Inventario SISCO del estrés académico: revisión de sus propiedades psicométricas en estudiantes universitarios / SISCO inventory of academic stress: review of its psychometric properties in university students

Resumen: Los estudios superiores representan el punto culminante del estrés académico, proceso multifactorial complejo, con alta carga de trabajo. El inventario SISCO del estrés académico posee buenas propiedades psicométricas para sus subescalas de Estresores, Sintomatología y para la puntuación media total, no así para la subescala de Afrontamiento. El objetivo de este artículo es corroborar lo reportado previamente en base a un análisis psicométrico completo. En 1126 estudiantes universitarios, se obtuvieron buenas propiedades psicométricas para las subescalas de Estresores y Sintomatología, con un buen ajuste en el análisis factorial confirmatorio, en base a una estructura de cuatro factores. La subescala de Sintomatología quedó conformada por las subescalas Reacciones físicas y psicológicas y por Reacciones del comportamiento social. La subescala de Afrontamiento mantiene propiedades psicométricas deficientes. La puntuación para el total de los ítems del instrumento muestra buenas propiedades psicométricas (alfa de Cronbach y omega de 0.820 y 0.860, respectivamente). Se corrobora lo reportado previamente, avalándose la necesidad de más estudios, y la modificación del instrumento, en especial la subescala de Afrontamiento.

Abstract: Higher education represents the peak of academic stress, a complex multifactorial process with a high workload. The SISCO academic stress inventory has good psychometric properties for its subscales Stressors, Symptomatology and for the whole instrument, but not for the Coping subscale. The aim of this paper is to corroborate previous reports based on a full psychometric analysis. In 1,126 university students, good psychometric properties were obtained for the Stressors and Symptomatology subscales, with a good fit in the confirmatory factor analysis, based on a four-factor structure. The Symptomatology subscale consisted of the subscales Physical and Psychological Reactions and Social Behavioural Reactions. The Coping subscale maintains poor psychometric properties. The complete scale score shows good psychometric properties (Cronbach's alpha and omega of 0.820 and 0.860, respectively). This corroborates previous reports and supports the need for further study and modification of the instrument, especially the Coping subscale.

Metazoan parasite communities of the Pacific red snapper, Lutjanus peru (Perciformes: Lutjanidae): interannual variations in parasite communities.

Metazoan parasite communities can experience temporal structural changes related to seasonal and/or local variations in several biotic and abiotic environmental factors. However, few studies have addressed this issue in tropical regions, where changes in water temperature are less extreme than in temperate regions, so the factors or processes that can generate variations in these parasite communities are as yet unclear. We quantified and analysed the parasite communities of 421 Lutjanus peru (Nichols & Murphy, 1922) collected from Acapulco Bay in Guerrero, Mexico, over a four-year period (August 2018 to April 2021), to identify any interannual variation due to local biotic and abiotic factors influenced by natural oceanographic phenomena, such as El Niño-Southern Oscillation, or La Niña. Twenty-five metazoan parasite taxa were recovered and identified: seven Digenea species; two Monogenea; one Cestoda; one Acanthocephala; four Nematoda; and ten of Crustacea (seven Copepoda and three Isopoda). The digeneans and copepods were the best represented parasite groups. The parasite communities were characterized by a high numerical dominance of helminth larvae. Species richness at the component community level (13 to 19 species) was similar to reported richness in other Lutjanus spp. The parasite communities of L. peru had a high variability in species composition, but low aggregate variability (e.g. species diversity), suggesting that structure of these communities may be quite stable over time. A clear interannual variation pattern was not observed, suggesting that parasite species of this host may respond differently to variations in environmental factors. Interannual variations were possibly caused by a combination of biotic (i.e. host feeding behaviour and body size) and local abiotic factors (influenced by climatic anomalies) which generated notable changes in the infection levels of several component species.

[Psychometric evaluation of breastfeeding self efficiency scale in chilean sample]. / Evaluación psicométrica de la escala de autoeficacia de la lactancia materna, en una muestra chilena.

Breastfeeding self-efficacy is one of the indicators associated with the mental health of puerperal women and the maintenance of exclusive breastfeeding. OBJECTIVE: To evaluate the psychometric properties of an instrument to measure self-efficacy to breastfeed on the second postpartum day in the Chilean population. SUBJECTS AND METHOD: A convenience sample of 320 puerperal women who volunteered to participate in an interview on their second postpartum day was evaluated. Reliability was evaluated using the coefficient Cronbach's alpha. To assess its factorial structure, an exploratory factor analysis was performed. RESULTS: The results indicate that the final instrument, which has the factors "Intrapersonal Thoughts", composed of six items and "Breastfeeding Techniques", composed of eight items, presented an internal consistency by factor and total scale of F1 = 0.90, F2 = 0.91, and Total = 0.94, respectively. CONCLUSION: The breastfeeding self-efficacy scale showed good psychome tric characteristics during the second postpartum day among Chilean puerperal women.

Variables psicológicas y su relación con la evolución del índice de masa corporal en personas sometidas a cirugía bariátrica / Psychological variables and their relationship with the evolution of the body mass index in people undergoing bariatric surgery

Resumen Introducción La cirugía bariátrica es una de las opciones efectivas para la reducción del peso corporal, sin embargo, no existe claridad respecto de la evolución de la baja de peso corporal, más aún, algunos hallazgos sugieren amplia variabilidad individual en la curva de variación del Índice de Masa Corporal (IMC). Los factores asociados a este fenómeno no son claros aún. Objetivo Esta investigación buscó identificar la influencia de factores psicológicos: autoeficacia alimentaria, patrones de alimentación y apoyo social percibido, en la variación del IMC en pacientes sometidos a cirugía bariátrica. Materiales y Método Participaron 31 pacientes intervenidos en un hospital público del sur de Chile. Se utilizó la curva de crecimiento de Gompertz para modelar las curvas de variación de IMC y regresión no lineal para conocer la influencia de las variables de estudio. Resultados El porcentaje máximo de reducción de IMC, se produjo al noveno mes tras la cirugía. El IMC de inicio mostró una influencia significativa en la reducción del IMC (p = 0,04) lo mismo que el apoyo social percibido, subfactor amigos (p = 0,03). Las variables psicológicas estudiadas, tratadas individualmente, no afectaron la curva de variación de IMC, sin embargo, tratadas de modo agrupado lograron predecir el porcentaje máximo de reducción de IMC y su velocidad, incluso controlando el IMC de inicio. Discusión: Se confirman hallazgos previos respecto de que la variabilidad individual en la evolución del IMC postcirugía se ve afectada por factores psicológicos. Conclusión Variables psicológicas y no exclusivamente biomédicas, inciden en la evolución del IMC postcirugía, por lo que se sugiere atender a estos aspectos, tanto en la evaluación prequirúrgica como en el seguimiento postcirugía.

Background Bariatric surgery is one of the effective options for the reduction of body weight, however, there is no clarity regarding the postoperative weight loss curve, moreover, there are findings that suggest wide individual variability and the factors associated with this phenomenon are not clear yet. Aim This study sought to identify the influence of psychological factors such as eating self-efficacy, eating patterns and social support on the variation of BMI in patients who have undergone bariatric surgery through the surgical technique of vertical sleeve gastrectomy. Materials and Method A total of 31 operated patients in a public hospital in southern Chile participated in the study. The Gompertz growth curve was used to model BMI variation curves and nonlinear regression to ascertain the influence of the study variables. Results The maximum weight loss occurs around the ninth month after surgery. The initial BMI shows a significant difference in the reduction of BMI (p = 0.04) as well as the social support perceived and the sub-factor friends (p = 0.03). The psychological variables, treated individually, had no effect on the weight variation curve; however, when treated as a group, they were able to predict the maximum of weight loss and its speed, even controlling for the initial BMI. Discussion According to previous studies, these findings confirm that the individual variability in the evolution of BMI after surgery is affected by psychosocial factors. Conclusion Pre-surgical assessment and post-surgery follow-up are recommended, taking into account not only biomedical variables but also psychological factors.

¿Qué venden los kioscos escolares al implementar la ley sobre composición nutricional de los alimentos y su publicidad? / What do school kiosks sell when implemented the law about food nutritional composition and advertisement?

El rápido aumento de la obesidad infantil se ha asociado al elevado consumo de alimentos procesados de alta densidad energética e insuficiente actividad física. Chile el año 2016, implementó la Ley 20.606 sobre Composición Nutricional de los Alimentos y su Publicidad, que prohíbe la publicidad de alimentos altos en calorías, grasas saturadas, azúcares y sodio para los niños menores de 14 años y la venta de estos alimentos al interior de las escuelas. El objetivo de este trabajo fue identificar los cambios en la oferta y consumo de alimentos de los kioscos escolares en escuelas públicas de Chile con la implementación de la Ley 20.606 sobre Composición Nutricional de los Alimentos y su Publicidad. Se hizo so de un estudio longitudinal. La muestra provino del estudio "Efectividad de una intervención en alimentación y actividad física orientada a controlar la obesidad en niños pertenecientes a escuelas públicas en escuelas de tres regiones del país" (estudio KIND), alcanzando 351 escolares de 8 a 14 años pertenecientes a tres escuelas municipalizadas. Para analizar la oferta en el kiosco se registraron en una base Excel todos los alimentos junto a su aporte nutricional, para el consumo de alimentos, se aplicó la encuesta utilizada en el estudio KIND y la medición del estado nutricional fue realizada por nutricionistas previamente estandarizadas. Se utilizó de la línea base la información obtenida en el estudio KIND, obtenida el año 2015 y se comparó con el año 2017 a través de Test de Mac Nemar y Test de proporciones para una muestra. Todos los análisis se realizaron con STATA 15 (Copyright 1984-2009 StataCorp). Los alimentos procesados y ultra procesados (84,8%) siguen siendo los más ofertados dentro de los kioscos en donde destacan los snacks dulces y los caramelos, manteniéndose la oferta al interior y exterior de las escuelas. Los grupos de alimentos que los niños prefieren comprar y traer desde la casa en ambos periodos analizados son los snacks dulces y las bebidas y jugos azucarados. Con la implementación de la Ley 20.606, disminuyó la variedad de alimentos ofertados altos en nutrientes críticos, sin embargo, se mantiene la oferta de alimentos ultra procesados y procesados en los kioscos escolares.

The fast growth in childhood obesity has been linked to the increased intake of high energy density processed food and poor physical activity. In 2016 in Chile the law 20.606 about Food Nutritional Composition and Advertisement, forbids the advertising of food with high calories, saturated fats, sugars, and sodium for children younger than 14 years and the sale of these food products inside schools. This work aimed to identify changes in the food supply and consumption in public school kiosks from Chile with the addition of the law 20.606 about Food Nutritional Composition and Advertisement. A longitudinal study was performed. The sample came from the study "Effectiveness of a food and physical activity intervention oriented to control obesity in children belonging to public schools from three regions of the country" (KIND study), reaching 351 students from 8 to 14 years belonging to three municipal schools. To analyze the supply at the kiosk, every food product along with its nutritional content was registered in an Excel base, for the intake of food it was used the survey from the KIND study and the nutritional state measurement was made by nutritionist standardized in advance. We used the baseline of the data obtained from the KIND study, this data was gathered in 2015 and we compared it to the one from 2017 using the Mac Nemar Test and the Test for proportions of a sample. Every analysis was made with STATA 15 (Copyright 1984-2009 StataCorp). Processed and ultra-processed food (84.8%) still is the most offered in the kiosks where the sweet snacks and candy are featured, keeping the supply at the inside and outside of schools. The foods that children prefer to buy and bring from home in both analyzed periods are the sweet snacks and sugary drinks and juices. With the addition of the law 20.606, the variety of the high critical nutrient food decreased, however, the supply of processed and ultra-processed food in school kiosks still remains.

European all-cause excess and influenza-attributable mortality in the 2017/18 season: should the burden of influenza B be reconsidered?

OBJECTIVES: Weekly monitoring of European all-cause excess mortality, the EuroMOMO network, observed high excess mortality during the influenza B/Yamagata dominated 2017/18 winter season, especially among elderly. We describe all-cause excess and influenza-attributable mortality during the season 2017/18 in Europe. METHODS: Based on weekly reporting of mortality from 24 European countries or sub-national regions, representing 60% of the European population excluding the Russian and Turkish parts of Europe, we estimated age stratified all-cause excess morality using the EuroMOMO model. In addition, age stratified all-cause influenza-attributable mortality was estimated using the FluMOMO algorithm, incorporating influenza activity based on clinical and virological surveillance data, and adjusting for extreme temperatures. RESULTS: Excess mortality was mainly attributable to influenza activity from December 2017 to April 2018, but also due to exceptionally low temperatures in February-March 2018. The pattern and extent of mortality excess was similar to the previous A(H3N2) dominated seasons, 2014/15 and 2016/17. The 2017/18 overall all-cause influenza-attributable mortality was estimated to be 25.4 (95%CI 25.0-25.8) per 100,000 population; 118.2 (116.4-119.9) for persons aged 65. Extending to the European population this translates into over-all 152,000 deaths. CONCLUSIONS: The high mortality among elderly was unexpected in an influenza B dominated season, which commonly are considered to cause mild illness, mainly among children. Even though A(H3N2) also circulated in the 2017/18 season and may have contributed to the excess mortality among the elderly, the common perception of influenza B only having a modest impact on excess mortality in the older population may need to be reconsidered.

Universal Rim Thickness in Unsteady Sheet Fragmentation.

Unsteady fragmentation of a fluid bulk into droplets is important for epidemiology as it governs the transport of pathogens from sneezes and coughs, or from contaminated crops in agriculture. It is also ubiquitous in industrial processes such as paint, coating, and combustion. Unsteady fragmentation is distinct from steady fragmentation on which most theoretical efforts have been focused thus far. We address this gap by studying a canonical unsteady fragmentation process: the breakup from a drop impact on a finite surface where the drop fluid is transferred to a free expanding sheet of time-varying properties and bounded by a rim of time-varying thickness. The continuous rim destabilization selects the final spray droplets, yet this process remains poorly understood. We combine theory with advanced image analysis to study the unsteady rim destabilization. We show that, at all times, the rim thickness is governed by a local instantaneous Bond number equal to unity, defined with the instantaneous, local, unsteady rim acceleration. This criterion is found to be robust and universal for a family of unsteady inviscid fluid sheet fragmentation phenomena, from impacts of drops on various surface geometries to impacts on films. We discuss under which viscous and viscoelastic conditions the criterion continues to govern the unsteady rim thickness.

Caracterización de las personas en situación de calle con problemas de salud mental, que se encuentran en la Región del BíoBío / Characterization of homeless persons with mental health problems, that are in the Bío Bío Region

Resumen Introducción: El objetivo del estudio fue determinar las características sociodemográficas, el uso de redes, la autopercepción de salud, las necesidades y los recursos de las personas en situación de calle con problemas de salud mental y/o consumo problemático de alcohol y/o drogas, en la región del Bío Bío (Chile). Método: Entre los meses de diciembre de 2014 y marzo de 2015, se obtuvo información de una muestra por conveniencia de 65 habitantes de calle con antecedentes de problemas mentales, vinculados a programas de la Secretaría Regional Ministerial (SEREMI) de Desarrollo Social. Se emplearon instrumentos de caracterización sociodemográfica, la Escala Maristán de Necesidades y el inventario de recursos para personas en situación de calle. Resultados: La muestra está constituida principalmente por hombres, con edad promedio de 41 años. Se caracteriza por tener bajo nivel escolar y condiciones de inestabilidad laboral, así como una moderada percepción de salud física y mental. Las personas tienen más necesidades sanitarias, de trabajo y uso del tiempo libre, y existenciales, que de la vida cotidiana. El Estado y la familia son las principales fuentes de apoyo para esta población. Conclusiones: Los hallazgos de la presente investigación, permiten realizar una primera aproximación al perfil sociodemográfico, de percepción de salud y de necesidades de las persona en situación de calle con problemas mentales y/o abuso problemático de alcohol y/o drogas. A partir de los resultados es posible determinar una línea de base para proponer futuros programas de atención en la región.

Introduction: The objective of the study was to determine the socio-demographic characteristics, the use of nets, the self-perception of health, needs and resources of persons in streets with problems of mental health or problematic consumption of alcohol and/or drugs, in the Bio Bio region (Chile). Method: Between the months of December 2014 and March 2015, information was obtained from a sample of convenience of 65 homeless persons with a history of mental problems, linked to programs of the Secretaría Regional Ministerial (SEREMI) of social development. Socio-demographic characterization instruments were used, the Maristán Scale of Needs and Inventory of Resources for Homeless People. Results: The General characteristics of the sample include being male, with an average age of 41 years. The sample is characterized by low scholastic level and conditions of job instability, as well as a regular perception of physical and mental health. People have more needs health, work, use of the free time, and existentials, that of everyday life. The State and the family are the main sources of support for this population. Conclusions: The findings of this research, allow a first approach to the socio-demographic profile, perception of health and needs of the homeless persons with mental health problems and/or problematic abuse of alcohol and/or drugs. From the results it is possible to determine a baseline for future programmes in the region. Rev Chil Neuro-Psiquiat 2018; 56 (2): 89-99

[Socioeconomical level and behavior in school-age children: the mediating role of parents]. / Nivel Socioeconómico y conductas externalizadas en preescolares: el rol del mediador parental.

A determinant of particular relevance in human development is the socioeconomic status (SES) and, specifically, low SES and poverty. Likewise, family environment is essential in the development of children and a potential mediator or moderator of the effect of broader social conditions. OBJECTIVE: To analyze the role of parenting stress as a mediating variable of the relationship between SES and both externalized and internalized behaviors in preschool children. SUBJECTS AND METHOD: Descriptive secondary base study based on the Longitudinal Survey of Chilean First Infancy that selected a stratified sample, representative by clusters, of 9.996 children from 3 to 5 years old and their caregivers, that completed a battery of instruments for measuring SES variables, parenting stress and externalized and internalized behaviors. The analysis used a linear model with least square estimate. As hypothesis testing, the Dm (an adaptation of the F-test for multiple imputation method) was used. RESULTS: The mediation model of parenting stress in the relationship between SES and both externalized and internalized behaviors was confirmed for the latter; regarding externalized behaviors a model of moderation was observed, being the stress influence lower on the low SES. CONCLUSIONS: Parental stress showed a clear relationship with the presence of externalized and internalized behaviors, stronger than the SES. The relationship between SES and parenting stress is very important to understand the processes that affect children’s development.

Evaluación del resultado de las acciones de detección, diagnóstico y tratamiento del Episodio Depresivo realizada en pacientes consultantes en el primer nivel de atención de la Provincia de Concepción, Chile / Evaluation of the results of the actions of detection, diagnosis and treatment of the Depressive Episode carried out in patients attended in primary care from the Province of Concepción, Chile

Resumen El Ministerio de Salud de Chile implementó, a partir del año 2001, el programa de tratamiento de la depresión en la Atención Primaria en Salud (APS). Objetivo general: Evaluar el resultado de las acciones de detección, diagnóstico y tratamiento del episodio depresivo realizadas en consultantes del primer nivel de atención de la Provincia de Concepción, Chile. Método: Seguimiento de seis meses de muestra aleatoria de usuarios consultantes por morbilidad general en centros APS Provincia de Concepción, Chile. Se ingresaron al estudio 307 usuarios, con diagnóstico positivo de depresión (DSM-IV), usando la entrevista psiquiátrica estructurada Composite International Diagnostic Interview 2.1 (CIDI). Se realizaron análisis de regresión logística binaria y ordinal para predecir la detección del trastorno, el tipo de tratamiento aplicado y el curso de la enfermedad a partir de las variables sociodemográficas, clínicas y de estructura. Resultados: La prevalencia de seis meses de depresión fue de 16.7% (n = 431), previo criterios de exclusión. Los médicos detectaron el 31,6% de los casos, existiendo marcadas diferencias por centro. En su mayoría las intervenciones fueron de tipos psicosociales (18,6%), seguidas por las farmacológicas(9,4%) y un 3,6% con ambos tipos. Al cabo de seis meses, el diagnóstico había remitido en un 60.7% de los usuarios. Sin embargo, esta evolución no estaba asociada a las intervenciones recibidas, ni al diagnóstico previo, sino a variables personales de los usuarios. Conclusiones: La capacidad de detección de los profesionales en APS es baja, las intervenciones son escasas y no parecen incidir sobre la evolución del diagnóstico.

The Chilean Ministry of Health implemented since 2001 the program for treating depression in primary health care (PCH). General objective: To evaluate the result of detection, diagnostic and treatment of depressive episodes performed by consultants of the first level of care in the Province of Concepción, Chile. Method: Follow-up of six months of a random sample of users consulting for general morbidity in PHC of the Province of Concepción, Chile. A total of 307 users with positive diagnosis of depression (DSM-IV) using the psychiatric structured Composite International Diagnostic Interview 2.1 (CIDI) were admitted to the study. Regression analyses, binary and ordinal logistic were performed to predict the detection of the disorder, the type of treatment applied and the course of the disease, from sociodemographic, clinical and structure variables. Results: The prevalence of six months of depression reached 16.5% (n=431), prior to exclusion criteria. Doctors detected the 31.6% of the cases, with significant differences per center. Most of the interventions were of the psychosocial type (18.6%), followed by pharmacological interventions (9.4%) and 3.6% of both types. After six months, the diagnosis had remitted in 60-7% of the users. However, this evolution was not linked to the interventions received or previous diagnosis, but to personal variables of the users. Conclusions: The detection capacity of the professionals in PHC is low, interventions are scarce and probably, the evolution of the diagnosis is not affected by the intervention.

Nivel Socioeconómico y conductas externalizadas en preescolares: el rol del mediador parental / Socioeconomical level and behavior in school-age children: the mediating role of parents

Un determinante de particular relevancia en el desarrollo humano es el nivel socioeconómico y, en específico, el nivel socioeconómico (NSE) bajo y la pobreza. El entorno familiar es asimismo fundamental en el desarrollo de niños y niñas, y un potencial mediador o moderador del efecto de condiciones sociales más amplias. Objetivo: Analizar el rol del estrés parental como variable mediadora de la relación del NSE con conductas externalizadas e internalizadas en niños y niñas preescolares. Sujetos y Método: Estudio descriptivo de base secundaria basado en la Encuesta Longitudinal de Primera Infancia Chilena que seleccionó una muestra estratificada, representativa por clusters, de 9.996 niños y niñas de 3 a 5 años y sus cuidadoras(es), los(as) que completaron una batería de instrumentos para la medida de las variables de NSE, estrés parental y conductas externalizadas e internalizadas. El análisis utilizó un modelo lineal con estimación por mínimos cuadrados. Como prueba de hipótesis, se usó la Dm, una adaptación de la prueba F para imputación múltiple. Resultados: El modelo de mediación del estrés parental en la relación entre NSE y conductas externalizadas e internalizadas se corroboró para las segundas; respecto de las conductas externalizadas se observó un modelo de moderación, siendo menor la influencia del estrés en el NSE bajo. Conclusiones: El estrés parental mostró una clara relación con la presencia de conductas externalizadas e internalizadas, más fuerte que el NSE; la relación entre NSE y estrés parental resulta de importancia para comprender los procesos que afectan el desarrollo de niños y niñas.

A determinant of particular relevance in human development is the socioeconomic status (SES) and, specifically, low SES and poverty. Likewise, family environment is essential in the development of children and a potential mediator or moderator of the effect of broader social conditions. Objective: To analyze the role of parenting stress as a mediating variable of the relationship between SES and both externalized and internalized behaviors in preschool children. Subjects and Method: Descriptive secondary base study based on the Longitudinal Survey of Chilean First Infancy that selected a stratified sample, representative by clusters, of 9.996 children from 3 to 5 years old and their caregivers, that completed a battery of instruments for measuring SES variables, parenting stress and externalized and internalized behaviors. The analysis used a linear model with least square estimate. As hypothesis testing, the Dm (an adaptation of the F-test for multiple imputation method) was used. Results: The mediation model of parenting stress in the relationship between SES and both externalized and internalized behaviors was confirmed for the latter; regarding externalized behaviors a model of moderation was observed, being the stress influence lower on the low SES. Conclusions: Parental stress showed a clear relationship with the presence of externalized and internalized behaviors, stronger than the SES. The relationship between SES and parenting stress is very important to understand the processes that affect children’s development.

Desesperanza y afrontamiento centrado en la tarea median la relación entre sintomatologia depresiva y conducta suicida no letal en pacientes de salud mental / Hopelessness and task-oriented coping mediate the association between depressive symptomatology and non-lethal suicidal behavior in mental health patients

Introduction: Suicide is a relevant subject to public health. Its incidence has increased in Chile during the last decade. The current study aims to analyze psychological factors mediating the influence of depressive symptomatology in suicide ideation and attempt in mental health patients. Method: 96 mental health patients from public services and private practice, 67 percent female, with an average age of 30.7 years (SD = 12.2) answered Goldberg’s 12 item general health questionnaire (GHQ-12), Beck’s hopelessness scale (BHS) and coping inventory for stressful situations (CISS-21). Logistic regression and mediation analysis were used to establish suicide ideation and lifetime suicide attempt risk. Results: 22.9 percent of patients had suicide ideation during the last six months and 41.7 percent tried to commit suicide at least once during their lives. Logistic regression results shows that, after controlling for depressive symptomatology, hopelessness influences suicide ideation, and task-oriented coping influences lifetime suicide attempt. Hopelessness mediates the association between depressive symptoms and suicide ideation, and task-oriented coping mediates between depressive symptomatology and history of suicide attempt. Conclusions: Psychological factors such as hopelessness and task-oriented coping mediate the association between depressive symptomatology and non-lethal suicidal behavior, therefore they must be specifically considered in the treatment of patients at suicide risk.

Introducción: El suicidio es un problema de salud pública. Pese a los avances en salud mental, las tasas de suicidio han aumentado en Chile en la última década. El presente estudio busca identificar factores psicológicos que medien la influencia de la sintomatología depresiva en la ideación e intento de suicidio en pacientes de salud mental. Método: 96 pacientes de salud mental, de servicios públicos y consulta particular, 67 por ciento mujeres, con edad promedio de 30,7 años (DS = 12,2) respondieron los cuestionarios de salud de Goldberg (GHQ-12), de desesperanza de Beck (BHS) y de afrontamiento a situaciones estresantes (CISS-21). Se realizaron análisis de regresión logística y de mediación para determinar la influencia de los factores psicológicos en la ideación e intento suicida de los pacientes evaluados. Resultados: Un 22,9 por ciento de los pacientes encuestados había pensado en quitarse la vida en los últimos seis meses y un 41,7 por ciento había intentado suicidarse al menos una vez durante su vida. Los resultados de las regresiones logísticas muestran que, controlando la sintomatología depresiva, la desesperanza influye sobre ideación suicida, y el afrontamiento centrado en la tarea sobre el antecedente de intento de suicidio. La desesperanza media la relación entre síntomas depresivos e ideación suicida, y el afrontamiento centrado en la tarea media entre la sintomatología depresiva y antecedente de intento de suicidio. Conclusiones: Factores psicológicos como desesperanza y afrontamiento centrado en la tarea mediarían la relación entre sintomatología depresiva, y conducta suicida no letal, por lo que deben ser considerados de forma específica en el tratamiento de pacientes con riesgo suicida.

Relación entre el funcionamiento de un hogar/residencia protegida para personas con trastorno mental severo, el apoyo social del cuidador y las habilidades de la vida diaria de los residentes / Relation between the functioning of sheltered housing/supported home for people with severe mental disorder, the social support of the caregiver and the daily life skills of the residents

Residential programs fulfill an important role in the overall operation of the people with severe mental disorders and they are considered promoters of the improvements observed in them. The study is aimed on determining the relation between the operation of a protected home/residence and the social support of the caregivers, with the daily life skills of the residents. Method: 122 users that reside in protected homes and residences from the Maule and Biobío Regions were interviewed, as well as 30 caregivers/monitors that worked in those places. Results: Both age and gender of the residents shows no significant relation with "skills of the overall daily life". However, a relation was found between the age of the residents and the subscale "activity and social relationships": the older the age, the lesser activity and social relationships of the users. Regarding the restrictiveness variable of the device, it was found that the lesser restrictiveness, the greater basic skills of the daily life of the residents was presented, especially in areas such as domestic and community skills. A relation between daily life skills of the residents and the perceived social support was not found. Nevertheless, a greater perception of social support, greater "activity and social relationships" of the users that reside in Protected Homes and Residences was observed. Conclusions: The restrictiveness of the device by being a relevant variable for daily life skills of the residents must be taken into account in the organization and structure of the residential programs in Chile.

Los programas residenciales cumplen un rol importante en el funcionamiento general de las personas con trastornos mentales severos y son considerados favorecedores de las mejoras observadas en ellos. El estudio tiene como objetivo determinar la relación entre el funcionamiento de un hogar/residencia protegida y el apoyo social de los cuidadores, con las habilidades de la vida diaria de los residentes. Método: Fueron entrevistados 122 usuarios que viven en hogares y residencias protegidas de las regiones del Maule y Bío Bío, además de 30 cuidadores/monitores que trabajaban en el lugar. Resultados: La edad y el sexo de los residentes no muestran una relación significativa con las "habilidades de la vida diaria general". Sin embargo, se encontró relación entre la edad de los residentes y la sub escala "actividad y relaciones sociales"; a mayor edad, menor actividad y relaciones sociales de los usuarios. Respecto de la variable restrictividad del dispositivo se encontró que a menor restrictividad mayores habilidades básicas de la vida diaria en los residentes, especialmente en áreas como "habilidades domésticas" y "habilidades comunitarias". No se encontró relación entre las habilidades de la vida diaria de los residentes y el apoyo social percibido. No obstante, se vio que a mayor percepción de apoyo social, mayor "actividad y relaciones sociales" de los usuarios que viven en hogares y residencias protegidas. Conclusiones: La restrictividad del dispositivo al ser una variable relevante en las habilidades de la vida diaria de los residentes, debe ser considerada en la organización y estructura de los programas residenciales en Chile.

Herniorrafia laparoscópica sin malla / Laparoscopic herniorraphy without mesh

Se trataron 25 pacientes con 26 hernias inguinocrurales por laparoscopia transperitoneal sin utilización de malla, durante el período septiembre de 1994 a julio de 1995. Se operaron 4 hernias crurales y 22 inguinales, de las cuales 2 eran recidivadas; 21 pacientes eran hombres y 4 mujeres. Predominó el sexo masulino con un margen de edad entre 20 y 85 años. Se describe la técnica quirúrgica utilizando una aguja de Doyen modificada por nosotros. El tiempo operatorio máximo fue de 110 minutos y el mínimo de 25 minutos. Se convirtió 1 paciente (4 por ciento). No hubo hemorragia, infección, dolor neurítico ni mortalidad. El tercer paciente de la serie recidivó (4 por ciento). El procedimiento es simple, rápido, reproducible, económico con mínimo de dolor, corta estadía y pronto reintegro a la actividad física irrestricta. Aunque se trata de una serie pequeña y de corto seguimiento creemos que el recurso del instrumento citado permite acceder a una plástica anatómica, asociada a los beneficios de la cirugía asistida por video reduciendo los costos y la morbilidad que tiene el uso de prótesis

The Rotter I-E scale as a predictor of relapse in a population of compulsive gamblers.

Profile surveys, completed Rotter I-E scales, and questionnaires on past relapse behavior were collected from 108 New Jersey compulsive gamblers who attended Gamblers Anonymous, and an attempt was made, based on the findings, to predict incidence of compulsive gamblers' relapse. Relationships between I-E scores and extent of relapse-free periods, and I-E scores and relapse, with the variables of religious background, age, marital status, education, type of work, and childhood physical abuse were investigated. In every instance the relationship found was statistically non-significant.

Comparison of two locus of control scales in predicting relapse in an alcoholic population.

A 3-mo. follow-up was made of 64 male veterans who were discharged from a 21-day Alcohol Detoxification Treatment Program at the Veterans Affairs Medical Center at Lyons, NJ. Scores on the Rotter I-E and Alcohol Responsibility Scales were significantly correlated with tendencies toward a more external direction among the 13% who relapsed, significant on the I-E scale and nonsignificant on the Alcohol Responsibility Scale. When tests were compared as possible predictor variables of alcoholic relapse, the difference in favor of the I-E scale was statistically nonsignificant.

Litiasis biliar en niños: reporte de un caso clínico / Biliary lithiasis in children: report of the case clinic

Del estudio de 256 traumatismos maxilo faciales, se concluye que estos traumatismos son más frecuentes en el sexo masculino (75%), en edades que fluctuan entre 21-30 años (51%) y en personas procedentes de zonas urbanas (80%). De este total 23 casos (9%) tuvieron repercusión directa sobre la órbita y su componente. El autor utiliza como tratamiento la reducción cruenta y osteosítesis con alambre quirúrgico, complementando con antrotomía maxilar y uso de balón antral o taponamiento del seno, según se trate de fractura simple o conminuta. En algunos casos deberá recurrir al uso de injertos naturales (hueso-cartílago) cuando la destrucción del piso de la órbita es grande y existe la posibilidad de que el globo caiga en el interior del seno maxilar

Enzyme replacement therapy in porphyrias--V. In vivo correction of delta-aminolaevulinate dehydratase defective in erythrocytes in lead intoxicated animals by enzyme-loaded red blood cell ghosts.

Resealed erythrocyte ghosts are potential in vivo carriers of exogenous therapeutic enzymes. In the present work, the effect of administering delta-aminolaevulinate dehydratase (ALA-D) encapsulated in autologous red blood cell ghosts (RBCg) to lead intoxicated and normal mice was investigated. Administration of ALA-D loaded RBCg to intoxicated mice produced an immediate and permanent recovery in erythrocytic ALA-D activity; the effect was also noticeable in liver and spleen and absent in kidney, indicating that the entrapped enzyme was significantly stabilized to allow retention of activity in both circulating and phagocytized cells. Administration of ALA-D loaded ghosts to normal mice did not produce significant changes in ALA-D activity in blood, liver, spleen or kidney. Administration of free exogenous enzyme or blood transfusion during lead intoxication was also ineffective; spontaneous recovery of the poisoned animals was very slow. We show that circulating as well as phagocytized ALA-D entrapped in autologous erythrocyte ghosts can be safe and beneficial in the treatment of lead poisoning. Clinical trial in patients is recommended.

Programa de vigiláncia epidemiológica nutricional en la población de 0-5 años / Epidemiological nutritional surveillance program in the population from 0-5 years old

Son enunciadas las características geográficas de la Provincia de Salta (noroeste de la República Argentina) y se identifican cuatro zonas. Se hace um diagnóstico de los servicios de salud, nivel de vida y de la problemática nutricional que es la patología de mayor prevaléncia en la Provincia. Son detallados los objetivos y las acciones básicas del Programa de Atención Primária de la Salud, en especial el control nutricional de la población menor de 6 años. Por medio de formularios se efectua la evaluación del Programa a partir de los cuales se analizan los resultados obtenidos. A través de dos modalidades de trabajo el 48% de la población infantil se encuentra bajo control nutricional. Se enumeran las conclusiones generales y las recomendaciones a implementar

Enteritis Hemorragica por Adenovirus en Pavos / Hemorrhagic Enteritis by Adenovirus in Turkeys

Se describe por primera vez en Colombia la enteritis hemorragica (EH), en pavos de 4 a 11 semanas de edad, mediante estudios macroscopicos, histologicos y de microscopia electronica. Se demostro una enteritis hemorragica severa, y esplenomegalia con inclusiones intranucleares en la mayoria de las celulas de la pulpa blanca esplenica y en algunos mononucleares en el intestino delegado. Las inclusiones son caracteristicas; consisten de un centro eosinofilico, rodeado de cromatina densa y condensada sobre la membrana nuclear y de una estructura muy basofila y densa sobre un polo nuclear que parece corresponder a un nucleolo. Al microscopio electronico se aprecian fases del desarrollo viral, desde un material filamentoso y amorfo hasta la formacion de grandes acumulos de viriones y capsides de 70-80 nm de diametro con morfologia tipica de adenovirus. Los viriones se demostraron facilmente en macerados de bazo fijado en formol, tenidos negativamente con fosfotungstato de potasio; no se visualizaron en el contenido intestinal hemorragico estudiado con el mismo metodo. El estudio de microscopia de luz de bazo e intestino es suficiente para establecer el diagnostico de esta entidad