Methodological considerations in the study of perceived discrimination at work and its association with workers health and occupational outcomes: A scoping review. / Consideraciones metodológicas en el estudio de la discriminación laboral percibida y su asociación con la salud de los trabajadores y resultados ocupacionales: revisión panorámica.

Introduction: Perceived workplace discrimination is a complex phenomenon involving unfair treatment in the workplace based on personal characteristics such as age, ethnicity, gender, or disability. The objective of this study is to explore the association of perceived workplace discrimination with health and occupational outcomes. Methods: Following the PRISMA-ScR guidelines and the Joanna Briggs Institute methodology, a scoping review of articles published between 2000 and 2022 was conducted in databases such as Pubmed, Scopus, and PsyInfo. Inclusion criteria focused on studies exploring perceived workplace discrimination among workers, excluding those on patients, students, or the general population, and articles not written in English or Spanish. Results: Of the 9,871 articles identified, 102 met the criteria and were analyzed. Research showed a progressive increase in the study of perceived workplace discrimination, with a majority of studies in North America and Europe and a predominance of cross-sectional designs. Most studies did not clearly define the concept of perceived workplace discrimination nor report the psychometric characteristics of the measurement instruments. A significant association was found between perceived discrimination and negative outcomes in workers' mental and physical health, as well as a negative impact on job satisfaction and an increase in absenteeism. Additionally, sociodemographic characteristics such as race/ethnicity, gender, and age influenced the perception of discrimination. Conclusions: This review confirms that perceived workplace discrimination significantly impacts the health and job satisfaction of workers, with particular detriment in minorities and women. Despite an increase in research over the last two decades, there remains a lack of consistency in the definition and measurement of the phenomenon. Most studies have used cross-sectional designs, and there is a notable absence of research in the Latin American context.

Introducción: La discriminación laboral percibida es un fenómeno complejo que implica un trato injusto en el lugar de trabajo, basado en características personales como edad, etnia, género o discapacidad. El objetivo de este estudio es explorar cómo ha sido investigada la discriminación laboral percibida, en el contexto de investigaciones acerca de su asociación con salud y resultados ocupacionales. Métodos: Siguiendo la guía PRISMA-ScR y la metodología del Instituto Joanna Briggs, se realizó una revisión panorámica de artículos publicados entre los años 2000 y 2022 en bases de datos como PubMed, Scopus y PsycInfo. Los criterios de inclusión se centraron en estudios que exploraron la discriminación laboral percibida en trabajadores, excluyendo aquellos en pacientes, estudiantes o población general, y artículos no escritos en inglés o español. Resultados: De los 9871 artículos identificados, 102 cumplieron con los criterios y fueron analizados. La investigación mostró un aumento progresivo en el estudio de la discriminación laboral percibida, con una mayoría de estudios en América del Norte y Europa y un predominio de diseños transversales. La mayoría no definió claramente el concepto de discriminación laboral percibida ni reportó las características psicométricas de los instrumentos de medición. Se encontró una asociación significativa entre la discriminación percibida y resultados negativos en la salud mental y física de los trabajadores, así como un impacto negativo en la satisfacción laboral y un aumento en el ausentismo. Además, las características sociodemográficas como raza/etnia, género y edad influyeron en la percepción de discriminación. Conclusiones: Esta revisión confirma que la discriminación laboral percibida impacta considerablemente la salud y satisfacción laboral de los trabajadores, afectando más a minorías y mujeres. A pesar de un incremento en su investigación en las últimas dos décadas, persiste una carencia de consistencia en la definición y medición del fenómeno. La mayoría de los estudios han utilizado diseños transversales, y se observa una notable ausencia de investigaciones en el contexto latinoamericano.

Consideraciones metodológicas en el estudio de la discriminación laboral percibida y su asociación con la salud de los trabajadores y resultados ocupacionales: revisión panorámica / Methodological considerations in the study of perceived discrimination at work and its association with workers health and occupational outcomes: A scoping review

Introducción La discriminación laboral percibida es un fenómeno complejo que implica un trato injusto en el lugar de trabajo, basado en características personales como edad, etnia, género o discapacidad. El objetivo de este estudio es explorar cómo ha sido investigada la discriminación laboral percibida, en el contexto de investigaciones acerca de su asociación con salud y resultados ocupacionales. Métodos Siguiendo la guía PRISMA-ScR y la metodología del Instituto Joanna Briggs, se realizó una revisión panorámica de artículos publicados entre los años 2000 y 2022 en bases de datos como PubMed, Scopus y PsycInfo. Los criterios de inclusión se centraron en estudios que exploraron la discriminación laboral percibida en trabajadores, excluyendo aquellos en pacientes, estudiantes o población general, y artículos no escritos en inglés o español. Resultados De los 9871 artículos identificados, 102 cumplieron con los criterios y fueron analizados. La investigación mostró un aumento progresivo en el estudio de la discriminación laboral percibida, con una mayoría de estudios en América del Norte y Europa y un predominio de diseños transversales. La mayoría no definió claramente el concepto de discriminación laboral percibida ni reportó las características psicométricas de los instrumentos de medición. Se encontró una asociación significativa entre la discriminación percibida y resultados negativos en la salud mental y física de los trabajadores, así como un impacto negativo en la satisfacción laboral y un aumento en el ausentismo. Además, las características sociodemográficas como raza/etnia, género y edad influyeron en la percepción de discriminación. Conclusiones Esta revisión confirma que la discriminación laboral percibida impacta considerablemente la salud y satisfacción laboral de los trabajadores, afectando más a minorías y mujeres. A pesar de un incremento en su investigación en las últimas dos décadas, persiste una carencia de consistencia en la definición y medición del fenómeno. La mayoría de los estudios han utilizado diseños transversales, y se observa una notable ausencia de investigaciones en el contexto latinoamericano.

Introduction Perceived workplace discrimination is a complex phenomenon involving unfair treatment in the workplace based on personal characteristics such as age, ethnicity, gender, or disability. The objective of this study is to explore the association of perceived workplace discrimination with health and occupational outcomes. Methods Following the PRISMA-ScR guidelines and the Joanna Briggs Institute methodology, a scoping review of articles published between 2000 and 2022 was conducted in databases such as Pubmed, Scopus, and PsyInfo. Inclusion criteria focused on studies exploring perceived workplace discrimination among workers, excluding those on patients, students, or the general population, and articles not written in English or Spanish. Results Of the 9,871 articles identified, 102 met the criteria and were analyzed. Research showed a progressive increase in the study of perceived workplace discrimination, with a majority of studies in North America and Europe and a predominance of cross-sectional designs. Most studies did not clearly define the concept of perceived workplace discrimination nor report the psychometric characteristics of the measurement instruments. A significant association was found between perceived discrimination and negative outcomes in workers' mental and physical health, as well as a negative impact on job satisfaction and an increase in absenteeism. Additionally, sociodemographic characteristics such as race/ethnicity, gender, and age influenced the perception of discrimination. Conclusions This review confirms that perceived workplace discrimination significantly impacts the health and job satisfaction of workers, with particular detriment in minorities and women. Despite an increase in research over the last two decades, there remains a lack of consistency in the definition and measurement of the phenomenon. Most studies have used cross-sectional designs, and there is a notable absence of research in the Latin American context.

Methodological considerations in the study of perceived discrimination at work: a scoping review protocol. / Consideraciones metodológicas en el estudio de la discriminación laboral percibida: protocolo de una revisión panorámica.

Introduction: Perceived discrimination is a complex phenomenon of study and has significant repercussions on people's health. Many studies confirm the negative effects of stress on workers' health in the workplace, affecting both their physical and mental health. However, there is no consensus when investigating the construct of "perceived work discrimination". Objective: To examine how perceived workplace discrimination has been investigated, considering its association with health and occupational outcomes. Methods: A scoping review will be performed according to the PRISMA guidelines for scoping reviews and the Joanna Briggs Institute. We will search for published articles in english and spanish between 2000 and 2022 in the Scopus, MEDLINE/PubMed, and PsycInfo databases. Through the Rayyan application, two reviewers will independently select titles and abstracts. Then, they will review the full texts. Subsequently, relevant information about the selected articles will be extracted, and their methodological quality will be evaluated. Finally, a narrative synthesis of the main results found will be made. Discussion: We expect the findings to improve methodological aspects when investigating perceived workplace discrimination, facilitating decision-making for those researchers who wish to address perceived work discrimination.

Introducción: La discriminación percibida es un fenómeno complejo de estudiar y que tiene grandes repercusiones en la salud de las personas. En el ámbito laboral, existe un gran número de estudios que confirma los efectos negativos en la salud de los trabajadores, afectando la salud física y psicológica de estos. Sin embargo, no existe un consenso al momento de investigar el constructo "discriminación laboral percibida". Objetivo: Explorar como se ha investigado la discriminación laboral percibida, considerando su asociación con salud y resultados ocupacionales. Métodos: Se realizará una revisión panorámica de acuerdo con las guías PRISMA para revisiones panorámicas y del Instituto Joanna Briggs. Se efectuará la búsqueda de los artículos publicados en idioma inglés y español entre los años 2000 y 2022 en las bases de datos Scopus, MEDLINE/PubMed y PsycInfo. A través de la aplicación Rayyan, dos revisores realizarán de manera independiente la selección de títulos y resúmenes. Luego, los mismos revisarán los textos completos. Posteriormente, se extraerá la información relevante sobre los artículos seleccionados y se evaluará la calidad metodológica de estos. Finalmente, se hará una síntesis narrativa de los principales resultados encontrados. Discusión: Se espera que los hallazgos contribuyan a mejorar los aspectos metodológicos al momento de investigar la discriminación laboral percibida y facilitar la toma de decisiones de aquellos investigadores que deseen abordar la discriminación laboral percibida.

Consideraciones metodológicas en el estudio de la discriminación laboral percibida: protocolo de una revisión panorámica / Methodological considerations in the study of perceived discrimination at work: a scoping review protocol

INTRODUCCIÓN: La discriminación percibida es un fenómeno complejo de estudiar y que tiene grandes repercusiones en la salud de las personas. En el ámbito laboral, existe un gran número de estudios que confirma los efectos negativos en la salud de los trabajadores, afectando la salud física y psicológica de estos. Sin embargo, no existe un consenso al momento de investigar el constructo "discriminación laboral percibida". OBJETIVO: Explorar como se ha investigado la discriminación laboral percibida, considerando su asociación con salud y resultados ocupacionales. MÉTODOS: Se realizará una revisión panorámica de acuerdo con las guías PRISMA para revisiones panorámicas y del Instituto Joanna Briggs. Se efectuará la búsqueda de los artículos publicados en idioma inglés y español entre los años 2000 y 2022 en las bases de datos Scopus, MEDLINE/PubMed y PsycInfo. A través de la aplicación Rayyan, dos revisores realizarán de manera independiente la selección de títulos y resúmenes. Luego, los mismos revisarán los textos completos. Posteriormente, se extraerá la información relevante sobre los artículos seleccionados y se evaluará la calidad metodológica de estos. Finalmente, se hará una síntesis narrativa de los principales resultados encontrados. DISCUSIÓN: Se espera que los hallazgos contribuyan a mejorar los aspectos metodológicos al momento de investigar la discriminación laboral percibida y facilitar la toma de decisiones de aquellos investigadores que deseen abordar la discriminación laboral percibida.

INTRODUCTION: Perceived discrimination is a complex phenomenon of study and has significant repercussions on people's health. Many studies confirm the negative effects of stress on workers' health in the workplace, affecting both their physical and mental health. However, there is no consensus when investigating the construct of "perceived work discrimination". OBJECTIVE: To examine how perceived workplace discrimination has been investigated, considering its association with health and occupational outcomes. METHODS: A scoping review will be performed according to the PRISMA guidelines for scoping reviews and the Joanna Briggs Institute. We will search for published articles in english and spanish between 2000 and 2022 in the Scopus, MEDLINE/PubMed, and PsycInfo databases. Through the Rayyan application, two reviewers will independently select titles and abstracts. Then, they will review the full texts. Subsequently, relevant information about the selected articles will be extracted, and their methodological quality will be evaluated. Finally, a narrative synthesis of the main results found will be made. DISCUSSION: We expect the findings to improve methodological aspects when investigating perceived workplace discrimination, facilitating decision-making for those researchers who wish to address perceived work discrimination.

Eating regularly and carefully, in appropriate environments and in company: An analysis between social representations and official stances on these recommendations of the Dietary Guidelines for the Brazilian Population

ABSTRACT The second edition of the Dietary Guidelines for the Brazilian Population (DGBP) advises "eating regularly and carefully", "eating in appropriate environments," and "eating in company". Individuals may interpret these guidelines differently. We analyzed social representations of these recommendations to ascertain how such representations relate to the official DGBP advice. This cross-sectional, exploratory study was conducted with a selected sample of teachers, administrative technicians, and students (N= 24) from the Federal University of Grande Dourados, Brazil. We carried out an exploratory content analysis of the responses to semi-structured interviews on the topic. We identified seven themes that encompassed the social representations of "eating regularly and carefully": 1) paying attention to what you eat; 2) having several meals; 3) eating slowly; 4) having time to eat; 5) eating without distractions; 6) eating adequate amounts; and 7) ensuring a nutritional balance. Four themes emerged from the analysis of the social representations of "eating in appropriate environments": 1) a pleasant environment; 2) at the table; 3) without interferences; and 4) a clean environment. The following themes encompassed the social representations of "eating in company": 1) eating in company is good; 2) I prefer to eat alone; and 3) eating in company is inconsequential. Although participant representations align with DGBP recommendations in the three orientations, in general, they extend beyond them. Professionals and government organizations in Brazil or abroad could take into consideration these results in order to optimize this tool's potential for research and policy in nutrition and public health.

RESUMEN La segunda edición de la Guía Alimentaria para la Población Brasileña (DGBP) aconseja "comer con regularidad y atención", "comer en ambientes adecuados" y "comer en compañía". Las personas pueden interpretar estas pautas de manera diferente. Analizamos las representaciones sociales de estas recomendaciones para determinar cómo se relacionan con la postura oficial de la DGBP. Este estudio transversal y exploratorio se realizó con una muestra seleccionada de profesores, técnicos administrativos y estudiantes (N= 24) de la Universidad Federal de Grande Dourados, Brasil. Realizamos un análisis exploratorio de contenido de las respuestas a entrevistas semiestructuradas sobre el tema. Identificamos siete temas que abarcan las representaciones sociales de "comer con regularidad y atención": 1) prestar atención a lo que come; 2) tener varias comidas; 3) comer despacio; 4) tener tiempo para comer; 5) comer sin distracciones; 6) comer cantidades adecuadas; y 7) asegurar un equilibrio nutricional. Cuatro temas surgieron del análisis de las representaciones sociales de "comer en ambientes adecuados": 1) ambiente agradable; 2) en la mesa; 3) sin interferencias; y 4) medio ambiente limpio. Los siguientes temas engloban las representaciones sociales de "comer en compañía": 1) comer en compañía es bueno; 2) prefiero comer solo; y 3) comer en compañía es intrascendente. Aunque las representaciones de los participantes se alinean con las recomendaciones de la DGBP en las tres orientaciones, en general, se extienden más allá de ellas. Investigadores y organizaciones gubernamentales en Brasil y en el extranjero podrían tener en cuenta estos resultados para optimizar el potencial de esta herramienta para la investigación y las políticas en nutrición y salud pública.

Translation and cross-cultural adaptation of the "Quality of Life in Epilepsy (QOLIE-31-P)" Questionnaire for Chile.

PURPOSE: To report the translation and cross-cultural adaptation of the Quality of Life in Epilepsy (QOLIE-31-P) Questionnaire in patients with epilepsy (PWE) in Chile. METHODS: Translation from the original and posterior back-translation was performed by independent translators, two in each step. The final consensual translation was modified for the Chilean context and assessed by cognitive interviews with 12 PWE from Chile's public healthcare system, selected by quotas. RESULTS: Main changes made to the original questionnaire were the addition, in some items, of an alternative, indicating the nonexistence of limitations produced by epilepsy, examples to clarify some questions, and some minor wording modifications. There was no addition or deletion of items. CONCLUSION: A culturally adapted version of the QOLIE-31-P questionnaire was obtained in conditions to be assessed psychometrically in a sample of PWE in Chile.

[Delphi method to reach consensus on education methods to promote healthy eating behaviors in adolescents]. / Método Delphi para consensuar metodologías educativas para promover la alimentación saludable en adolescentes.

INTRODUCTION: Background: adolescence is a relevant period to educate in healthy eating behaviors. For this purpose it is necessary to obtain expert opinions and reach consensus and prioritize the best methodologies available to educate adolescents on healthy eating. Methods: the Delphi method was chosen to get consensus through repeated iterations of anonymous opinions in two rounds. Participants were experts in nutrition (24), education (14), and cooking (2), selected with the following inclusion criteria: outstanding professional career; interest shown in their knowledge area, and expertise in healthy eating education. The 40 experts in the first round were reduced to 37 in the second round. The questionnaire was mailed in the first round and the results were sent to establish priorities in the second round. The analysis was done with descriptive statistics (%). Consensus was reached if ≥ 75th percentile. Cronbach's alpha coefficient was used to analyze internal consistency, which was considered good for an alpha value higher than 0.7, and moderate for values between 0.6 and 0.7. Results: there was 90% consensus for food habits, culinary skills, and methodologies. In food habits experts prioritized improving access to healthy food and curricular changes at school. In culinary skills they agreed on healthy breakfast and healthy snack preparations; in methodologies the consensus was to educate in healthy eating at breakfast and lunch at school, and on participative activities such as cooking workshops. Conclusions: the Delphi method was useful to obtain consensus and priorities on the methodologies to educate adolescents in healthy eating.

INTRODUCCIÓN: Antecedentes: la adolescencia es un período importante para reforzar la educación sobre alimentación saludable. Para ello se requiere consensuar y establecer prioridades con expertos sobre las mejores metodologías para educar a los adolescentes en alimentación saludable. Métodos: se escogió el método Delphi para obtener consenso a través de opiniones anónimas repetidas en dos rondas. Se seleccionaron expertos en nutrición (24), educación (14) y cocina (2) con los siguientes criterios de inclusión: carrera profesional relevante; mostrar interés en su área de conocimiento y experiencia en educación en alimentación saludable. Los 40 expertos de la primera ronda disminuyeron a 37 en la segunda ronda. El cuestionario enviado por correo en la primera ronda y sus resultados fueron reenviados para establecer prioridades. El análisis se efectuó con estadísticas descriptivas (%). Se consideró consenso el valor ≥ percentil 75. La consistencia interna se analizó con el coeficiente alfa de Cronbach (se considera buena si alfa es mayor de 0,7 y moderada si se sitúa entre 0,6 y 0,7). Resultados: hubo más de un 90 % de consenso en las metodologías para hábitos alimentarios, habilidades culinarias y estrategias metodológicas. En los hábitos alimentarios se consideró como prioritario mejorar el acceso a la comida saludable y cambiar los currículos en la escuela. En las habilidades culinarias, la preparación de un desayuno saludable y colaciones saludables, y en las estrategias metodológicas, educar en hábitos alimentarios durante el desayuno y el almuerzo, y desarrollar actividades participativas tales como talleres de cocina. Conclusiones: el método Delphi fue útil para obtener el consenso y las prioridades en cuanto a las metodologías para educar a los adolescentes en alimentación saludable.

[User perceptions of a public health program to reduce disability among Chilean older adults]. / Percepción usuaria de beneficios en salud del Programa Más Adultos Mayores Autovalentes en el Servicio de Salud Metropolitano Norte.

BACKGROUND: The Program "Más Adultos Mayores Autovalentes" (Más AMA) started in 2015 as a strategy for the prevention of disability among older adults. AIM: To describe the health benefits, from user's perspective, of the Functional Stimulation Component of the Más AMA program. MATERIAL AND METHODS: Eleven focus groups including 97 participants of the Más AMA program were conducted in Northern Metropolitan Santiago municipalities. RESULTS: The benefits perceived by Más AMA participants were a reduction in loneliness and isolation, physical reactivation, engagement in activities, and the use of support resources within the community. The relationship with professionals working at Más AMA was described as highly satisfactory. CONCLUSIONS: The benefits of attending the Más AMA program from the point of view of their users are mainly related with social and affective dimensions, which contrast with the emphasis in physical and cognitive dimensions given by the technical orientation of the Más AMA program.

Percepción usuaria de beneficios en salud del Programa Más Adultos Mayores Autovalentes en el Servicio de Salud Metropolitano Norte / User perceptions of a public health program to reduce disability among Chilean older adults

Background: The Program "Más Adultos Mayores Autovalentes" (Más AMA) started in 2015 as a strategy for the prevention of disability among older adults. Aim: To describe the health benefits, from user's perspective, of the Functional Stimulation Component of the Más AMA program. Material and Methods: Eleven focus groups including 97 participants of the Más AMA program were conducted in Northern Metropolitan Santiago municipalities. Results: The benefits perceived by Más AMA participants were a reduction in loneliness and isolation, physical reactivation, engagement in activities, and the use of support resources within the community. The relationship with professionals working at Más AMA was described as highly satisfactory. Conclusions: The benefits of attending the Más AMA program from the point of view of their users are mainly related with social and affective dimensions, which contrast with the emphasis in physical and cognitive dimensions given by the technical orientation of the Más AMA program.

Disclosing Product Placements of Fast Food to Children: The Importance of Reinforcing the Use of Disclosures and the Age of Children.

Product or brand placement, the integration of brand/products into TV programs/films, is one of the most controversial forms of promotion. Based on its embedded character, the European Union promulgated in 2010 a norm that obligates broadcasters to disclose the presence of placement. Taking the case of fast food marketing, this paper examines the effects of using disclosures and reinforcing their use during a program (only at the beginning vs. at the beginning and after a commercial break) on children at different ages (9,12 and 15) in terms of the awareness of the nature of placement, and brand effects (recall and preference). The results showed that (1) reinforcing the use of disclosures increased the awareness of placements; (2) both forms of disclosures (single and reinforced) raised brand recall and limited brand preference of the advertised brand; older children (3) increased the awareness of placements and decreased their brand preference; and also (4) enhanced the effect of disclosures on awareness and brand preference.

[Primary Care Assessment Tool applied to primary health care workers from Conchalí, Santiago]. / Estructura y funciones de la Atención Primaria de Salud según el Primary Care Assessment Tool para prestadores en la comuna de Conchalí - Santiago de Chile.

BACKGROUND: The Chilean public health system is based on Primary Health Care (PHC), whose assessment is challenging due to the heterogeneity of services and multi-dimensionality of expected results. The Primary Care Assessment Tool was adapted and validated for Chile. AIM: To analyze, from the provider's perspective, the structure and functioning of the health centers, to determine the achievement of PHC's core functions: access, continuity, coordination, comprehensiveness of care, cultural competence, family centeredness and community orientation. MATERIAL AND METHODS: All professionals working in primary care in a commune of Metropolitan Santiago were invited to answer an online version of the Primary Care Assessment Tool. RESULTS: One hundred and nine professionals (51% of those invited) from four Family Health Centers, two Community Health Centers, and a Community Mental Health Center, answered the online questionnaire. Their distribution by profession and health units does not resemble the whole research population, which should be considered when interpreting the results. Data show a good performance of the system: general and domain specific scores are all near three for a maximum score of four. Family centeredness obtained the highest score, whereas cultural competence had the lowest. CONCLUSIONS: Reinforcing intercultural skills and a wider approach to psycho-social problems is recommended to strengthen the new healthcare model implementation.

Estructura y funciones de la Atención Primaria de Salud según el Primary Care Assessment Tool para prestadores en la comuna de Conchalí - Santiago de Chile / Primary Care Assessment Tool applied to primary health care workers from Conchalí, Santiago

Background: The Chilean public health system is based on Primary Health Care (PHC), whose assessment is challenging due to the heterogeneity of services and multi-dimensionality of expected results. The Primary Care Assessment Tool was adapted and validated for Chile. Aim: To analyze, from the provider's perspective, the structure and functioning of the health centers, to determine the achievement of PHC's core functions: access, continuity, coordination, comprehensiveness of care, cultural competence, family centeredness and community orientation. Material and Methods: All professionals working in primary care in a commune of Metropolitan Santiago were invited to answer an online version of the Primary Care Assessment Tool. Results: One hundred and nine professionals (51% of those invited) from four Family Health Centers, two Community Health Centers, and a Community Mental Health Center, answered the online questionnaire. Their distribution by profession and health units does not resemble the whole research population, which should be considered when interpreting the results. Data show a good performance of the system: general and domain specific scores are all near three for a maximum score of four. Family centeredness obtained the highest score, whereas cultural competence had the lowest. Conclusions: Reinforcing intercultural skills and a wider approach to psycho-social problems is recommended to strengthen the new healthcare model implementation.

The role of gender in the association between self-rated health and mortality among older adults in Santiago, Chile: A cohort study.

BACKGROUND: Previous studies on the role of gender in the association between self-rated health and mortality have shown contrasting results. This study was aimed to determine the importance of gender in the association between self-rated health and mortality among older people in Santiago, Chile. METHODS: A 10 year follow-up of 1066 people aged 60 or more, from the Chilean cohort of the Study of Health, Ageing and Well-Being. Self-rated health was assessed in face to face interviews through a single general question, along with socio-demographic and health status information. Cox proportional hazards and flexible parametric models for survival analyses were employed. RESULTS: By the end of follow-up, 30.7% of women and 39.4% of men died. Adjusted hazard ratio of poor self-rated health, compared to good self-rated health, was 1.92(95% CI 1.29-2.86). In models stratified by gender, an increased risk of mortality was observed among women who rated their health as poor (HR = 2.21, 95% CI 1.43-3.40), but not among men (HR = 1.04, 95% CI 0.58-1.86). Age was associated with mortality in both groups; for men, functional limitation and underweight were also risk factors and obesity was a protective factor. CONCLUSIONS: Compared to older women who rated their health as good, older women who rated their health as poor had a 2 fold increased risk of mortality over the subsequent 10 years. These findings stress the importance of considering a gender perspective into health programmes, including those focused on older people, in order to address the different elements that increase, on the long run, the risk of dying among older women and men.

The effects of TV unhealthy food brand placement on children. Its separate and joint effect with advertising.

This paper examines the effect of unhealthy food brand placement on children across different age groups (9, 12 and 15 year-old children). Results show that both brand awareness, and the behavioral disposition (toward junk food and McDonald's) increased when children were exposed to this marketing technique (in comparison with the control group). In the case of age, older groups (12-15) performed better in brand awareness, but scored lower in behavioral disposition than the 9-year-old group. Moreover, the joint use of advertising and placement (synergy) increased the effect of these communication tactics on children. Results are discussed in terms of previous results of the studies providing evidence of the influence of promotional tools of junk food on children.

Gobierno de redes asistenciales: evaluación de los Consejos Integradores de la Red Asistencial (CIRA) en el contexto de la reforma del sector salud en Chile / Governance of health care networks: assessment of the health care integrating councils in the context of the health sector reform in Chile

Objetivo. Este artículo busca evaluar la contribución de los Consejos Integradores de la Red Asistencial (CIRA) en mejorar la gobernanza en salud en Chile. Material y métodos. Se realizó una revisión de los documentos oficiales asociados con el proceso de constitución y desarrollo de los CIRA; se aplicó un cuestionario ad hoc a los 29 CIRA del país y se realizaron 35 entrevistas semiestructuradas en profundidad a participantes de una muestra de seis CIRA. Resultados. Los CIRA se han constituido en una herramienta de integración funcional y un espacio valorado de diálogo, cooperación y aprendizaje por parte de los actores de las redes asistenciales públicas chilenas. Conclusiones. Se concluye que hay un espacio de mejora con respecto a su rol en la gobernanza de la red en la medida en que desarrollan facultades relacionadas con las inversiones en infraestructura, tecnología y recursos humanos, así como con las decisiones que corresponden a las asignaciones presupuestarias en la red.

Objective. This paper aims at assessing the contribution of Chile's Health Care Integrating Councils (CIRA, Spanish acronym) to strengthening governance in health. Materials and methods. A literature review on the official documents related to the process of creation and development of CIRA was carried out; an ad hoc questionnaire was applied to all 29 health services of the country; finally, 35 semi-structure in-depth interviews were carried on a sample of six CIRA. Results. The CIRAs have become a tool for functional integration and a valuable space for dialogue, cooperation and learning for all of the actors of the Chilean public health network. Conclusions. In this study, we conclude that there is room for improvements of CIRA's role regarding governance of the health care network as long as CIRA is authorized to deal with strategic topics, such as investment in infrastructure, technology and human resources, and budgeting.

[Socioeconomic inequalities in the onset and progression of disability in a cohort of older people in Santiago (Chile)]. / Desigualdades socioeconómicas en el proceso de discapacidad en una cohorte de adultos mayores de Santiago de Chile.

OBJECTIVE: To describe and compare socioeconomic inequalities in the onset and progression of disability in a cohort of Chilean community-dwelling older people that provides unprecedented information about this process in Chile. METHODS: The data were drawn from a 10-year longitudinal study (2000-2010) that followed a probabilistic and representative sample of the SABE (Health, Welfare and Aging) cohort. The present study was based on 78% (1019) of the baseline sample of adults aged 60 years or more living in Santiago, Chile. Functional limitation was defined on the basis of a combination of six basic activities of daily living, seven instrumental activities, and seven mobility activities (limited, no limited). Socioeconomic position (high, medium and low) was assessed by combining measures of household equipment, wealth, and education. RESULTS: The initial prevalence of functional limitation was 47.3% (95%CI: 44.2-50.4) with a clear socioeconomic gradient (60.1% low, 47.5% medium, and 28.7% high; p<0.001). At the end of the follow-up, older adults with low socioeconomic status remained functionally limited while those with high socioeconomic status remained non-limited. The incidence density of functional limitation also followed a socioeconomic gradient (5.33, 6.59 and 7.73 per 100 years-person for low, medium and high socioeconomic status). Social inequalities were also observed for mortality. CONCLUSION: This study corroborates the social stratification of functional status and mortality, suggesting that aging is not a leveler of inequalities. In Latin-American countries, policies should aim to reduce inequalities by attempting to limit exposure to risk factors and to compensate for deficiencies (especially among the poorest older people) in order to prevent the progression of functional impairment to disability.

Validity and reliability of the SF-36 in Chilean older adults: the ALEXANDROS study.

To validate short-form-36 health survey (SF-36) with specific scoring algorithm obtained in a large sample of Chilean older people and to associate quality of life in this sample with social and health related factors. A cross-sectional study on 2,143 community-living subjects aged 60-92 years (33 % men and 67 % women) conducted in Santiago, Chile. Scores in 8 scales of SF-36-physical function (PF), role physical (RP), bodily pain (BP), general health (GH), vitality (VT), social functioning (SF), role emotional (RE) and mental health (MH)-, were calculated. Factor analysis was used to extract two principal factors and logistic regression model was applied to estimate its association with socio-demographic and health variables. The internal consistency of scales was high (Cronbach's alpha 0.86-0.87). Factor analysis retained two factors: mental (MCS) and physical (PCS) components accounting for 65.3 % of total variance (55.3 and 10.0 % respectively). High correlations (0.61-0.94) between MCS and MH, V, RE and SF were obtained. PCS correlated highest (0.72-0.86) with RP, PF and BP. Self-perceived symptoms of depression (GDS-15 ≥5) was the main variable explaining low scores in both MCS and PCS (adjusted OR = 26.9; 95 % CI: 15.3-47.2; OR = 3.4; 95 % CI: 2.1-5.5, respectively). We have demonstrated the reliability and validity of SF-36 questionnaire to evaluate health related quality of life, reporting Chilean-Specific factor score coefficients for MCS and PCS based in national Chilean means and standard deviations for older people. After adjusting by age and gender, the main predictors of low health related QoL in Chilean older people were self-perceived symptoms of depression, the presence of two or more chronic diseases and illiteracy. Important gender inequalities were observed in all of these results, being consistently less favorable in women than in men.

Oral health-related quality of life of older people from three South American cities.

OBJECTIVE: To describe subjective oral health status and its association with overall health conditions and socioeconomic factors in the elderly (60 years and older) living in the capital cities with the oldest average populations in South America. BACKGROUND: Oral diseases are a public health problem, frequently neglected in older adults. In recent years, the subjective assessment of psychological and social consequences of the problems related to oral health has been valued. One of the instruments used to estimate the Oral Health-Quality of Life is the Geriatric Oral Health Assessment (GOHAI). MATERIAL AND METHODS: Representative samples from SABE study (1999-2000) of Santiago (n = 1301), Buenos Aires (n = 1043), and Montevideo (n = 1450) aged 60 and over community-dwelling people. We assessed OH-QoL (GOHAI), self-reported missing teeth, denture use, and self-rated-health, among other indicators. Logistic regression models(GOHAI < 58) for each city, adjusted by sex and age, were applied. RESULTS: GOHAI average scores were higher in Montevideo (54.8 ± 6.1) than in Buenos Aires (53.1 ± 7.4) and Santiago (49.9 ± 8.6). A pronounced gradient of the oral condition and GOHAI scores were observed within the three-cities. Denture use -less prevalent in Santiago and more common among women- is a protective factor against a poor OH-QoL. CONCLUSION: Socioeconomic inequalities in oral health status and OH-QoL are observed in the three cities. The increasing life expectancy emphasizes the need to integrate prevention and treatment efforts, as a way to improve OH-QoL over the course of a lifetime.