Background Previous studies have assessed the prevalence and characteristics of self-medication in COVID-19. However, no systematic review has summarized their findings. Objective We conducted a systematic review to assess the prevalence of self-medication to prevent or manage COVID-19. Methods We used different keywords and searched studies published in PubMed, Scopus, Web of Science, Embase, two preprint repositories, Google, and Google Scholar. We included studies that reported original data and assessed self-medication to prevent or manage COVID-19. The risk of bias was assessed using the Newcastle–Ottawa Scale (NOS) modified for cross-sectional studies. Results We identified eight studies, all studies were cross-sectional, and only one detailed the question used to assess self-medication. The recall period was heterogeneous across studies. Of the eight studies, seven assessed self-medication without focusing on a specific symptom: four performed in the general population (self-medication prevalence ranged between <4% to 88.3%) and three in specific populations (range: 33.9% to 51.3%). In these seven studies, the most used medications varied widely, including antibiotics, chloroquine or hydroxychloroquine, acetaminophen, vitamins or supplements, ivermectin, and ibuprofen. The last study only assessed self-medication for fever due to COVID-19. Most studies had a risk of bias in the “representativeness of the sample” and “assessment of outcome” items of the NOS. Conclusions Studies that assessed self-medication for COVID-19 found heterogeneous results regarding self-medication prevalence and medications used. More well-designed and adequately reported studies are warranted to assess this topic.

RESUMENObjetivos. Evaluar la frecuencia de publicación y sus factores asociados en docentes universitarios de investigación científica de escuelas de Medicina del Perú. Materiales y métodos. Estudio de corte transversal analítico. Se incluyó a todos los docentes universitarios de los cursos de investigación de las 32 escuelas de medicina del Perú en el año 2011. La búsqueda de publicaciones se realizó mediante Google Scholar, SCOPUS y Medline. Se calculó las razones de prevalencias crudas y ajustadas (RPa) con intervalos de confianza al 95% mediante regresión de Poisson simple y múltiple con varianza robusta. Resultados. De los 201 docentes universitarios, 43,8% nunca ha publicado un artículo en una revista, 26,9% publicó un artículo original en una revista indizada en Medline y 16,4% lo hizo en los últimos dos años. Solo 3,0% han sido autores corresponsales en alguna revista indizada no peruana. Los factores asociados con haber publicado un artículo original en Medline durante los dos últimos años es ser menor de 40 años de edad (RPa: 2,97; IC 95%:1,21-7,32), ser profesor en una universidad donde se requiere tesis obligatoria para graduarse (RPa: 8,84; IC 95%: 2,60-30,12) y trabajar para una universidad altamente productiva (RPa: 3,24; IC 95%: 1,03-10,20). Conclusiones. La frecuencia de publicación de los docentes en investigación de las escuelas de medicina del Perú es baja. Los docentes universitarios jóvenes y los que trabajan para universidades científicamente productivas presentaron más probabilidades de publicar en una revista indizada en Medline. ABSTRACT Objectives.To evaluate the frequency of publication and its associated factors by professors of scientific research in medical schools in Peru. Materials and methods. This was a cross-sectional study. We included all teachers of research courses from the 32 medical schools in Peru in 2011. The publication search was conducted using Google Scholar, Scopus and Medline. Both the crude and adjusted prevalence ratios (aPR) were calculated with confidence intervals at 95% using simple and multiple Poisson regression with robust variance. Results. Of the 201 university teachers, 43.8% had never published an article in a journal, 26.9% had an original article published in a journal indexed in Medline and 16.4% did so in the past two years. Only 3% had been corresponding authors in non-Peruvian, indexed journals Factors associated with having an original article published in Medline in the past two years were: being under 40 years of age (aPR 2.97, 95% CI: 1.21-7.32), being a professor at a university where a final thesis is required for graduation (aPR 8.84, 95% CI: 2.60-30.12) and working for a highly productive university (aPR 3.24, 95% CI: 1.03-10.20). Conclusions. The frequency of publication of research faculty in medical schools in Peru is low. Young university teachers and those working at scientifically productive universities were more likely to publish in an indexed journal.

BackgroundDog-assisted therapy (DAT) is a non-pharmacological intervention based on the interaction between patients and dogs, which has been proposed to help adults with dementia. However, evidence to support it is lacking. Thus, we aim to evaluate the effects of DAT on this population and to assess the certainty of the evidence of the RCTs estimates.MethodsA systematic search was performed. We included randomized controlled trials (RCTs) and quasi-experimental (QE) controlled studies published up to March 2018, which evaluated the beneficial and deleterious effects of DAT in adults with dementia. Mean differences (MD) or standardized mean differences (SMD) and their 95% confidence intervals (95% CI) were calculated and random effects meta-analyses were performed. Certainty of evidence was assessed for RCTs estimates using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. The study protocol has been registered in PROSPERO (CRD42018090434).ResultsTen studies (six RCTs and four QE controlled studies) were eligible for inclusion. Meta-analysis of RCTs showed no effect of DAT in daily life activities (SMD: 0.16; 95% CI: -0.80 to 1.12), depression (SMD: -0.45; 95% CI: -2.81 to 1.91), agitation (SDM: -1.12; 95% CI: -2.67 to 0.43), quality of life (SDM: 0.16; 95% CI: -0.41 to 0.73), and cognitive impairment (SDM: -0.52; 95% CI: -1.33 to 0.30), but it found a beneficial effect in apathy (1 study, n = 37, MD: 1.81; 95% CI: 1.26 to 2.36). All outcomes had a very low certainty of evidence according to GRADE methodology.ConclusionsRCTs evidence of very low certainty suggests that, in adults with dementia, DAT has no effect in daily life activities, depression, agitation, quality of life, and cognitive impairment, although one small study found an apparent beneficial effect in apathy. More well-designed and correctly reported studies are needed in order to provide a conclusion.Trial registrationCRD42018090434 (PROSPERO).Electronic supplementary materialThe online version of this article (10.1186/s12888-018-2009-z) contains supplementary material, which is available to authorized users.

Nearly all participants reported having experienced at least one category of disrespect and abuse during childbirth care, which was associated with type of delivery, being referred, and geographic region.

Background Research suggested that waiting time and consultation time are associated with overall patient satisfaction concerning health services. However, there is a lack of information regarding this subject in Latin American countries, where particular aspects of health systems and population characteristics could modify this association. Our aim was to evaluate the association of waiting time and consultation time with patient satisfaction, in Peruvian ambulatory care facilities and propose a cut-off points of waiting and consultation time based on patient satisfaction. Methods Cross-sectional secondary data analysis of the National Survey on User Satisfaction of Health Services (ENSUSALUD-2015), a national-wide survey with a probabilistic sample of 181 Peruvian ambulatory care facilities. Patient satisfaction, waiting time, consultation time, and sociodemographic variables were collected from the ENSUSALUD-2015. All variables were collected by survey directly to patients, from the selected ambulatory care facilities, after their consultation. Complex survey sampling was considered for data analysis. In the association analysis, we grouped the waiting time and consultation time variables, every 10 min, because for it is more relevant and helpful in the statistical and practical interpretation of the results, instead of the every-minute unit. Results The survey was performed in 13,360 participants. Response rate were 99.8 to 100% in the main variables. Waiting time (for every 10 min) was inversely associated with patient satisfaction (aOR: 0.98, 95% CI: 0.97–0.99), although the aOR was lower among those who reported a waiting time ≤ 90 min (aOR: 0.92, 95% CI: 0.89–0.96). Consultation time (for every 10 min) was directly associated with patient satisfaction (aOR: 1.59, 95% CI: 1.26–2.01), although the aOR was higher among those who reported a consultation time ≤ 15 min (aOR: 2.31, 95% CI: 1.66–3.21). Conclusion In Peruvian ambulatory care facilities, both waiting time and consultation time showed an association with overall patient satisfaction, which was stronger in the first 90 min of waiting time and in the first 15 min of consultation time. This should be taken into consideration when designing interventions to improve waiting times and consultation times in ambulatory care facilities from Peru or from similar contexts.

Peru, one of the most affected countries by the coronavirus disease 2019 (COVID-19) pandemic, imposed one of the earliest and toughest lockdowns in the world. 1 Despite regional variations, the overall picture situates Peru amongst the worst hit in the number of cases, deaths per million, and total excess deaths. 2 Factors contributing to these results are diverse, including geopolitics, international supply chain, political instability, social and economic crisis, and corruption.

BackgroundUnmanned aircraft vehicles (UAVs) have had a rapid escalation in manageability and affordability, which can be exploited in healthcare. We conducted a systematic review examining the use of drones for health-related purposes.MethodsA search was conducted in Medline, Embase, Global Health, Scopus, CINAHL and SciELO. Experimental studies were selected if the population included human subjects, the intervention was the use of UAVs and there was a health-related outcome.ResultsOf 500 results, five met inclusion criteria during an initial search. An updated search yielded four additional studies. Nine studies, all in high-income countries, were included for systematic syntheses: four studies addressed out-of-hospital cardiac arrest emergencies, three assessed drones for identification of people after accidents, one used drones to transport blood samples and one used drones to improve surgical procedures in war zones.ConclusionsResearch on the use of drones in healthcare is limited to simulation scenarios, and this review did not retrieve any studies from low- and middle-income countries.

Background: Three previous clinical trials have found that thermometry use reduced diabetic foot ulcers (DFUs) incidence four- to ten-fold among individuals with diabetes at high-risk of developing a DFU. However, these benefits depend on patient adherence to self-assessment. Therefore, novel approaches to improve self-management thermometry adherence are needed. Our objective was to compare incidence of DFUs in the thermometry plus mobile health (mHealth) reminders intervention arm vs. thermometry-only control arm. Methods: We conducted a randomized trial, enrolling adults with type 2 diabetes mellitus at risk of foot ulcers (risk groups 2 or 3) but without foot ulcers at the time of recruitment and allocating them to control (instruction to use a liquid crystal-based foot thermometer daily) or intervention (same instruction supplemented with text and voice messages with reminders to use the device and messages to promote foot care) groups and followed for 18 months. The primary outcome was time to occurrence of DFU. A process evaluation was also conducted. Results: A total of 172 patients (63% women, mean age 61 years) were enrolled; 86 to each study group. More patients enrolled in the intervention arm had a history of DFU (66% vs. 48%). Follow-up for the primary endpoint was complete for 158 of 172 participants (92%). DFU cumulative incidence was 24% (19 of 79) in the intervention arm and 11% (9 of 79) in the control arm. After adjusting for history of foot ulceration and study site, the Hazard Ratio (HR) for DFU was 1.44 (95% CI 0.65, 3.22). Adherence to ≥80% of daily temperature measurements was 87% (103 of 118) among the study participants who returned the logbook, with no difference between the intervention and control arms. Conclusions: This trial contributes to the evidence about the value of mHealth in preventing diabetes foot ulcers. Trial registration: ClinicalTrials.gov NCT02373592 (27/02/2015)