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1.

Propuesta de un Programa de Vigilancia Ambiental y de Salud para Trabajadores con Exposición a Agentes Químicos en Fundiciones de Cobre en Chile/ ENVIRONMENTAL AND HEALTH SURVEILLANCE PROGRAM PROPOSAL FOR WORKERS EXPOSED TO CHEMICAL AGENTS IN COPPER SMELTERS IN CHILE

Pérez-Montoya, Sergio Alfredo
| Idioma(s): Español
RESUMEN El presente trabajo tiene por objetivo proponer un programa de vigilancia ambiental y de salud para trabajadores expuestos a agentes químicos en fundiciones de cobre. La metodología fue en base a revisión bibliográfica en inglés y en español, búsqueda manual dirigida y criterio de expertos por medio de entrevistas cualitativas no estructuradas. El proceso de búsqueda se dividió en dos etapas, la primera orientada a responder dos preguntas relacionadas al estado del arte de programas preventivos de exposición y, la segunda, relacionada a búsqueda de referencias orientada a la vigilancia ambiental y de la salud en el trabajo. Se seleccionaron artículos científicos, donde se identificaron protocolos, normas, estándares y documentos de diversas organizaciones para la vigilancia ambiental y de la salud, desde los cuales se realizó una nueva búsqueda manual dirigida, sustentada por la directrices señaladas por expertos de las áreas de Higiene y Salud Ocupacional que colaboraron en el diseño del programa. Como resulado, los puntos más importantes fueron la identificación, evaluación y control de los agentes en contacto con los trabajadores como As, Hg, Pb, SO2, SiO2, Cd, Cr, Zn y Cu; propuesta de los niveles de riesgo y exposición en base a la presencia y el contacto de los contaminantes; se determinaron los niveles de acción para la vigilan cia ambiental y de la salud en niveles de 1 a 5; y finalmente los exámenes médicos y su periodicidad. ABSTRACT This work aims to propose an environmental and health surveillance program for workers exposed to chemical agents in copper foundry. The methodology was based on a bibliographical review in English and Spanish, directed manual search and expert judgment through unstructured qualitative interviews. The search process was divided into two stages; the first one aimed answering two questions related to the state of the art of preventive exposure programs, and the second, related to reference search aimed at environmental monitoring and health at work. Scientific articles were selected, where protocols, norms, standards and documents from various organizations for environmental and health surveillance were identified, from which a new manual search was conducted, supported by the guidelines indicated by experts from the areas of Hygiene And Occupational Health that collaborated in the design of the program. As a result, the most important points were the identification, evaluation and control of agents in contact with workers such as As, Hg, Pb, SO2, SiO2, Cd, Cr, Zn and Cu; Proposal of risk and exposure levels based on the presence and contact of pollutants; the levels of action for environmental and health surveillance were determined at levels 1 to 5; And finally the medical examinations and their periodicity.
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2.

Conocimientos y prácticas sobre hidatidosis y triquinosis en usuarios y acompañantes del Hospital Comunitario de Salud Familiar El Carmen, Región del Biobío, Chile./ [Knowledge and practices regarding cystic echinococcosis and trichinellosis in users and companions of users of the Hospital Comunitario de Salud Familiar El Carmen, Biobio Region, Chile].

Lisboa-Navarro, Raúl; González, Jorge; Junod, Tania; Melín-Coloma, Millaray; Landaeta-Aqueveque, Carlos
| Idioma(s): Español
We surveyed users of the Hospital Comunitario de Salud Familiar El Carmen and their companions to analyze knowledge and practices regarding cystic echinococcosis and trichinellosis. Most people recognized risky practices. Previous attendance at talks and working in agricultural-livestock enhanced the knowledge. Age, sex and formal education were not associated with the knowledge. Knowledge was not associated with practices.
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3.

Impacto económico del tabaquismo en los sistemas de salud de América Latina: un estudio en siete países y su extrapolación a nivel regional/ Financial impact of smoking on health systems in Latin America: A study of seven countries and extrapolation to the regional level

Pichon-Riviere, Andrés; Bardach, Ariel; Augustovski, Federico; Alcaraz, Andrea; Reynales-Shigematsu, Luz Myriam; Pinto, Márcia Teixeira; Castillo-Riquelme, Marianela; Torres, Esperanza Peña; Osorio, Diana Isabel; Huayanay, Leandro; Munarriz, César Loza; de Miera-Juárez, Belén Sáenz; Gallegos-Rivero, Verónica; Puente, Catherine De La; Navia-Bueno, María del Pilar; Caporale, Joaquín
| Idioma(s): Español
RESUMEN Objetivo Estimar los costos médicos directos atribuibles al tabaquismo en los sistemas de salud de América Latina. Métodos Se utilizó un modelo de microsimulación para cuantificar el impacto económico en enfermedad cardiovascular y cerebrovascular, enfermedad pulmonar obstructiva crónica (EPOC), neumonía, cáncer de pulmón y otras nueve neoplasias. Se realizó una búsqueda sistemática de datos epidemiológicos y de costos de los eventos. El modelo se calibró y validó para Argentina, Bolivia, Brasil, Chile, Colombia, México y Perú, países que representan el 78% de la población de América Latina; luego se extrapolaron los resultados a nivel regional. Resultados Cada año el tabaquismo es responsable de 33 576 millones de dólares en costos directos para el sistema de salud. Esto equivale a 0,7% del producto interno bruto (PIB) de la región y a 8,3% del presupuesto sanitario. La enfermedad cardiovascular, la EPOC y el cáncer fueron responsables de 30,3%, 26,9% y 23,7% de este gasto, respectivamente. El costo atribuible al tabaquismo varió entre 0,4% (México y Perú) y 0,9% (Chile) del PIB y entre 5,2% (Brasil) y 12,7% (Bolivia) del gasto en salud. En la región, la recaudación impositiva por la venta de cigarrillos apenas cubre 37% del gasto sanitario atribuible al tabaquismo (8,1% en Bolivia y 67,3% en Argentina). Conclusiones El tabaquismo es responsable de una importante proporción del gasto sanitario en América Latina, y la recaudación impositiva por la venta de cigarrillos está lejos de llegar a cubrirlo. La profundización de medidas como el aumento de impuestos al tabaco debería ser seriamente considerada por los países de la región. ABSTRACT Objective Estimate smoking-attributable direct medical costs in Latin American health systems. Methods A microsimulation model was used to quantify financial impact of cardiovascular and cerebrovascular disease, chronic obstructive pulmonary disease (COPD), pneumonia, lung cancer, and nine other neoplasms. A systematic search for epidemiological data and event costs was carried out. The model was calibrated and validated for Argentina, Bolivia, Brazil, Chile, Colombia, Mexico, and Peru, countries that account for 78% of Latin America’s population; the results were then extrapolated to the regional level. Results Every year, smoking is responsible for 33 576 billion dollars in direct costs to health systems. This amounts to 0.7% of the region’s gross domestic product (GDP) and 8.3% of its health budget. Cardiovascular disease, COPD, and cancer were responsible for 30.3%, 26.9%, and 23.7% of these expenditures, respectively. Smoking-attributable costs ranged from 0.4% (Mexico and Peru) to 0.9% (Chile) of GDP and from 5.2% (Brazil) to 12.7% (Bolivia) of health expenditures. In the region, tax revenues from cigarette sales barely cover 37% of smoking-attributable health expenditures (8.1% in Bolivia and 67.3% in Argentina). Conclusions Smoking is responsible for a significant proportion of health spending in Latin America, and tax revenues from cigarette sales are far from covering it. The region’s countries should seriously consider stronger measures, such as an increase in tobacco taxes.
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4.

Influencia de las conductas promotoras de salud de los padres en la de sus hijos adolescentes./ [The influence of parental healthy behaviors on healthy lifestyles of early adolescents].

Gaete, Jorge; Rojas-Barahona, Cristian A; Olivares, Esterbina; Chen, Mei-Yen
| Idioma(s): Español
BACKGROUND: Family behavior models may influence health promoting conducts among adolescents. AIM: To determine the association between health promoting behaviors among parents and healthy behaviors of early adolescents. MATERIAL AND METHODS: Analysis of the baseline assessment of a longitudinal study of early adolescents in the city of San Felipe, Region of Valparaiso, Chile. Parents and their teenage children, attending 5th to 7th grade, from ten municipal schools, participated in this study. Self-reported questionnaires were used to assess healthy lifestyles, answered separately by parents and their children. Univariable and multivariable ordinal logistic regression analyses with complete data were carried out, using the students’ health promoting behaviors as dependent variables and the same behaviors among parents as the main predictors, controlling for other personal and family variables. RESULTS: We contacted 1,035 parents and 682 consented to participate along with 560 students. The mean age of adolescents was 11.5 ± 1.2 years (49% females) The mean age of parents was 39.8 ± 8.8 years and 90% were women. The parental behaviors associated with teenage health promoting behaviors were eating vegetables (odds ratio (OR) = 1.22, p < 0.05), having breakfast (OR = 1.27, p < 0.05), do stretching exercises every day (OR = 1.19, p < 0.05) and take some time for relaxation (OR = 1.24, p < 0.05). CONCLUSIONS: These results show an association between healthy behaviors among parents and these behaviors among their adolescent offspring.
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5.

FREQUENCY OF ANTI- Toxocara spp. ANTIBODIES IN INDIVIDUALS ATTENDED BY THE CENTRO DE SALUD FAMILIAR AND ENVIRONMENTAL CONTAMINATION WITH Toxocara canis EGGS IN DOG FECES, IN THE COASTAL NIEBLA TOWN, CHILE.

Vargas, Catalina; Torres, Patricio; Jercic, María Isabel; Lobos, Marta; Oyarce, Alan; Miranda, Juan Carlos; Ayala, Salvador
| Idioma(s): Inglés
The frequency of anti-Toxocara spp. antibodies in individuals attended by the Centro de Salud Familiar in the coastal Niebla town, Chile, was related to the host and to environmental factors. IgG anti- Toxocara antibodies were detected with a commercial ELISA kit (SCIMEDX Corporation, USA). Samples with undetermined absorbance values were subjected to an additional ELISA standardized by the Instituto de Salud Pública, Chilean Health Ministry, a commercial ELISA (NOVATEC, Germany), and a commercial Western blot kit (LDBio Diagnostics, France). Hematological exams were performed using an automated blood counter and blood smears. Dog feces were collected from the ground along the main road in Niebla, including rural and urban locations. Ninety (25.4%) of the 355 examined individuals were positive by the ELISA test. The frequency of anti-Toxocara antibodies and the infection risk were significantly higher (p < 0.05) among those individuals ≥ 40 years old with respect to the 20-39 years old group, in individuals from rural locations, those who did not have a safe drinking water supply in the house or who presented blood eosinophilia. The proportion of positive samples of dog feces and the mean number of Toxocara canis eggs/g of feces in urban and rural areas were similar (p > 0.05).
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6.

Los incentivos y actores de los Sistemas de Salud de Costa Rica, Estados Unidos, Canadá, Chile y Ecuador - 2015/ Incentives and actors of Health Systems in Costa Rica, The United States of America, Canada, Chile and Ecuador - 2015

Camargo-García, Samantha Carolina; Cortés-Bermeo, Aura Maritza; Abreu-Flechas, Andrea Katherine; Suárez-Rativa, Manuel Eliecer; Jiménez-Barbosa, Wilson Giovanni
| Idioma(s): Español
Ante los diferentes sistemas de salud propuestos en cada país surge la necesidad de analizar la participación de cada uno de los elementos que lo componen. Este análisis se realiza con el fin de identificar y analizar los actores que intervienen en los sistemas de salud, especialmente, el uso de incentivos y la relación intersectorial que entre estos existe. Para ello, se llevó a cabo un estudio cualitativo descriptivo, mediante una revisión bibliográfica de los sistemas implementados en Costa Rica, Estados Unidos, Canadá, Chile y Ecuador. Se tuvieron en cuenta dos factores: el sistema de salud, definido por la Organización Mundial de la Salud como la suma de todas las organizaciones, instituciones y recursos empleados, cuyo objetivo consiste en mejorar la salud. El segundo, los incentivos, que brindan una motivación a los trabajadores, mejorando sus expectativas frente al trabajo y la manera de ejecutarlo, favoreciendo el cumplimiento de metas establecidas por las empresas. Como resultado, se encontró que en los sistemas de salud expuestos, si bien existen similitudes en relación con su desarrollo e implementación, también hay profundas diferencias, en especial, en la participación de actores públicos y privados. Conclusión: los incentivos existentes en los sistemas de salud estudiados no tienen un enfoque estratégico que articule a los actores en pro de la salud y el bienestar de la población. Before the different systems of health proposed in every country there arises the need to analyze the participation of each one of the elements that compose it. This analysis is realized in order identify and to analyze the actors who intervene in the systems of health, especially, the use of incentives and the intersectorial relation that between these exists. For it, there was carried out a qualitative descriptive study, by means of a bibliographical review of the systems implemented in Costa Rica, The United States, Canada, Chile and Ecuador. Two factors were born in mind: the system of health, defined by the World Health Organization (WHO) like the sum of all the organizations, institutions and used resources, which aim consists of improving the health. The second one, the incentives, that offer a motivation to the workers, improving his expectations opposite to the work and the way of executing it, favoring the fulfillment of goals established by the companies. As result, one found that, in the systems of health exposed, though similarities exist in relation with his development and implementation, also there are deep differences, especially, in the participation of public and private actors. Conclusion, incentives in health care systems do not have strategic perspective so that there are many problems to obtain wellbeing for all citizens.
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7.

Coping strategies and the Salutogenic Model in future oral health professionals.

Gambetta-Tessini, Karla; Mariño, Rodrigo; Morgan, Mike; Anderson, Vivienne
| Idioma(s): Inglés
BACKGROUND: Attention to the role of context in shaping individuals' coping strategies is necessary. This study used the Salutogenic Model (SM) as a framework to identify the coping strategies of oral health profession students from three countries. METHODS: Students from Australia, New Zealand and Chile were invited to participate in this cross-sectional study, and were given a questionnaire including socio-demographics, the Perceived Stress Scale, The SOC-13 and the Brief COPE. Descriptive analysis, correlation analysis and profile analysis were computed using SPSS v 20.0. RESULTS: Eight-hundred and ninety-seven valid questionnaires were returned, achieving a 44 % response rate. The coping dimension that the participants most commonly reported using was "Active Coping" with a mean value of 5.9 ± 1.5. Chilean respondents reported higher stress levels (19.8 vs. 17.7) and a lower Sense of Coherence (55.6 vs. 58.0) compared to Australian/New Zealand participants (p < 0.001). The SOC was positively correlated with active coping (p < 0.01) and positive reframing (p < 0.01). Profile analysis showed that when the differences in responses by sex were accounted for, there was no significant effect by country on the coping strategies used (p < 0.32). CONCLUSION: This initial investigation provides insights into the students' coping strategies and the validity of the SM. Students reporting high SOC scores where those who demonstrated the use of active coping and positive reframing as strategies to deal with stressful situations, which indicates the accuracy of the theoretical framework of the SM in health education environments. The results also suggest that a distinctive coping strategy pattern may apply to all participants, regardless of their country and sex.
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8.

Uso inapropiado de medicamentos en adultos mayores: resultados de la Encuesta Nacional de Salud 2010./ [Inappropriate medication use among Chilean older people].

Passi, Alvaro; Margozzini, Paula; Valenzuela, Eduardo; Hoyl, Trinidad; Marín, Pedro Paulo; Carrasco, Marcela; Olea, Ricardo; Gac, Homero
| Idioma(s): Español
BACKGROUND: Inappropriate medication use in older people is an important source of adverse events and complications. AIM: To determine the frequency of inappropriate medication use in the general population. MATERIAL AND METHODS: As part of the 2010 Chilean National Health Survey, 1,048 persons aged 65 years or more were interviewed about medication use. The information obtained was analyzed using standardized Beer’s criteria, adapted for the Chilean population, to define inappropriate medication use. A logistic regression model was performed to define risk factors for inappropriate medication use. RESULTS: Ten percent of subjects had a high risk of inappropriate medication use. The most common medications used were chlorphenamine, amitriptyline, diazepam, chlorpromazine, chlordiazepoxide and piroxicam. The risk factors detected were female gender, polypharmacy and a bad health self-perception. CONCLUSIONS: Inappropriate medication use is common among Chilean older people and should be discouraged.
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9.

Costo efectividad de un programa de rehabilitación cardiovascular modelo para personas post infarto agudo al miocardio en el Servicio de Salud Metropolitano Norte./ [Cost effectiveness of a theoretical cardiac rehabilitation program after myocardial infarction].

López-Montecinos, Paulina; Rebolledo S, Jame; Gómez L, José Miguel
| Idioma(s): Español
BACKGROUND: Secondary prevention programs are an essential part of comprehensive care of patients with cardiovascular disease (CVD), and its effectiveness in reducing morbidity or mortality has been proved. AIM: To determine the cost-effectiveness of a theoretical comprehensive cardiac rehabilitation (CCR) outpatient program after Myocardial Infarction, to be implemented in a Chilean Public Health System. MATERIAL AND METHODS: We designed a theoretical protocol of a CCR program based on recommendations of international guidelines, but adapted to local needs. A cost analysis was developed. Life years due to premature death were estimated with and without participation in CCR. The gained life-years and cost-effectiveness of the program were thus calculated. RESULTS: The annual cost of cardiac rehabilitation center is $ 64,407,065 Chilean pesos (CLP). The Incremental Cost Effectiveness Ratio (ICER) considering a reduction of late mortality of 25%, is $ 475,209.7 CLP per year of life gained. Since this figure is lower than one unit of per capita gross domestic product, the intervention is considered very cost-effective. CONCLUSIONS: A comprehensive cardiac rehabilitation program after myocardial infarction is very cost-effective in the context of its implementation in a public health service.
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10.

Diferencias de género en la calidad de vida relacionada con la salud en adolescentes escolarizados chilenos./ [Gender differences in health-related quality of life of Chilean adolescent students].

González A, Electra; Martínez N, Vania; Molina G, Temistocles; George L, Myriam; SepúLveda P, Rodrigo; Molina C, Ramiro; Hidalgo-Rasmussen, Carlos
| Idioma(s): Español
BACKGROUND: Health-related quality of life (HRQOL) refers to individuals' perception of their subjective well-being, considering various aspects of their life and the impact on their health. AIM: To analyze gender differences in the HRQOL of adolescent students in Chile, by age, type of school attended, and area of residence. MATERIAL AND METHODS: Analytical cross-sectional study conducted in a population of 5th and 12th grade students attending municipal, subsidized and private schools in 11 regions of the country. HRQOL was assessed with the KIDSCREEN-52, an instrument that has been previously adapted and validated in Chile. The database obtained from that adaption and validation process was analyzed. RESULTS: In total, 7,910 students (median age 14 years, 53% female) completed the questionnaire. Compared to males, females had lower HRQOL scores in most of the KIDSCREEN-52 dimensions. However, males were more likely to have lower scores in the “Peers and Social Support” and “School Environment” dimensions. These differences remained valid when the sample was stratified by age, type of school, and area of residence were analyzed. CONCLUSIONS: This study supports the existence of inequalities in the self-perceived HRQOL of Chilean adolescent students. The existing differences are not only related to gender but are also evident when stratifying by type of school attended.
Resultados  1-10 de 1.342