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We evaluated the effect of periosteal-releasing incisions on flap displacement in anterior maxillary sites following implant placement and simultaneously guided bone regeneration. Thirty patients, each requiring a single dental implant and guided bone regeneration in the maxillary esthetic zone, were recruited. After full-thickness flap elevation, the displacement of the flap was measured under a standardized tension of 1 Ncm. Then, a 2-step periosteal releasing incision was placed in the internal aspect of the flap, and the displacement was remeasured using the same standardized tension. Keratinized tissue width and mucosal thickness at the surgical site were recorded. Patient-reported outcomes were assessed at the 7- and 14-day recall visits. Flap displacement (primary outcome) was calculated before and after periosteal-releasing incisions. Multivariable linear regression models were used to evaluate the influence of mucosal thickness on flap displacement and adjusted for Keratinized tissue width. Primary wound closure was achieved in all patients. The mean difference in flap coronal displacement before and after the periosteal-releasing incisions was 8.2 mm (p < .0001). Adjusted regression models showed no association between mucosal thickness and keratinized tissue width with the amount of flap displacement (p = .770). Patient-reported outcome measures for pain, swelling, and bleeding amounted to 1.28 ± 1.93, 1.36 ± 1.87, and 0.0 ± 0.0 at 7 days and 0.11 ± 0.57, 0.56 ± 1.03, and 0.0 ± 0.0 at 14 days, respectively. Periosteal-releasing incisions using the 2-step procedure described here are a predictable technique to obtain coronal flap displacements >8 mm without increased surgical complications.
Subject(s)
Maxilla , Periosteum , Humans , Periosteum/surgery , Male , Female , Middle Aged , Maxilla/surgery , Bone Regeneration , Dental Implantation, Endosseous/methods , Guided Tissue Regeneration, Periodontal/methods , Surgical Flaps/surgery , Adult , Patient Reported Outcome Measures , Aged , Dental Implants, Single-ToothABSTRACT
BACKGROUND: The PHQ-4 is an ultrabrief screening test for depression and anxiety symptoms. The psychometric properties of this test among the population in Chile are unknown. This study was aimed to determine the factor structure of the PHQ-4 in the adult population in Chile, and to assess its measurement invariance across different groups. METHODS: The study considered a nationally representative sample of 10921 people aged 18 and above, in Chile in 2021. Exploratory and confirmatory factor analysis were conducted, and configural, metric, scalar, and strict measurement invariance were assessed. RESULTS: The two-factor structure of the PHQ-4 supported the two underlying constructs of depression and anxiety. This model explained 67% of the variance and had excellent fit (CFI: 0.9999; TLI: 0.9994; RMSEA: 0.0107; SRMR: 0.0022). Strict measurement invariance held across gender, age, area of residence, household income quintile, immigrant or host population, and indigenous or non-indigenous population (ΔCFI<0.01). CONCLUSION: The PHQ-4 can be used to assess depressive and anxiety symptoms in population studies, and as a screening test for depression and anxiety in public mental health programs in Chile.
Subject(s)
Anxiety , Depression , Patient Health Questionnaire , Psychometrics , Humans , Chile , Male , Female , Adult , Middle Aged , Depression/epidemiology , Depression/psychology , Depression/diagnosis , Adolescent , Anxiety/psychology , Anxiety/epidemiology , Psychometrics/methods , Young Adult , Factor Analysis, Statistical , AgedABSTRACT
BACKGROUND: Lassa fever is a viral haemorrhagic fever with few options for diagnosis and treatment; it is also under-researched with knowledge gaps on its epidemiology. A point-of-care bedside test diagnosing Lassa fever, adhering to REASSURED criteria, is not currently available but is urgently needed in west African regions with high Lassa fever burden. We aimed to assess the validity and feasibility of a rapid diagnostic test (RDT) to confirm Lassa fever in people in Nigeria. METHODS: We estimated the diagnostic performance of the ReLASV Pan-Lassa RDT (Zalgen Labs, Frederick, MD, USA) as a research-use-only test, compared to RT-PCR as a reference standard, in 217 participants at a federal tertiary hospital in Abakaliki, Nigeria. We recruited participants between Feb 17, 2022, and April 17, 2023. The RDT was performed using capillary blood at the patient bedside and using plasma at the laboratory. The performance of the test, based on REASSURED criteria, was assessed for user friendliness, rapidity and robustness, sensitivity, and specificity. FINDINGS: Participants were aged between 0 and 85 years, with a median age of 33·0 years (IQR 22·0-44·3), and 24 participants were younger than 18 years. 107 (50%) participants were women and 109 (50%) were men; one participant had missing sex data. Although the specificity of the Pan-Lassa RDT was high (>90%), sensitivity at bedside using capillary blood was estimated as 4% (95% CI 1-14) at 15 min and 10% (3-22) at 25 min, far below the target of 90%. The laboratory-based RDT using plasma showed better sensitivity (46% [32-61] at 15 min and 50% [36-64] at 25 min) but did not reach the target sensitivity. Among the 52 PCR-positive participants with Lassa fever, positive RDT results were associated with lower cycle threshold values (glycoprotein precursor [GPC] gene mean 30·3 [SD 4·3], Large [L] gene mean 32·3 [3·7] vs GPC gene mean 24·5 [3·9], L gene mean 28·0 [3·6]). Personnel conducting the bedside test procedure reported being hindered by the inconvenient use of full personal protective equipment and long waiting procedures before a result could be read. INTERPRETATION: The Pan-Lassa RDT is not currently recommended as a diagnostic or screening tool for suspected Lassa fever cases. Marked improvement in sensitivity and user friendliness is needed for the RDT to be adopted clinically. There remains an urgent need for better Lassa fever diagnostics to promote safety of in-hospital care and better disease outcomes in low-resource settings. FUNDING: Médecins Sans Frontières.
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BACKGROUND: Depression and anxiety are common mental disorders among older adults, but they are frequently underdiagnosed. Attitudes towards seeking professional mental health care is one of the barriers to access to treatment. This study was aimed at assessing the attitudes towards seeking psychological help among older adults who are enrolled in primary care in Chile, and to determine the associated factors. METHODS: This cross-sectional study recruited 233 primary care users aged 65 or more years. The Attitudes Towards Seeking Professional Psychological Help was used. Reliability and factor analysis of this scale were carried out. The average scores of the scale and factors were calculated and compared, by selected variables. Multivariate linear regression was estimated to determine factors associated with attitudes towards seeking psychological help. RESULTS: Three factors were identified in the attitudes towards seeking psychological help: confidence in psychologists, coping alone with emotional problems, and predisposition to seek psychological help. On average, participants had a favorable attitude towards seeking psychological help, compared with previous research. Lower level of education, and risk of social isolation were inversely associated with these attitudes. CONCLUSION: Strategies to improve mental health literacy and social connection among older adults, could have an impact on factors that mediate the access to mental health care, such as attitudes towards seeking psychological help, among people who have a lower level of education or are at risk of social isolation.
Subject(s)
Independent Living , Patient Acceptance of Health Care , Primary Health Care , Humans , Male , Aged , Female , Chile/epidemiology , Primary Health Care/methods , Cross-Sectional Studies , Patient Acceptance of Health Care/psychology , Independent Living/psychology , Aged, 80 and over , Attitude to HealthABSTRACT
Los desafíos del envejecimiento de la población y la acumulación de daño oral nos obligan a desarrollar herramientas diagnosticas validas y confiables que nos permitan caracterizar a la población, evaluar sus necesidades terapéuticas, planificar intervenciones significativas y realizar seguimiento de su condición. Con este propósito realizamos una revisión sistemática de la literatura relevante para establecer una metódica secuencial para la validación de la herramienta diagnostica Examen Dental Preventivo del Adulto Mayor. Seleccionamos 48 artículos relevantes, cuya heterogeneidad impidió la realización de un metaanálisis. Sin embargo, los artículos seleccionados fueron sometidos a una síntesis cuantitativa analítica, que nos permitió identificar los dominios y estrategias relevantes para la validación y proponer un protocolo de cinco fases secuenciales que presentamos en extenso en el presente artículo.
The challenges of population aging and the accumulation of oral damage force us to develop valid and reliable diagnostic tools to characterize the population, evaluate their therapeutic needs, plan significant interventions, and monitor their condition post treatment. We carried out a systematic review of the relevant literature to establish a sequential method for the validation of the Preventive Dental Examination of the Elderly diagnostic tool. We selected 48 relevant articles, whose heterogeneity prevented us from performing a meta-analysis. However, the selected articles were subjected to an analytical quantitative synthesis, which allowed us to identify the relevant domains and strategies for validation and then propose a protocol of five sequential phases that we present in detail in this article.
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The aim of the study was to analyze gender differences in life expectancy free of depressive symptoms among the adult population in Chile between 2003 and 2016. The Sullivan method was used to estimate the total and marginal life expectancy, based on prevalence data from the National Health Survey (2003, 2010 and 2016), and abridged life tables for the Chilean population. There was a compression of morbidity among middle-aged men during the first period and among younger and older women during the last one. Men at all ages could expect to live a higher proportion of their lives without depressive symptoms during the whole period. The gender gap in the proportion of life expectancy free of depressive symptoms reached 10 percent points or more, considering almost all ages and periods. Unemployment and lower education increased the probability of depressive symptoms, and these effects were more marked among women. Public policies should have a gender-sensitive approach to address the gap in depression and the disadvantage experienced by women in life expectancy free of depressive symptoms, considering those dimensions that intersect with gender, such as access to education, employment or income.
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OBJECTIVES: To quantify the buccal bone thickness, area, and perimeter following guided bone regeneration (GBR) using stabilizing periosteal sutures. The loss in hard tissue volume may impair proper implant placement. GBR has been used to regenerate the lost alveolar ridge prior to or at the same time as dental implant placement. The most important factor for GBR success is graft stability. The periosteal mattress suture (PMS) stabilizing technique is an alternative to pins and screws to stabilize bone grafting material and has the advantage of not requiring the removal of the fixing devices. MATERIALS AND METHODS: A CBCT was acquired before and 6 months after surgery from six patients who underwent GBR with the PMS stabilizing technique. Images were analyzed for buccal bone thickness, area, and perimeter. RESULTS: The mean change in buccal bone thickness was 3.42 mm (± 1.31 SD) and proved statistically significant (P = .005). The mean change in bone crest area also proved statistically significant (P = .001). No significant difference was found in bone perimeter (P = .12). CONCLUSIONS: The PMS technique delivered optimal results without clinical complications. This study shows the potential of this technique as an alternative to pins or screws for graft stabilization in the esthetic zone.
Subject(s)
Alveolar Ridge Augmentation , Dental Implants , Humans , Dental Implantation, Endosseous , Pilot Projects , Esthetics, Dental , Bone Regeneration , Alveolar Ridge Augmentation/methods , Suture TechniquesABSTRACT
Objetivo: Analizar la necesidad de regeneración ósea guiada en pacientes sometidos a terapia implantológica entre el año 2012 y 2019 del Hospital San Camilo, San Felipe. Material y Método: Estudio observacional retrospectivo. Se incluyeron todos los pacientes pertenecientes al programa de implantes entre el 2012 y 2019. Los pacientes fueron organizados de acuerdo a la edad, género, marca de implante, uso de injerto, tiempo de carga y tasa de pérdida. Estos datos se evaluaron empleando estadística descriptiva calculando frecuencias y porcentajes en tablas de contingencias. Resultados: Se incluyeron 182 pacientes. La distribución por sexo fue de 121 mujeres y 61 hombres. La edad promedio de los pacientes fue de 51,23 años. El 41,76% casos del total requirió ROG. El 74,3% del grupo de implantes unitarios requirió injerto óseo. Sólo un 4,71% del grupo de sobredentadura requirió de injerto óseo. El tiempo de carga promedio fue de 3,68 meses. La tasa de pérdida en implantes fue de 3,85%. Conclusiones: El conocimiento y análisis de estos datos permite replantear la distribución de los recursos con el fin de realizar tratamientos más predecibles, disminuyendo las complicaciones y generando un ahorro de presupuesto.
Objective: To determine and analyze the need for guided bone regeneration (GBR) in patients who underwent implant therapy between 2012 and 2019 at the San Camilo Hospital, San Felipe. Material and methods: Retrospective observational study. All patients belonging to the implant program were included, with the need for either single implants or overdentures, which were installed between 2012 and 2019. Patients were organized according to their age, gender, implant brand, use of graft, loading time and loss rate. These data were evaluated using descriptive statistics calculating frequencies and percentages in contingency tables. Results: A total of 182 cases of implants were included. The distribution by sex was 121 women and 61 men. The average age of the patients was 51,23 years. The percentage of cases that required GBR was 41.76%. In the single implant group, 74.3% of cases required bone grafting. In the overdenture group, only 4.71% required bone grafting. The average loading time was 3,68 months. The implant loss rate was 3,85%. Conclusions: The knowledge and analysis of these data allow us to evaluate the distribution of resources to carry out more predictable treatments to reduce complications and generate budget savings.
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In Chile, depressive symptoms are highly prevalent among Chilean older adults, and research that examines the factors associated with them is scarce. This study aimed to determine if subjective assessments of quality of life are associated with positive screen for depressive symptoms among older adults enrolled in primary care in Chile. The participants of the study were people aged 70 years or more enrolled in primary care centers in three Chilean cities. The 15-item Geriatric Depression Scale was used to determine depressive symptoms. Multivariate logistic models were used to determine the associations. Overall, 17.28% men, and 26.47% women (p = 0.003) screened positive for depression. Subjective assessments of quality of life, including self-perceived health, memory, quality of life, and pain, were associated with a positive screen for depression. Only 17.65% of men and 43.55% of women who screened positive for depressive symptoms reported a diagnosis of depression. Assessments of quality of life in health checks of older adults in primary care could contribute to narrow the diagnosis and treatment gap by improving the ability to identify those who are more likely to experience depressive symptoms.
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BACKGROUND: Sarcopenia is an important risk factor for disability and dependency at old age. The prevalence of sarcopenia among the Chilean older population is high. OBJECTIVE: To estimate life expectancy, healthy life expectancy and unhealthy life expectancy among sarcopenic and non-sarcopenic older adults from Santiago, Chile. METHODS: A sample of 1,897 community-dwelling older adults aged 60 years or more, living in Santiago, was observed between 5-15 years. Disability was defined as the unhealthy state, assessed through self-reported difficulties in activities of daily living. Sarcopenia was determined via HTSMayor software. Total and marginal life expectancies were estimated using the Interpolated Markov Chain method "IMaCh". RESULTS: At 60 years, estimated life expectancy for sarcopenic and non-sarcopenic older adults was similar (22.7 and 22.5 years, respectively). The proportion of years to be lived with disability was three times greater in sarcopenic adults, compared to non-sarcopenic people. This difference was observed up to 80 years. Non-sarcopenic women had a higher proportion of years to be lived with disabilities compared to non-sarcopenic men of the same age, but this proportion was higher among sarcopenic men, compared to sarcopenic women until 70 years of age. DISCUSSION: People with sarcopenia expect to live a higher proportion of years with disabilities. Sarcopenic men until 70 years expected to live a higher proportion of years with disability, compared to sarcopenic women. Monitoring sarcopenia among older people may help to identify individuals with higher risk of disability onset. Future research should focus on disentangling the mechanisms explaining sex differences.
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BACKGROUND: Different factors are associated with late life depression and diagnosis, including gender. It has also been reported that depression among older people is underdiagnosed. As a result, the mental health needs of this group are insufficiently met. The aim of this study was to explore gender differences in the factors associated with positive screens for depression and self-reported diagnosis among older adults in Chile. METHODS: Data from 3786 older adults who participated in the Social Protection Survey in 2016 were analysed. PHQ-9 was used to identify screen-positive cases. Self-reported diagnosis of depression was used to determine the proportion of people with a screen-positive result who had received a diagnosis of depression. Logistic regression models were used to determine sociodemographic and health factors associated with depression and underdiagnosis in older men and women. RESULTS: The prevalence of a screen-positive result was 20.91% (5.83% major depressive disorder) among men, and 36.38% (12.43% major depressive disorder) among women. 18.77% of men and 34.11% of women with a positive depression screening had received a diagnosis. More educated men were more likely to receive a diagnosis. Older age was associated with a lower probability of diagnosis among older women. CONCLUSIONS: Our results suggest that depressive disorders are undiagnosed in a high proportion of older adults in Chile. Gender is a relevant factor in the underdiagnosis of depression in this group. Further research is needed to understand the factors involved in these gaps, to improve detection and provide timely support and treatment.
Subject(s)
Depression , Depressive Disorder, Major , Aged , Chile/epidemiology , Depression/diagnosis , Depression/epidemiology , Female , Humans , Male , Prevalence , Sex FactorsABSTRACT
BACKGROUND: Chile has one of the longest life expectancies of Latin America. The country is characterised by an important macroeconomic growth and persisting socioeconomic inequalities. This study analyses socioeconomic differences in life expectancy (LE) and disability-free life expectancy (DFLE) among Chilean older people. METHODS: The sample of the Social Protection Survey, a longitudinal study, was analysed. Five waves, from 2004 to 2016, were considered. The indicator was disability, defined as having difficulties to perform at least one basic activity of daily living. Type of health insurance was used to determine socioeconomic position (SEP). Total LE and DFLE were estimated with multistate life table models. RESULTS: At age 60, men in the higher SEP could expect to live 3.7 years longer (22.2; 95% CI 19.6-24.8) compared to men of the same age in the medium SEP (18.4; 95% CI 17.4-19.4), and 4.9 years longer than men of the same age in the lower SEP (17.3; 95% CI 16.4-18.2). They also had a DFLE (19.4; 95% CI 17.1-21.7) 4 (15.4; 95% CI 14.6-16.1) and 5.2 (14.2; 95% CI 13.4-14.9) years longer, compared to the same groups. Women aged 60 years in the higher SEP had a LE (27.2; 95% CI 23.7-30.8) 4.6 (22.7; 95% CI 21.9-23.5) and 5.6 (21.6; 20.6-22.6) years longer, compared to women in the medium and the lower SEP. The difference in DFLE, for the same age and groups was 4.9 and 6.1 years, respectively (high: 21.4; 95% CI 19.5-23.3; medium: 16.5; 95% CI 15.8-17.1; low: 15.3; 95% CI 14.6-16.0). Socioeconomic differences in LE and DFLE were observed among both sexes until advanced age. DISCUSSION: Socioeconomic inequalities in LE and DFLE were found among Chilean older men and women. Older people in the highest SEP live longer and healthier lives. CONCLUSION: A reform to the Chilean health system should be considered, in order to guarantee timely access to care and benefits for older people who are not in the wealthiest group.
Subject(s)
Disabled Persons , Life Expectancy , Aged , Aged, 80 and over , Chile/epidemiology , Female , Health Status Disparities , Humans , Longitudinal Studies , Male , Socioeconomic FactorsABSTRACT
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.
Subject(s)
Disabled Persons , Public Health , Aged , Chile , Focus Groups , Humans , LonelinessABSTRACT
BACKGROUND: Chile has one of the highest life expectancies at 60 years in South America. This study was aimed to determine healthy life expectancies among Chilean older people, according to self-rated health and disability, and to explore gender differences. METHODS: Data from the National Survey of Health (2009 and 2016) were used to estimate prevalence of less than good self-rated health and disability among people aged 60 years and above. Health expectancies were calculated with the Sullivan method. RESULTS: In both years, women expected to live a lower proportion of their life expectancy in good self-rated health (54.5% [95% CI 50.0-58.8] for men and 37.6% [95% CI 34.3-40.8] for women in 2009; 46.1% [95% CI 42.6-49.7] for men and 38.5% [95% CI 35.6-41.4] for women in 2016). Life expectancy in less than good self-rated health increased for men (9.4 years [95% CI 8.4-10.3] in 2009; 11.5 years [95% CI 10.7-12.2]). Women expected to live a lower proportion of their remaining life without disabilities (65.3% [95% CI 61.2-69.4] for men and 44.9% [95% CI 41.9-47.9] for women in 2009; 71.9% [95% CI 68.7-75.0] for men and 61.1% [95% CI 58.5-63.8] for women in 2016). In 2016, disability-free life expectancy increased among women, but they still had a higher life expectancy with mild disability (2.8 years [95% CI 2.3-3.4] for men and 6.0 years [95% CI 5.4-6.7] for women). CONCLUSIONS: Women expected to spend more years in less than good self-rated health and disabled. There was an expansion of life expectancy in less than good SRH among men and a compression of disability in both sexes. The high proportion of years expected to be lived in less than good self-rated health and gender differences in disability-free life expectancy of older adults should be addressed by public health policies in Chile.
Subject(s)
Anticipation, Psychological , Diagnostic Self Evaluation , Life Expectancy , Self Report/statistics & numerical data , Aged , Aged, 80 and over , Chile , Disability Evaluation , Female , Geriatric Assessment/statistics & numerical data , Humans , Male , Middle Aged , Morbidity , Sex FactorsABSTRACT
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.
Subject(s)
Humans , Aged , Public Health , Disabled Persons , Chile , Focus Groups , LonelinessABSTRACT
BACKGROUND: Chile has one of the highest life expectancies within Latin American. This is the first study to determine health expectancies in older populations in Chile, considering cognitive status as a health indicator. METHODS: We estimated prevalence of cognitive decline among people aged 60 years and over based on the Mini-mental State Examination and the Pfeffer Functional Activities Questionnaire, with data from the National Survey of Health (2003, 2009, 2016). Life expectancy free of cognitive impairment was calculated using the Sullivan method. RESULTS: At age 60, life expectancy free of cognitive impairment was more than 3 years longer for women, compared to men of the same age. Life expectancy free from cognitive impairment was higher for both men and women aged 60 in 2016 when compared to 2003 (2.1 and 2 years higher, respectively). CONCLUSIONS: Longer life expectancy in women was accompanied by more years free of cognitive impairment. Men expected to live a similar proportion of years free of cognitive impairment, compared to women. Common and standardised assessments of health status of older people should be adopted in Latin American studies, to allow for time-trend analyses and international comparisons.
Subject(s)
Cognitive Dysfunction/epidemiology , Cognitive Dysfunction/psychology , Health Status , Health Surveys/trends , Life Expectancy/trends , Aged , Aged, 80 and over , Chile/epidemiology , Cross-Sectional Studies , Female , Health Surveys/methods , Humans , Male , Mental Status and Dementia Tests , Middle AgedABSTRACT
BACKGROUND: This study was aimed to estimate life expectancy (LE), disability-free life expectancy (DFLE) and disabled life expectancy (DLE) among older adults from Santiago, Chile, and to determine the existence of differences by gender and by body mass index (BMI) categories in these indicators. METHODS: A sample of 1216 people aged 60 or more, from the Chilean cohort of the Study of Health, Ageing and Well-Being was recruited in 2000; two follow-up assessments were carried out in a 10-year period. Functional limitation was assessed through self-report of difficulties in activities of daily living, instrumental activities of daily living and mobility. BMI was determined with measured weight and height. Multistate life tables were employed to estimate LE and healthy life expectancy (HLE). RESULTS: At 60 years, women could expect to live on average an additional 20.4 years (95% CI 19.0-21.6), and men an additional 16.4 years (95% CI 14.9-17.7). Total LE was longer among women at all ages, but they had a higher proportion of disabled years to be lived compared to men, with a difference of 14% at 60 years, and 10% at 90 years. There were no significant differences in LE, DFLE and DLE between BMI categories. DISCUSSION: Despite a longer LE, Chilean older women expect to live a higher proportion of years with disabilities, compared to men. Public health programs should address factors affecting LE of older men, and those associated with disability among older women.
Subject(s)
Disabled Persons/statistics & numerical data , Nutritional Status/physiology , Activities of Daily Living/psychology , Age Factors , Aged , Aged, 80 and over , Body Mass Index , Chile , Cohort Studies , Female , Humans , Life Expectancy , Life Tables , Male , Middle Aged , Sex FactorsABSTRACT
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.
Subject(s)
Health Status , Self Report , Aged , Chile , Cohort Studies , Female , Humans , Male , Sex Factors , Survival AnalysisABSTRACT
The study was aimed to explore social representations of older adults among Chilean people aged 70 or more, living in three cities with differences in historical, geographic, and sociodemographic characteristics and to explore the importance of the local context on their shaping. Multiple correspondence analysis was employed to analyze the terms produced through free-word association technique, by 741 people. The two first dimensions explained 62.4 % of the inertia and showed that the contribution of city of residence was several times higher than the average; the contribution of gender and educational level was higher than average as well. The northern city representations were characterized by positive terms, whereas more negative contents were characteristic of the city of the center, and terms without an explicitly positive or negative assessment were associated to the southern city. These findings reinforce the relevance of the local sociocultural context in shaping social representations of old age and stress the importance of considering particular regional features in the design of policies and interventions aimed to recognize and integrate older adults in Chile.
Subject(s)
Aging/psychology , Cities , Residence Characteristics/statistics & numerical data , Social Participation , Social Perception , Aged , Aged, 80 and over , Chile , Correspondence as Topic , Female , Humans , Interpersonal Relations , Male , Socioeconomic FactorsABSTRACT
Research plays a central role in professional training in dentistry. There is a clear recommendation to include a minimum training in biomedical research at undergraduate level. In Chile, there is no standardized curriculum structure including research training for undergraduate students. Objective: To describe the presence of research courses in the undergraduate dental curriculum in Chile during 2014. Methodology: A descriptive cross-sectional study. The curriculum for all Chilean universities teaching dental careers and updated during 2014 were analyzed. Results: The dental curriculum for twenty Chilean universities was analyzed. On average, each university has 4.05+/-2.06 research courses (semesterly) from which 1+/-0.92 are thesis courses. In the private universities, these numbers were 4.64+/-1.91 and 1.18+/-0.87 respectively. Meanwhile, these numbers were 3.33+/-2.12 and 0.78+/-0.97 respectively in the traditional universities. Sixty percent of universities have thesis or research project courses. Conclusion: There is a disparate presence of research courses in the undergraduate dental curriculum in Chile, with a higher presence in private institutions. However, this does not actualize a greater scientific production by them.
La investigación juega un rol central en la formación del profesional en Odontología. Existe una clara recomendación de incluir en el pregrado una cantidad mínima de formación en investigación biomédica. En Chile no existe una estructura curricular estandarizada que incluya investigación a alumnos de pregrado. Objetivo: Identificar la presencia de asignaturas de investigación en las mallas curriculares de las carreras de odontología dictadas en Chile para el año 2014. Metodología: Estudio descriptivo de corte transversal, la unidad de análisis correspondió a las mallas curriculares de la carrera odontología, de todas las universidades dictantes en Chile y actualizadas al año 2014. Resultados: Se analizaron las mallas curriculares de las carreras de odontología de 20 universidades chilenas. En promedio cada universidad tiene 4,05+/-2,06 ramos (semestrales) de investigación y de los cuales 1+/-0,92 son ramos de tesis. En las universidades privadas estas cifras son 4,64+/-1,91 y 1,18+/-0,87 respectivamente, mientras que en las tradicionales fueron de 3,33+/-2,12 y 0,78+/-0,97 respectivamente. El 60 por ciento de las universidades tiene algún ramo de tesis o proyecto de investigación. Conclusión: Existe una dispar presencia de ramos de investigación en los programas curriculares de odontología en Chile, con una mayor presencia en instituciones privadas. Sin embargo, esto no se materializa en una mayor producción científica por parte de ellas.