ObjectivesTo determine attention performance of medical students after sleep deprivation due to night shift work.MethodsProspective cohort design. All seventh, eighth and ninth semester students were invited to participate (n= 209). The effectiveness and concentration indices (d2 Test for attention, dependent variable) from 180 students at 3 evaluations during the semester were compared. Eighth and ninth semester students underwent their second evaluation after a night shift. The independent variables were nocturnal sleep measurements.ResultsNo differences in nocturnal sleep hours during the previous week (p=0.966), sleep deprivation (p=0.703) or effectiveness in the d2 Test (p=0.428) were found between the groups at the beginning of the semester. At the beginning and the end of the semester, the d2 Test results were not different between groups (p=0.410, p=0.394) respectively. The second evaluation showed greater sleep deprivation in students with night shift work (p<0.001). The sleep deprived students had lower concentration indices (p<0.001).The differences were associated with the magnitude of sleep deprivation (p=0.008). Multivariate regression analysis showed that attention performance was explained by sleep deprivation due to night shift work, adjusting for age and gender. Students with sleep deprivation had worse concentration than those without.ConclusionsSleep deprivation due to night shift work in medical students had a negative impact on their attention performance. Medical educators should address these potential negative learning and patient care consequences of sleep deprivation in medical students due to night shifts.
Being young, the overrepresentation of females and suffering scholastic and family conflict were noteworthy. Gender association with socio-cultural, behavioural and emotional profile is also worth noting. Socio-family and scholastic conflict is frequent in youth people's suicide attempts. The child-youth suicide problem must be made socially visible to prevent it.
RESUMENObjetivos Determinar en tres municipios de Cundinamarca la prevalencia del Trastorno por Estrés Postraumático (TEPT) infantil y factores asociados, según tipo de exposición a la guerra. Métodos Estudio de corte transversal. Muestra representativa de 493 escolares de 5 a 14 años de edad. 167 niños en La Palma, con exposición crónica; 164 en Arbeláez, con un hostigamiento armado reciente y 162 en Sopó, sin exposición. Por medio de entrevistas psiquiátricas semi-estructuradas y la Escala para Trastorno de Estrés Postraumático Administrada por el Clínico se determinó la prevalencia de TEPT y factores de vulnerabilidad, la razón de desventaja (RD) y Ji-cuadrada. Se hizo análisis multivariado con regresión logística. Los niños afectados requirieron intervención de salud mental. Resultados Prevalencia de TEPT bélico: La Palma 16,8 %, Arbeláez 23,2 %, y Sopó 1,2 %. Al comparar los municipios expuestos con Sopó: RD 19,9 (IC 4,7, 119,2), Ji-cuadrada 30,4 P=0,000. La regresión logística identificó que la proximidad geográfica y la alteración emocional intensa con el evento estresante incrementaron el TEPT. Los factores de vulnerabilidad predominaron en los municipios expuestos a la guerra. Los indicadores de pobreza, baja escolaridad paterna y maltrato infantil predominaron en La Palma. En Arbeláez predominó el déficit de atención y los trastornos psicosomáticos. Conclusiones La Guerra afecta la salud mental infantil. Los niños de los municipios expuestos tuvieron 19 veces mayor probabilidad de sufrir TEPT bélico que los no expuestos. Intervenir tempranamente es prioridad en salud pública. Los resultados son útiles para países con conflicto bélico o terrorismo. ARTÍCULOS/INVESTIGACIÓN
RESUMENObjetivos Caracterizar pacientes con intento suicida atendidos en Psiquiatría en la Unidad Primaria de Atención (UPA) La Estrella entre octubre-2004 y octubre-2005 y determinar la persistencia de ideación suicida, los factores asociados así como factores predictores. Métodos Caracterización inicial de pacientes con intento suicida (n=156). Diseño posterior de casos y controles (n=77) según persistencia de ideación suicida (n=27). Se determinaron los factores asociados y la predicción del riesgo suicida con un modelo multivariado. Resultados Los casos aumentaron de 6 en octubre-2004 hasta 10 en octubre-2005, con promedio mensual: 12 ± 3,6 casos. El 80 % tenía 30 años o menor edad, 66,7 % eran mujeres, 24,4 % estudiantes y 20,5 % desempleados. Como desencadenantes: disfunción familiar y conflictos de pareja en 35,2 % cada uno. El 49 % consumió alcohol previo al intento suicida. La persistencia de ideación suicida se asoció con tener 31 años o más, desempleo, más de un intento suicida previo, conflictos sin resolver y disfunción familiar. La no resolución de conflictos, OR=106,7 (IC 95 %: 6,8, 1668,4) y la disfunción familiar, OR=11,05 (IC95 %: 1,7, 71,2) fueron predictores de la persistencia de ideación suicida en el modelo de regresión logística. Conclusión La no resolución de conflictos y la disfunción familiar, predictores de la persistencia de ideación suicida en sujetos con intento suicida, el consumo de alcohol y otros factores asociados podrían controlarse con programas de prevención y promoción de salud mental.Palabras Clave: Intento de suicidio, conflicto, relaciones familiares, factores de riesgo, Colombia (fuente: DeCS, BIREME). Granada -Modelo movilización actividad física L ABSTRACTObjective Characterising patients attempting suicide who were evaluated by psychiatry at the Primary Care Unit (PCU) "La Estrella" from October/2004 to October/2005 and determining persistent suicidal ideation and associated factors. Methods An initial description of attempted suicide patients (n=156). A subsequent case control study (n=77) determined persistent suicidal ideation cases (n=27). A multivariate model was used for determining the remaining factors associated with persistent suicide ideation. Results Cases increased from 6 in October/2004 to 10 in October/2005, average 12 ± 3,6 cases monthly. 80 % were aged 30 or younger, 66,7 % were female, 24,4 % were students and 20,5 % were unemployed. 35,2 % suffered family dysfunction and 35.2% had conflicts between couples as precipitant factors. 49 % had consumed alcohol prior to the suicide attempt. Persistent suicidal ideation was associated with being 31 years old or older, being unemployed and having a higher number of previous suicide attempts, unresolved conflicts and family dysfunction. Logistical regression revealed unresolved conflicts (OR=106.7; 6,8; 1 668,4 95 % CI) and family dysfunction (OR=11.05; 1,7; 71,2 95 % CI) as predictor variables for persistent suicidal ideation. Conclusion Unresolved conflicts and family dysfunction were found to be predicto...
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