Factorial Structure and Diagnostic Accuracy of a Digital Version of the Alcohol Use Disorders Identification Test (d-AUDIT) to Detect Hazardous and Problematic Drinking in Primary Care.

OBJECTIVE: We studied the factorial structure and diagnostic performance in primary care of a digital version of the Alcohol Use Disorders Identification Test (d-AUDIT) for screening for excessive drinking. METHOD: In two primary care centers in Santiago, Chile, we conducted a cross-sectional study involving 330 people 18 years of age or older who had drunk alcohol six or more times in the last year. The d-AUDIT was developed from the paper version validated in Chile and was self-administered on 7-inch tablets. Trained psychologists evaluated the participants using a 1-year Timeline Followback and the alcohol use disorders section from the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. We used confirmatory factorial analysis to examine the structure of the d-AUDIT and areas under the receiver operating characteristic curves (AUCs) to examine the diagnostic performance of the d-AUDIT. RESULTS: A two-factor model presented good overall fit, with item loads in the 0.53-0.88 range. The correlation among factors was .74, reflecting a good discriminant validity. The total score and the Fast Alcohol Screening Test (FAST) score (i.e., bingeing, role failure, blackouts, and others' concern items) obtained the best diagnostic performance for problematic drinking, with AUCs of 0.94 (CI [0.91, 0.97]) and 0.92 (CI [0.88, 0.96]), respectively. The FAST could differentiate hazardous drinking (cut point three in men and one in women) from problematic drinking (cut point four in men and two in women). CONCLUSIONS: We replicated prior factor analysis findings of a two-factor structure for the d-AUDIT with a good discriminant validity. The FAST obtained excellent diagnostic performance and retained some ability to discriminate between hazardous and problematic drinking.

A Health Technician-delivered Brief Intervention linked to AUDIT for reduction of alcohol use in Chilean primary care: a randomized controlled trial.

BACKGROUND: Because of the shortage of health professionals in Chilean primary care, Health Technicians (HT) are providing Brief Interventions (BI) for risky alcohol consumption. We compared the efficacy of two AUDIT-linked interventions provided by HTs: an informative leaflet and a BI plus leaflet. METHODS: This is a parallel-group randomized controlled trial with 1:1 randomization. Participants were identified through screening with the Alcohol Use Disorders Identification Test (AUDIT) at five primary care centers between March 2016 and July 2017. People older than 18 years at intermediate-risk (AUDIT score 8 to 15, inclusive) were randomized to receive either an HT-delivered BI (n = 174) or an informative leaflet (n = 168). Only data from participants (n = 294) who completed the 6-month assessment were analyzed. The leaflet was delivered without further advice. It contains alcohol consumption limits, a change planner, and strategies to decrease drinking. The BI was a 5-min discussion on the leaflet´s content plus normative feedback, tailored information on alcohol and health, and a change plan. The change in the AUDIT risk category six months after randomization (primary outcome) was compared among groups with a Chi-squared test. Changes in the secondary outcomes, which were scores on the AUDIT and the AUDIT´s consumption items (AUDIT-C), were compared with T-tests. Mixed-effects linear models adjusted for potential confounders. Outcome adjudicators were blinded to group assignment. RESULTS: At 6-month follow-up, low-risk alcohol consumption was observed in 119 (80%) participants in the BI group, and in 103 (71%) in the leaflet group, with no difference among groups ([Formula: see text] [1, N = 294] = 2.6, p = 0.1; adjusted odds ratio 0.6; 95% confidence interval [CI] 0.34, 1.05). The mean AUDIT score decreased by 5.76 points in the BI group, and by 5.07 in the leaflet group, which represents a 0.86 AUDIT point reduction attributable to the BI (secondary outcome) (T = 2.03, p = 0.043; adjusted mean difference 0.86 CI 0.06, 1.66). CONCLUSIONS: The AUDIT-linked BI delivered by HTs was not associated with a greater reduction of risky alcohol consumption than an informative leaflet. Delivering a leaflet could be more efficient than a BI when provided by HTs; however, more research on the effectiveness of the leaflet is needed. Trial registration ClinicalTrials.gov NCT02642757 (December 30, 2015) https://clinicaltrials.gov/ct2/show/NCT02642757 .

Dietas vegetarianas en alumnos universitarios / Vegetarian diets in first year university students

INTRODUCCIÓN: Se ha observado un aumento en la popularidad de las dietas vegetarianas, en especial en la población adolescente y adulto joven. Estas dietas se presentan como saludables y balanceadas pero las recomendaciones son controversiales en cuanto a los potenciales déficit nutricionales. OBJETIVO: Identificar la frecuencia y tipos de dieta vegetariana utilizada, su motivación y fuentes de información. PACIENTES Y MÉTODO: Estudio transversal y analítico en universitarios de primer año de la Pontificia Universidad Católica de Chile (PUC). Se realizó una encuesta vía online obteniendo información demográfica y caracterización de dietas de aquellos que se consideraban vegetarianos. Las variables fueron analizadas mediante el software IDM SPSS Statistics® y en planilla Excel® de forma cuantitativa. RESULTADOS: 152 alumnos respondieron la encuesta (15,2% del total), siendo el 49,4% de estos vegetariano. El 32,4% inició este patrón alimentario entre los 12-18 años; sus motivaciones más frecuentes fueron las medio ambientalistas (91,9%) y animalistas (72,9%). El 52,9% de los vegetarianos reciben suplementación de vitamina b 12 pero solo un 15,9% reportó presentar este déficit. El 75,7% obtiene información relacionada acerca de las dietas vegetarianas a través de medios digitales. CONCLUSIÓN: Se encontró un alto porcentaje de estudiantes vegetarianos en las encuestas contestadas, lo que hace necesario que los profesionales de salud estén capacitados en esta área para asegurar una adecuada educación nutricional, suplementación si es necesario, y seguimiento.

INTRODUCTION: There has been an increase in the popularity of vegetarian diets, especially among adolescents and young adults. These diets seem to be healthy and balanced, but the recommendations are contro versial regarding potential nutritional deficits. OBJECTIVE: To identify the frequency and types of ve getarian diet used, their motivation, and sources of information. PATIENTS AND METHOD: Cross-sec tional analytical study in freshmen students from the Pontifical Catholic University of Chile (PUC). Through an online survey, we collected demographic information and diet characterization of those who considered themselves as vegetarians. Variables were analyzed using IDM SPSS Statistics® soft ware and in Excel® spreadsheet in a quantitative way. RESULTS: 152 students answered the survey (15.2% of the sample) and, out of these, 49.4% were vegetarian. 32.4% started this eating pattern bet ween the ages 12 and 18 and among their most frequent motivations were environmentalists (91.9%) and animalists (72.9%). 52.9% of vegetarians take vitamin B 12 supplementation but only 15.9% reported having this deficiency. 75.7% obtain information related to vegetarian diets through digital media. CONCLUSION: In the surveys answered, we found a high percentage of vegetarian students, the refore, health professionals need to be trained in this area to assure adequate nutritional education, supplementation if necessary, and follow-up.

Brief motivational therapy versus enhanced usual care for alcohol use disorders in primary care in Chile: study protocol for an exploratory randomized trial.

BACKGROUND: Harmful alcohol use is a leading cause of global disability and death. However, increased detection and brief intervention capacity of more severe alcohol use disorders has not been accompanied by increased availability of treatment services. Incorporating treatment for such disorders into primary care is of paramount importance for improving access and health outcomes. This study aims to estimate the effectiveness of a Brief Motivational Treatment (BMT) applied in primary care for treatment of these disorders. METHODS: A parallel-group, single-blinded, severity-stratified, randomized clinical trial will test the superiority of BMT over enhanced usual care. Eligible participants will be those seeking treatment and who fulfill DSM-V criteria for alcohol use disorder and criteria for harmful alcohol use. With an estimated a loss to follow-up of 20%, a total of 182 participants will be recruited and equally randomized to each treatment group. The intervention group will receive an adaptation of the motivational enhancement therapy, as manualized in Project MATCH. This treatment consists of four 45-min sessions provided by a general psychologist with at least 3 years of primary care experience. The primary outcome is the change from baseline in the drinks per drinking day during the last 90 days, which will be captured using the Timeline Follow Back method. Secondary outcomes will describe the changes in alcohol use pattern, motivational status, and severity of the disorder. All participants will be analyzed according to the group they were allocated, regardless of the treatment actually received. Mean differences (MD) will be computed for continuous outcomes and relative risks (RR) and RR reductions (RRR) for dichotomous results. Linear models will deliver the subgroup analyses. Missingness is assumed to be associated with the baseline alcohol use pattern and severity, so a multiple imputation method will be used to handle missing data. DISCUSSION: This trial aims to test the superiority of BMT over enhanced usual care with a reasonable superiority margin, over which the BMT could be further considered for incorporation into PC in Chile. Its pragmatic approach ultimately aims to inform policymakers about the benefit of including a brief psychosocial treatment into PC. TRIAL REGISTRATION: ClinicalTrials.gov NCT04345302 . Registered on 28 April 2020.

Vegetarian diets in first year university students. / Dietas vegetarianas en alumnos universitarios.

INTRODUCTION: There has been an increase in the popularity of vegetarian diets, especially among adolescents and young adults. These diets seem to be healthy and balanced, but the recommendations are contro versial regarding potential nutritional deficits. OBJECTIVE: To identify the frequency and types of ve getarian diet used, their motivation, and sources of information. PATIENTS AND METHOD: Cross-sec tional analytical study in freshmen students from the Pontifical Catholic University of Chile (PUC). Through an online survey, we collected demographic information and diet characterization of those who considered themselves as vegetarians. Variables were analyzed using IDM SPSS Statistics® soft ware and in Excel® spreadsheet in a quantitative way. RESULTS: 152 students answered the survey (15.2% of the sample) and, out of these, 49.4% were vegetarian. 32.4% started this eating pattern bet ween the ages 12 and 18 and among their most frequent motivations were environmentalists (91.9%) and animalists (72.9%). 52.9% of vegetarians take vitamin B 12 supplementation but only 15.9% reported having this deficiency. 75.7% obtain information related to vegetarian diets through digital media. CONCLUSION: In the surveys answered, we found a high percentage of vegetarian students, the refore, health professionals need to be trained in this area to assure adequate nutritional education, supplementation if necessary, and follow-up.

Medición del clima educativo y factores que influyen en su resultado. Estudio en una carrera de odontología chilena / Measuring the educational environment and factors that influence its outcome. Study in a Chilean dentistry career

Introducción: La medición del clima educativo en una carrera universitaria permite detectar elementos relacionados con los logros, satisfacción y éxito de los estudiantes. Teniendo en cuenta el alto nivel de exigencia y multiplicidad de competencias que se requiere establecer en el estudiante de pregrado, la carrera de Odontología de la Pontificia Universidad Católica de Chile (PUC) realizó el año 2015 una medición de su clima educativo. Sujetos y métodos: Se realizó un estudio cualitativo y cuantitativo, no experimental, transversal y correlacional, con el objetivo de medir el clima educativo. Se aplicó la escala Dundee Ready Education Environment Measure (DREEM) a los 331 estudiantes de primer a quinto año de la carrera, y se relacionaron variables sociodemográficas con los resultados del clima educativo para estudiar posibles asociaciones entre estos factores. Complementariamente, se realizaron tres grupos focales con los estudiantes de los segmentos que evidenciaron una menor puntuación en algunos de los ítems del DREEM. Resultados: En los cinco dominios del DREEM se obtuvieron resultados satisfactorios, pero se observa una disminución año a año en casi todas las variables estudiadas, y se ven mayormente disminuidas durante el quinto año de carrera. Los grupos focales con los estudiantes de los grupos con peor evaluación evidenciaron que el estrés es una variable emergente que se relaciona con el clima educativo. Conclusiones: Esta investigación reveló que, en términos generales, la carrera de Odontología en la PUC posee un clima estudiantil más bien positivo, aunque existen algunos grupos que deben ser estudiados y apoyados precozmente

Introduction: Measuring the educational environment in a university career allows the detection of elements related to achievements, satisfaction and success of the students. Due to the high level of demand and the multiple competencies that an undergraduate student has to acquire, the Dental School at the Pontifical Catholic University of Chile (PUC) performed in 2015 a study to measure its educational environment. Subjects and methods: A cross-sectional qualitative, non-experimental, transverse and correlational study was carried out to measure the educational environment. The Dundee Ready Education Environment Measure (DREEM) was applied to 331 students, from first to fifth year of the career, and correlations with the sociodemographic aspects were studied, in order to identify possible associations between these factors. In addition, three focus groups were conducted with the student that had the segments that showed the lower scores in some of the DREEM items. Results: In all five domains of the DREEM, results were satisfactory, but a year-on-year decrease was observed in almost all the studied variables, especially during the fifth year of the career. Focus groups with students with the worst evaluation showed that stress is an emerging variable that can be related to the educational environment. Conclusions: This research revealed that, in general terms, the dental career in the PUC has a rather positive educational environment, with some groups that need to be detected and supported in early stages

[How to implement Chile's new anti-tobacco law within the university]. / Cómo implementar la nueva ley chilena antitabaco al interior de la universidad.

On the 16th of May 2006, the Diario Oficial de la República de Chile (Official News of the Republic of Chile), published Law No. 20.105, which modified Law No. 19.419 regarding advertising and consumption of tobacco. Since it entered into force, different institutions and public spaces have had to enact its regulations. The purpose of this article is to share how the new anti-tobacco law is being implemented, with a health promotion angle, by the Pontificia Universidad Católica de Chile (UC). As such, we highlight key findings from a review of the literature on the subject and describe the implementation strategies developed and substantiated in theory as well as by how they address the concerns of the university community. The main accomplishments of the anti-tobacco implementation were: reaching a compromise between the university directorate and the student leaders, who in turn motivated the student body to participate during the large-scale roll-out of the new law; the participation of all of the UC stakeholders; utilizing the varied methods of mass communication; and lastly, providing an opportunity for reflection and analysis for those directly affected: the smokers. The challenge is to evaluate the strategies implemented in the incorporation of the new Chilean anti-tobacco law.

Cómo implementar la nueva ley chilena antitabaco al interior de la universidad / How to implement Chile’s new anti-tobacco law within the university

On the 16th of May 2006, the Diario Oficial de la República de Chile (Official News of the Republic of Chile), published Law No. 20.105, which modified Law No. 19.419 regarding advertising and consumption of tobacco. Since it entered into force, different institutions and public spaces have had to enact its regulations. The purpose of this article is to share how the new anti-tobacco law is being implemented, with a health promotion angle, by the Pontificia Universidad Católica de Chile (UC). As such, we highlight key findings from a review of the literature on the subject and describe the implementation strategies developed and substantiated in theory as well as by how they address the concerns of the university community. The main accomplishments of the anti-tobacco implementation were: reaching a compromise between the university directorate and the student leaders, who in turn motivated the student body to participate during the large-scale roll-out of the new law; the participation of all of the UC stakeholders; utilizing the varied methods of mass communication; and lastly, providing an opportunity for reflection and analysis for those directly affected: the smokers. The challenge is to evaluate the strategies implemented in the incorporation of the new Chilean anti-tobacco law.