Garantías explícitas en salud odontológica de las embarazadas y la salud pública por regiones y años 2010-2019 en Chile

Objetivo: Estimar la tasa de uso de las Garantías Explícitas de Salud (GES) dental de la embarazada entre 2010 a 2019 en todas las regiones de Chile. Pacientes y métodos: Diseño: descriptivo, observacional. Participantes: mujeres embarazadas, atendidas en el sistema público. Se estudió un total de 1 854 621 gestantes, 1 445 903 de gestantes con ingreso al GES y 1 257 775 de gestantes con alta dental integral pertenecientes a cada región y año analizado. Mediciones: estimación de tasas de uso del GES odontológico, análisis de las tasas de eficacia y de la evolución de las tasas de uso del GES mediante series de tiempo. Resultados: Las medias del uso del GES y la eficacia de la atención por GES fue inferior al valor óptimo (100 %). Ambas tasas difieren del valor meta de la autoridad sanitaria. Los valores de las tasas del uso del GES varían por año y región. La forma de las curvas fue predominantemente no lineal. Conclusión: El uso y la eficacia del GES odontológico en embarazadas chilenas no está en correspondencia con los objetivos del Ministerio de Salud Pública. Se requieren nuevos estudios para explicar las causas de estos resultados.

Objective. Estimate the rate of use of the Explicit Dental Health Guarantees (GES) by pregnant women from 2010 to 2019 in the regions of Chile. Patients and methods. Design: Descriptive, observational. Participants: Pregnant women, cared for in the public system. The total of pregnant women (1,854,621), pregnant women admitted to the GES (1,445,903), and pregnant women with full dental discharge (1,257,775) belonging to each of the regions and years analyzed (2010-2019) were studied. Measurements: estimation of dental GES use rates, evolution of rates over time using time series (regressions). Results. The means of the use of the GES and the effectiveness of the care by the GES was less than the optimal value (100%). Both rates differ from the target value of the health authority. The value of usage fees varies by year and region. The shape of the curves was predominantly non-linear. Conclusions. The use and effectiveness of the dental GES in Chilean pregnant women is not in correspondence with the objectives of the Ministry of Public Health. New studies are required to explain the causes of these results.

Psychological needs in parents and clinically referred adolescents: An integrative model via parenting and parental mindfulness.

Framed on Self-Determination Theory, this study sought to examine the interplay between parents' and adolescents' need satisfaction and need frustration, as well as to investigate the potential mediating role of autonomy-supportive and psychologically controlling parenting. Whether parents' dispositional mindfulness moderated the relation between parental need frustration and parenting was also investigated. Participants were 213 clinically referred adolescents between 12 and 17 years (Mage = 14.36; 55.9% girls) and 225 parents (85.3% mothers). Findings from structural equation models revealed a bright and a dark pathway linking parents' and adolescents' need-based experiences through parenting. Specifically, parental need satisfaction was positively related to autonomy-supportive parenting, which, in turn, contributed to greater adolescents' need satisfaction. In contrast, parents' need frustration yielded a positive association with psychologically controlling parenting, which, in turn, positively related to adolescents' need frustration. Latent moderation analyses also indicated that parents' mindfulness played a role as a moderator of the relationship between parental need frustration and psychological control; the association was attenuated when parents reported higher levels of mindfulness. Implications for the promotion of positive parenting among families of adolescents with mental health problems are outlined. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Demographic, Social, and Economic Factors of Internalizing Problems in Referred and Non-Referred Adolescents.

Depressive symptoms and suicidal ideation are common internalizing problems during adolescence. Numerous studies have explored the role of certain demographic, social, and economic factors in their development in referred or non-referred adolescents, but not simultaneously in both groups. In this study, we examined the association between age, gender, parents' educational level, and socioeconomic status (SES) and depressive symptoms and suicidal ideation in a referred group (n = 211) and a non-referred (n = 1401) group of adolescents. We also examined the moderating role that these factors play in the relationships between both internalizing problems. The results showed: higher levels of depressive symptoms and suicidal ideation in the referred group; an increase in both problems during early-to-middle adolescence in the non-referred group; an association between low SES and suicidal ideation in both groups; an association between low father's education level and depressive symptoms in the non-referred group; and no gender differences in either of these two internalizing problems. The moderation analyses showed that age, in referred adolescents, and SES, in non-referred adolescents, moderated the relationship between depressive symptoms and suicidal ideation. This study contributes to the identification of groups of vulnerable adolescents that could constitute the target populations of preventive programs.

When is Parental Monitoring Effective? A Person-centered Analysis of the Role of Autonomy-supportive and Psychologically Controlling Parenting in Referred and Non-referred Adolescents.

Over the last few years, the protective role of parental monitoring on adolescent adjustment (i.e., active parental efforts aimed at setting limits and tracking adolescents' activities and whereabouts) has been challenged. Recent research has shifted attention to the conditions under which monitoring may be more or less effective. Grounded in Self-Determination Theory, this study investigated the role of parents' autonomy-supportive and psychologically controlling parenting in effects of parental monitoring on adolescents' adjustment. It also considered the role of adolescents' clinical status (i.e., clinically referred vs non-referred). Adopting a person-centered approach, we aimed to identify naturally occurring profiles of monitoring, autonomy-support, and psychological control and to examine differences between these profiles in terms of life satisfaction, positive affect, and internalizing and externalizing problems. Participants included 218 referred (Mage = 14.44, 56% girls) and 218 matched adolescents from a larger sample of 1056 community (Mage = 14.83, 52.9% girls). Multigroup Latent Profile Analyses revealed five parenting profiles which were structurally equivalent in both samples: high monitoring with either high autonomy support or high psychological control, low monitoring with either high autonomy-support or high psychological control, and an average profile. Referred youth were significantly more present in the average profile and in the profiles characterized by high levels of psychological control. As hypothesized, profiles showed a differential association with adolescents' self-reported adjustment, with the high monitoring-high autonomy support profile yielding the most optimal and the low monitoring-high psychological control profile yielding the worst outcomes. Associations between profiles and outcomes were similar for referred and non-referred adolescents. These findings highlight the importance of considering the parenting climate (i.e., autonomy-supportive versus psychologically controlling) to understand effects of parental monitoring during adolescence.

Development and validation of the Scale of Motives for Using Social Networking Sites (SMU-SNS) for adolescents and youths.

Over the past decade, the Uses and Gratifications theory has driven research on the motives behind social media use. The three most commonly explored motives have been: maintaining relationships, seeking information, and entertainment. The aim of this study was to develop and validate the Scale of Motives for Using Social Networking Sites (SMU-SNS), a measure to assess a wider range of motives for using Social Networking Sites than have previously been researched. A multi-method design with different samples of high-school and university students was used. First, to develop the pool of items, a literature review and a focus group study (n = 48, age range = 16-21) was conducted. Second, to reduce and refine the pool of items a pilot study (n = 168, age range = 14-24) was performed. Third, a validation study (n = 1102, age range = 13-25) was conducted to assess the validity and reliability of the SMU-SNS. Cross-validation using EFA and CFA resulted in a final version comprising 27 items distributed in nine factors (Dating, New Friendships, Academic Purposes, Social Connectedness, Following and Monitoring Others, Entertainment, seeking Social Recognition, Self-expression, and seeking Information). Internal consistency was excellent and evidence of measurement invariance across gender and age was largely achieved. The SMU-SNS scores significantly correlated with other relevant variables, including age, gender, certain personality traits, social support, loneliness, and life satisfaction. Overall, findings supported the SMU-SNS as a valid and reliable measure to assess youth's motives for using Social Networking Sites. Psychometric and general implications are discussed.

A Model on the Contribution of School Assets to the Achievement of Adolescents' Well-Being and Academic Performance.

The aim of this study was to examine a model on the contribution of school assets on the development of adolescent´s well-being and school success. The sample comprised 1944 adolescents (893 girls and 1051 boys) aged between 12 and 17 years (M = 14.4; SD = 1.13), from secondary schools in Western Andalusia, which completed some self-report questionnaires. The results of structural equation modeling showed the goodness of fit of the initial theoretical model. This model confirmed the importance of school connectedness as a key factor in the relationships between other school assets (social climate; clarity of the rules and values, and positive opportunities and empowerment) and commitment to learning, academic performance and life satisfaction. However, the re-specification of the initial model considered two complementary paths with theoretical sense: first, a direct influence between clarity of the rules and values and commitment to learning, and second, between academic performance and life satisfaction. This model obtained better goodness of fit indices than the first one: χ2 = 16.32; gl = 8; p = .038; χ2/gl = 2.04; SRMR = .018; RSMEA = .023 (95% C.I. = .005; 040); NNFI = .98; CFI = .99. From our study, the need to invest in initiatives focused on the promotion of adolescents' links with their school emerges as a key goal to contribute towards, at the same time, both a good academic performance and a better life satisfaction.

Development of emotional autonomy from adolescence to young adulthood in Spain.

The main objective of this study was to learn whether emotional autonomy is truly part of a developmental stage for Spanish adolescents and young adults or if it is an indicator of difficult family relationships. Using a longitudinal design, a sample of ninety young people was followed for ten years, from their initial adolescence until their first years of adulthood. At four observation points, the participants completed various questionnaires to evaluate their emotional autonomy, the cohesion in their family relationships and their life satisfaction. There were no gender differences in the development of emotional autonomy. Family cohesion and life satisfaction showed significant negative associations with emotional autonomy and these associations became more pronounced as participants moved from adolescence into adulthood. Based on our results, emotional autonomy from parents does not seem to be a developmental stage taking place during adolescence, but rather, an indicator of difficult family relationships.

[An approach to the assessment of the effectiveness of a drug use prevention program in secondary education in Andalusia]. / Una aproximación a la evaluación de la eficacia de un programa de prevención de drogodependencias en Educación Secundaria en Andalucía.

This article examines the analysis of drug use among Secondary Education students in Andalusia from two different studies: the Health Behavior in School-aged Children Study (HBSC), in its 2006 edition, and a study assessing the implementation of the Prevenir para Vivir ("Prevent to Live") drug use prevention program in the education field. To this end, on the one hand the paper analyzes the use of tobacco, alcohol and cannabis among Andalusian adolescents on the HBSC Study, and on the other, selects two groups of adolescents to examine and compare their drug use: a group from the HBSC Study who had not participated in any drug use prevention program and in whose schools the staff had not received training in relation to these issues (called HBSC Control Group), and a group of adolescents who had participated in the Prevenir para Vivir drug use prevention program working with specialized staff (called Prevenir para Vivir Experimental Group). The results indicate, first, higher levels of drug use in older students than in younger ones; and, second, on comparing the two groups, that adolescents who have received drug prevention programs with specialized staff are not always those most likely to present healthier drug use. These results must therefore be interpreted as offering only limited support to drug use prevention programs.

A longitudinal research on the development of emotional autonomy during adolescence.

The purpose of the present paper was to study the development of emotional autonomy through adolescence analysing its association with family relationships. The development of emotional autonomy involves an increase in adolescents' subjective sense of his or her independence, especially in relation to parents. From some scholars emotional autonomy is a normative manifestation of the detachment process from parents, however, others point out that detachment from parental ties is not the norm, so high level of adolescent emotional autonomy is the consequence of negative family relationships. In our study a sample of 101 adolescents were followed for 5 years, from early to middle adolescence, and completed questionnaires to measure their emotional autonomy and the quality of their family relationships. Our results showed that over the course of adolescence some dimensions of emotional autonomy increase, meanwhile others decrease, so the global level of emotional autonomy global level remains stable. On the other hand, emotional autonomy is associated with negative family relationships, so emotional autonomy, more than a necessary process to become adult, could be indicating an insecure attachment to parents.

Protective effect of supportive family relationships and the influence of stressful life events on adolescent adjustment.

The purpose of this study was to determine the association between the occurrence of stressful life events and internalizing and externalizing problems, and to analyze longitudinally buffering effects of supportive family relationships. To this end, 100 Spanish adolescents were studied twice, when they were in mid-adolescence (15-16 years) and two years later. They completed questionnaires regarding stressful life events, family relationships, and adolescent adjustment. Results showed that high quality parent-adolescent relationships protected boys and girls against the negative consequences of stressful life events on externalizing, but not internalizing, symptoms. The adolescents who enjoyed good relationships with their parents in mid-adolescence did not increase their externalizing problems in late adolescence as consequence of the occurrence of stressful events. However, these stressors did lead to an increase in the number of externalizing problems when the family relationships were of a middle or low quality. These results highlight the important role that supportive family relationships play in the behavioral adjustment of adolescents, protecting them against some negative consequences of stressful life events, and suggest the relevance of supporting parents through resources such as parent education in order to help them to improve their relationships with their adolescents.