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1.
Acta bioeth ; 22(1): 71-79, jun. 2016. graf, tab
Article in English | LILACS | ID: lil-788886

ABSTRACT

This paper describes the changes in alcohol research, from a traditional individual focus on individual bodily and mental effects, to a broader focus on harm to others. This shift has coincided with broader sequential definitions of the progression from normal through harmful alcohol dependence, both in the specialized epidemiological and also in the newer classificatory systems (DSM 5 and CIE 11 draft). After presenting updated global, regional and chilean data, an international collaborative Project (Alcohol Harm to Others, ATOH) is described, with the participating institutions: the local study and the chilean components of the research team, the conceptual framework of harm to others (families, children, women; neighbors, friends, co-workers; society at large). Ethical aspects and institutional approval are presented and the principal results outlined: socio-demographic data (with special focus on the role of gender, socio-economic level and religiosity/spirituality). The data is presented for the chilean sample, with examples from other participating countries. The complexity of the link between alcohol harm to others and religious and spiritual factors is studied comparing data from several of the participating countries, and the impact upon vulnerable populations, especially women and children. The discussion reviews some of the confounding and intervening factors that could influence the results. The conclusion about prevention and policy development closes the paper.


Este artículo describe los cambios en investigación sobre el abuso de alcohol, desde un enfoque tradicional sobre los efectos corporales y mentales en el individuo, a un enfoque amplio sobre el daño a otros. Este cambio ha coincidido con definiciones secuenciales más amplias de la progresión desde el estado normal a la dependencia dañina al alcohol, ambas en la especialidad de la epidemiología y también en los nuevos sistemas de clasificación (DSM 5 y propuesta de CIE 11). Después de presentar datos actualizados globales, regionales y chilenos, se describe un proyecto internacional colaborativo (Daño a Otros por Causa del Alcohol, ATOH) con las instituciones participantes: el estudio local y los componentes chilenos del equipo de investigación, la estructura conceptual de daño a otros (familias, niños, mujeres; vecinos, amigos, compañeros de trabajo; la sociedad en general). Se presenta la aprobación institucional y aspectos éticos, así como se delinean los principales resultados: datos sociodemográficos (con enfoque especial en el rol de género, nivel socioeconómico y espiritualidad/religiosidad). Se presentan los datos de la muestra chilena, con ejemplos de otros países participantes. Se estudia la complejidad del vínculo entre el daño por alcohol a otros y factores religiosos y espirituales, comparando datos de varios de los países participantes, y el impacto sobre poblaciones vulnerables, especialmente mujeres y niños. La discusión revisa algunos de los factores de confusión y de intervención que podrían influenciar los resultados. Se cierra el artículo con conclusiones sobre prevención y desarrollo de normativas.


Este artigo descreve as alterações na pesquisa do álcool, a partir de um foco individual tradicional sobre os efeitos orgânicos e mentais individuais, para um foco mais amplo sobre danos a outros. Essa mudança coincidiu com mais amplas definições sequenciais da progressão do normal através de dependência de álcool prejudiciais, tanto na epidemiologia especializada como nos sistemas classificatórios mais recentes (DSM 5 e CIE 11 minuta). Depois de apresentar dados atualizados globais, regionais e chileno, um projeto internacional colaborativo (Alcohol Harm to Others, ATOH) é descrito, com as instituições participantes: o estudo local e os componentes chilenos da equipe de pesquisa, o quadro conceitual do dano a outrem ( famílias, crianças, mulheres, vizinhos, amigos, colegas de trabalho, e sociedade em geral). Aspectos éticos e aprovação institucional são apresentados e os principais resultados delineados: dados sócio-demográficos (com especial destaque para o papel do sexo, nível socioeconômico e espiritualidade / religiosidade). Os dados são apresentados para a amostra chilena, com exemplos de outros países participantes. A complexidade da relação entre efeitos nocivos do álcool para os outros e fatores religiosos e espirituais é estudada comparando os dados de vários dos países participantes, bem como o impacto sobre populações vulneráveis, especialmente mulheres e crianças. A discussão revê alguns dos fatores de confusão e intervenientes que poderiam influenciar os resultados. A conclusão sobre a prevenção e desenvolvimento de políticas define o papel.


Subject(s)
Humans , Male , Female , Dangerous Behavior , Alcoholism/complications , Interpersonal Relations , Religion , Socioeconomic Factors , Chile , Surveys and Questionnaires , Cultural Factors , Alcoholism/epidemiology
2.
Rev. méd. Chile ; 144(1): 47-54, ene. 2016. tab
Article in Spanish | LILACS | ID: lil-776974

ABSTRACT

Background: Diverse and sustained efforts have been developed to improve the management of depression by general practitioners (GPs), but they have not improved treatment coverage and quality of services. Aim: To explore the level of knowledge and clinical skills to diagnose and treat depression by GPs in Primary Health Care (PHC) in the Metropolitan Area of Santiago de Chile (RM). Material and Methods: Theoretical knowledge (TK), diagnostic skills (DS) and treatment skills (TS) were evaluated in 56 GPs of the RM with a battery of specially designed instruments. Results: In TK there were significant differences between GPs aged 31 years or less and their older counterparts and between Chilean and foreign doctors. Five percent of observed differences in TK were explained by age and nationality, respectively. Chilean GPs achieved higher scores in recognition of symptoms (RS), one of the dimensions of DS. No significant differences by age or nationality were observed for DS and TS. Conclusions: Achievement of GPs on tests measuring TK, DS, and TS was generally below 50%. This deficiency should be improved.


Subject(s)
Humans , Male , Female , Adult , Clinical Competence , Depressive Disorder/diagnosis , General Practitioners/standards , Primary Health Care , Practice Patterns, Physicians' , Chile , Depressive Disorder/therapy , Quality Improvement
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