[Maternal anemia in Concepción province, Chile: association with maternal nutritional status and fetal growth]. / Anemia del embarazo en la Provincia de Concepción, Chile: relación con el estado nutricional materno y el crecimiento fetal.

Previous studies in Santiago, Chile have established that anemia in the earliest stages of pregnancy is a public health issue. The situation in other parts of the country is unknown. The purpose of this study is to establish the prevalence of anemia in pregnant women in the province of Concepcion and evaluate its association with maternal nutricional status and fetal growth. The study included 1782 women with singleton pregnancies who began prenatal check-ups in 2004 at the public primary health care centers. Anemia was established using the following criteria: from WHO (Hb < 11 g / dl) and from the USA Center for Disease Control (CDC) (Hb < percentile 5 for each gestational week). Anemia prevalence was compared in relation to independent study variables: maternal age, parity, morbidity and smoking habit, and mother and child anthropometry. A multivariable logistic regression model studied the possible effect of anemia on fetal growth. The prevalence of anemia was 10.9% and 14.5% using the WHO and CDC criteria, respectively. The mother's nutritional status was significantly associated with anemia. However, anemia according to WHO and CDC criteria at the beginning of pregnancy was not significantly associated to fetal growth in the univariate and multivariate analyses. The prevalence of anemia in the province of Concepcion constitutes a public health problem that needs to be addressed and it is slightly higher to that recently observed in the county of Puente Alto, Santiago.

Mortality outcomes in hospitals with public, private not-for-profit and private for-profit ownership in Chile 2001-2010.

UNLABELLED: Public, private not-for-profit (PNFP) and private for-profit (PFP) hospitals may have different behaviour and performance in different indicators such as health outcomes, cost-efficiency and quality. Chile has a mixed healthcare system both in financing and service delivery. The public National Health Fund (Fondo Nacional de Salud) covers 76% of the population-poorer and with higher health risks-whereas private health insurers cover 16% of the population-richer and with lower health risks. The aim of the study was to analyse the in-patient mortality outcomes by hospital ownership in Chile. METHODS: We use hospital discharge data in Chile for the period 2001-10 with a total of 16,205,314 discharges in 20 public, 6 PNFP and 15 PFP hospitals. We analyse in-patient mortality considering all diagnoses and a subsample considering only myocardial infarction and stroke diagnoses. Using a probit regression, we estimate how hospital ownership explains in-patient mortality controlling for other confounding variables like health and socioeconomic status, and hospital characteristics. RESULTS: The discharge condition was reported as death in 3.5% of the public hospitals' discharges, 1.3% in PNFP and 0.7% in PFP. PNFP and PFP hospitals show a lower risk of in-hospital mortality for all diagnoses, myocardial infarction and stroke in comparison with public hospitals. DISCUSSION: The question about which type of hospital ownership performs better in Chile remains open. Policy decisions regarding health service provision requires more evidence explaining differences by ownership. Better controls for health risk and hospital characteristics are suggested to address these differences in hospital performance.

Long-distance neural synchrony correlates with processing strategies to compare fractions.

Adults use different processing strategies to work with fractions. Depending on task requirements, they may analyze the fraction components separately (componential processing strategy, CPS) or consider the fraction as a whole (holistic processing strategy, HPS). It is so far unknown what is the brain coordination dynamics underlying these types of fraction processing strategies. To elucidate this issue, we analyzed oscillatory brain activity during a fraction comparison task, presenting pairs of fractions either with or without common components. Results show that CPS induces a left frontal-parietal alpha phase desynchronization after the onset of fraction pairs, while HPS induces an increase of phase synchrony on theta and gamma bands, over frontal and central-parietal sites, respectively. Additionally, the HPS evokes more negative ERPs around 400 ms over the right frontal scalp than the CPS. This ERP activity correlates with the increase of Theta phase synchrony. Our results reveal the emergence of different functional neural networks depending on the kind of cognitive strategy used for processing fractions.