research is needed to identify how IPT implementation can be improved, potentially through improving staff training or monitoring and supervision. Graphic abstract

Forty-six health centers in south Lima, Peru.To assess the association between caregivers' knowledge and perceptions around isoniazid preventive therapy (IPT) and whether their children complete IPT.We conducted a retrospective medical record review of children who initiated IPT during 2017-2018. We administered structured surveys to caregivers of the children about their knowledge about and perceptions of IPT. We used a modified Poisson regression to determine factors associated with IPT completion.We included 550 children, of whom 31% did not complete IPT. Independent factors associated with not completing IPT were low caregiver knowledge about TB and IPT (adjusted risk ratio [aRR] 1.41, 95% CI 1.06-1.78), low caregiver perception of the importance of IPT (aRR 1.76, 95% CI 1.30-2.39), low caregiver satisfaction with the health services (aRR 1.57, 95% CI 1.14-2.16), experience of adverse events (aRR 2.08, 95% CI 1.51-2.87), and living in a household with moderate or severe family dysfunction (aRR 1.53, 95% CI 1.07-2.19).IPT completion among children was associated with the knowledge and perceptions of their caregivers, as well as the experience of adverse events. To improve IPT completion among children, health care providers should prioritize education and counseling for caregivers, promote positive interpersonal relationships with them, and monitor adverse events.Quarante-six centres de santé au Sud de Lima, Pérou.Evaluer l’association entre les connaissances et les perceptions relatives au traitement préventif par l’isoniazide (TPI) des responsables des enfants et le fait que leurs enfants aient achevé le TPI.Nous avons réalisé une revue rétrospective des dossiers médicaux des enfants qui ont démarré le TPI entre 2017 et 2018. Nous avons administré aux responsables des enfants des questionnaires structurés relatifs à leurs connaissances et perceptions du TPI. Nous avons utilisé une régression de Poisson modifiée afin de déterminer les facteurs associés à l’achèvement du TPI.Nous avons inclus 500 enfants dont 31% n’ont pas achevé le TPI. Les facteurs indépendants associés au non achèvement étaient faibles connaissances relatives à la TB et au TPI (risque relatif ajusté [RRa] 1,41 ; IC 95% 1,06–1,78), faibles perception par les responsables de l’importance du TPI (RRa 1,76 ; IC 95% 1,30–2,39), faible taux de satisfaction des responsables par rapport aux services de santé (RRa 1,57 ; IC 95% 1,14–2,16), survenue d’effets secondaires (RR 2,08 ; IC 95% 1,51–2,87) et dysfonction familiale modérée ou grave (RRa 1,53 ; IC 95% 1,07–2,19).L’achèvement du TPI chez les enfants a été associé aux connaissances et perceptions de leurs responsables, ainsi qu’à la survenue d’effets secondaires. Pour améliorer l’achèvement du TPI chez les enfants, les prestataires de soins de santé devraient accorder la priorité à l’éducation des responsables, promouvoir des relations inter personnelles positives avec eux et surveiller les effets secondaires.

Background: Prevention of TB through the use of preventive treatment is a critical activity in the elimination of TB. Health personnel are a key element in achieving proper management of isoniazid preventive therapy (IPT) for TB contacts. This study aims to determine the association between health center characteristics and indicators of TB contact care management with isoniazid preventive therapy in southern Lima. Methods: We conducted an ecological study. Through the review of medical records, we identified children and adolescent contacts of tuberculosis patients, who initiated IPT between 2016 and 2018. We assessed bivariate associations between clinic staffing and IPT initiation and completion using binomial logistic regression with robust standard errors.Results: We included 977 contacts, among whom 69% took more than a week to start IPT and 41% did not complete IPT. For those who did successfully complete IPT, 58% were not medically evaluated with three follow-up appointments. While completion of IPT and 3 clinical appointments was better among health centers with more physicians and nurses, these differences were not statistically significant. Contact sex was associated with initiating IPT (p=0.005), and contact age was associated with completion of IPT (p=0.025) and completion of clinical evaluations (p=0.041). Conclusion: There are significant gaps in IPT management in health centers of southern Lima, Peru, but insufficient staffing of health centers may not be responsible. Further research is needed to identify how IPT management can be improved, including through improving training and staffing.

Objective: To understand the experiences of parents of children with cancer who come from areas distant from Lima-Peru during the search for cancer treatment for their children. Method: A descriptive-exploratory qualitative approach study. Focus groups and semi-structured interviews were carried out. The sample consisted of 18 parents who come from remote areas from Lima who attended specialized hospitals. The qualitative analysis was of thematic content, proposed by Minayo. Results: Three categories emerged: Accessing cancer care in Lima hospitals; Having diverse personal experiences during their child’s treatment; and Reporting the socioeconomic and labor impact during their stay in Lima. Final considerations: Understanding these experiences could help health professionals to implement strategies of socioeconomic support to facilitate access to health services for children with cancer. Hospitals must guarantee the satisfaction of the basic needs of parents. RESUMO Objetivo: Compreender as experiências de pais de crianças com câncer provenientes de áreas distantes de Lima, Peru, durante a busca pelo tratamento oncológico de seus filhos. Método: Estudo de abordagem qualitativa, do tipo descritivo-exploratório. Grupos focais e entrevistas semiestruturadas foram realizadas. A amostra foi composta por 18 pais de áreas remotas que foram a hospitais e a análise foi do tipo temático proposto por Minayo. Resultados: Surgiram três categorias: Acesso ao tratamento do câncer nos hospitais de Lima; Tendo diversas experiências pessoais durante o tratamento do filho; e Relatando o impacto socioeconômico e trabalhista durante a estadia em Lima. Considerações finais: O entendimento dessas experiências poderia ajudar aos profissionais de saúde a implementar estratégias de apoio socioeconômico para facilitar o acesso de crianças com câncer aos serviços de saúde. Os hospitais devem garantir a satisfação das necessidades básicas dos pais. RESUMEN Objetivo: Comprender las experiencias de los padres de niños con cáncer que proceden de zonas distantes a Lima-Perú durante la búsqueda del tratamiento oncológico de sus hijos. Método: Estudio de enfoque cualitativo tipo descriptivo-exploratorio. Se realizó grupos focales y entrevistas semiestructuradas. La muestra estuvo constituida por 18 padres provenientes de zonas alejadas a Lima que acudieron a hospitales especializados. El análisis cualitativo fue de contenido temático, propuesto por Minayo. Resultados: Emergieron tres categorías: Accediendo a atención oncológica en los hospitales de Lima; Teniendo diversas experiencias personales durante el tratamiento de su niño; y Relatando el impacto socioeconómico y laboral durante su permanencia en Lima. Consideraciones finales: Comprender estas experiencias podría ayudar a los profesionales de la salud a implementar estrategias de soporte socioeconómico para facilitar el acceso de los niños con cáncer a los servicios de salud. Los hospitales deben garantizar la satisfacción de necesidades básicas de los padres.

Background: Giving preventive therapy to children living in the households of TB patients to prevent them from developing TB themselves is important for reducing morbidity and mortality in this high-risk group. Children’s adherence to medications is likely dependent on their caregivers. We conducted a study to assess the association between caregivers’ knowledge and perceptions around isoniazid preventive therapy (IPT) and whether their children completed IPT. Methods: We conducted a retrospective medical record review of children who initiated IPT during 2017-2018 in 50 health facilities in south Lima, Peru. We administered structured surveys to caregivers of the children and about their knowledge and perceptions around IPT. To determine factors associated with IPT completion, we used a modified Poisson regression with generalized estimating equations to account for clustering by household. Results: We included in the study 550 children, of whom 31% did not complete IPT. Independent factors associated with not completing IPT were: low caregiver knowledge about TB and IPT (adjusted risk ratio [aRR]: 1.41; 95% confidence interval [CI]: 1.06-1.78), low caregiver perception of the importance of IPT (aRR: 1.76; 95% CI: 1.30-2.39), low caregiver satisfaction with the health services (aRR: 1.57; 95% CI: 1.14-2.16), experiencing adverse events (aRR: 2.08; 95% CI: 1.51-2.87), and living in a household with moderate or severe family dysfunction (aRR: 1.53; 95% CI: 1.07-2.19). Conclusions: IPT completion among children was associated with the knowledge and perceptions of their caregivers, as well as whether they experienced adverse events. To improve IPT completion among children, health care providers should prioritize education and counseling for caregivers, promote positive interpersonal relationships with them, and monitor adverse events.

To identify factors associated with attitudes towards violence (ATV) in schoolchildren from public educational institutions (EI) located in marginal urban areas of Metropolitan Lima in 2019.Observational, descriptive and transversal study. The sample was made up of adolescents from 10 mixed-gender EIs enrolled between the sixth grade of primary school and the third year of secondary school. The questionnaire of attitudes towards violence (CAHV-25) was used. During the bivariate analysis, the Spearman Correlation Coefficient, the Mann-Whitney U test and the Kruskal-Wallis H test with Dunn's post-hoc adjusted by Bonferroni were used. To determine the associated factors, multivariate analysis was performed using negative binomial regression model.45.1% of the schoolchildren were female and 87.3% received information on school bullying. In the bivariate analysis, statistically significant differences were found between the ATV scores and age (p = 0.003), sex (p 0.001), having a social network account (p = 0.009) and year of study (p 0.001); however, in the multivariate model, the factors associated with the total ATV scores were age (p = 0.012) and sex (p 0.001).The factors associated with ATV in schoolchildren from public EIs were age and sex, these findings would indicate the need to consider the gender perspective in the analysis of school violence and differentiate interventions according to age.Identificar los factores asociados a las actitudes hacia la violencia (AHV) en escolares de instituciones educativas (IE) públicas ubicadas en zonas urbano-marginales de Lima Metropolitana en 2019.Estudio observacional, descriptivo y transversal. Los participantes fueron adolescentes de diez IE mixtas del sexto grado de primaria al tercer año de secundaria. Se empleó el cuestionario de actitudes hacia la violencia (CAHV25). En el análisis bivariado se empleó la prueba de coeficiente de correlación de Spearman, la U de Mann-Whitney y la H de Kruskal Wallis con post hoc de Dunn, ajustado por método de Bonferroni. Para determinar los factores asociados se realizó el análisis multivariado mediante un modelo de regresión binomial negative.El 45,1% de escolares fueron de sexo femenino y el 87,3% recibió información sobre acoso escolar. En el análisis bivariado, se encontraron diferencias estadísticamente significativas entre los puntajes de las AHV con la edad (p = 0,003), el sexo (p 0,001), tener una cuenta de red social (p = 0,009) y el año de estudios (p 0,001); sin embargo, en el modelo multivariado, los factores que estuvieron asociados al puntaje total de las AHV fueron la edad (p = 0,012) y el sexo (p 0,001).Los factores asociados a las AHV en escolares de IE públicas fueron la edad y el sexo; estos hallazgos indicarían la necesidad de considerar la perspectiva de género en el análisis de la violencia escolar y diferenciar las intervenciones según edad.