Co-Active Coping Inventory: Development and Validation for the Chilean Population

Co-active coping is a fundamental construct in organizational and work environments as it allows for the exploration of individual and group behaviors within organizations. The aim of this study was to develop a new scale called the Co-Active Coping Inventory in the Chilean context. The sample was comprised of 1,442 workers with an average age of 30.48 years (SD = 11.13). 55% were public-sector workers, 34.5% were workers in private commercial organizations, and 10.5% belonged to non-profit private organizations. Different exploratory factor analyses were performed, and the best exploratory model was verified with a confirmatory factor analysis. In addition, multiple linear regressions were used to analyze which dimensions of co-active coping helped predict workers’ burnout (emotional exhaustion, affective hardening, and personal fulfillment) and symptomatology (psychological and somatic). Based on the exploratory and confirmatory approach, the Co-Active Coping Inventory showed a good fit to a structure of five correlated factors (Reflective Action, Rash Action, Search for Spiritual Support, Search for Affective Support and Evasion), demonstrating measurement invariance in terms of sex and type of organization. The different domains of co-active coping explain between 20% (emotional exhaustion) and 41% (affective hardening) of occupational burnout and around 3–5% of workers’ symptomatology, with reflective action being the most important variable. These results indicate that the new scale has suitable psychometric properties; it can assess coping strategies in the Chilean organizational context in a reliable and valid way. These coping strategies have demonstrated certain importance in relation to organizational and clinical variables. (AU)

Perfil Antropométrico de una Población Privada de Libertad Masculina medida a través del protocolo ISAK / Anthropometric Profile of a male deprived liberty population measured through ISAK protocol

Fundamentos: la composición corporal, como elemento predictor de posible aparición de enfermedades crónicas no transmisibles (ECNT), brinda información importante para evaluar el riesgo de salud de las personas. En la población privada de libertad, existen distintos factores de riesgo de podrían afectar su condición de salud, entre ellos, la composición corporal. Por lo que este trabajo busca determinar el perfil antropométrico de una población de individuos masculinos privados de libertad. Métodos: estudio no experimental de tipo transversal, de corte descriptivo que pretende caracterizar el perfil antropométrico de 100 individuos privados de libertad de la ciudad de Talca, Chile. La selección de la muestra fue de tipo no probabilística por conveniencia, ya que se escogieron a los evaluados de acuerdo a la accesibilidad que se tenía a ellos. Se utilizó estadística descriptiva e inferencial. Resultados: la población evaluada presentó un IMC catalogado como sobrepeso con valor 25,69 kg/m2. Los individuos evaluados presentaban un peso corporal promedio de 73,2 kilos y un porcentaje de masa grasa de 24,2%; en cuanto al índice cintura-cadera (ICC), todos los grupos evaluados presentaban un valor menor de 1 o de normalidad. Finalmente, el somatotipo observado correspondía a mesomorfo-endomórfico. Conclusiones: Los individuos privados de libertad evaluados presentan variables antropométricas levemente alteradas, pero con valores cercanos a normalidad (IMC; Masa Grasa), con un ICC menor a 1, clasificándose como normal y con un somatotipo que da cuenta de un relativo desarrollo musculo esquelético, de diámetros óseos y articulaciones grandes, con moderada adiposidad relativa. (AU)

Background: body composition, as a predictive element of the possible appearance of non-communicable chronic diseases, provides important information to assess the health risk of population. In the populationdeprived of liberty, there are different risk factors that could affect their health condition including body composition. Therefore, this work seeks to determine the anthropometric profile of a population of male individuals deprived of liberty Methods: non-experimental cross-sectional and descriptive study that aims to characterize the anthropometric profile of 100 individuals deprived of their liberty in the city of Talca, Chile. The sample selection was non-probabilistic for convenience, because the evaluated were chosen for the accessibility tothem. Descriptive and inferential statistics were used. Results: the evaluated population shows a body mass index (BMI) classified as overweight (25,69 kg/m2). The evaluated population shows an average weight of 73,2 kilos, and a fat mass average of 24,2%, regarding the waist-hip ratio (WHR), all measured groups have an value of less than 1 classified as normality, finally, the observed somatotype is mesomorph-endomorphic.Conclusions: the evaluated deprived liberty population present slightly altered anthropometric variables with values close to normality (BMI, Fat Mass), with WHR less than 1, being classified as normal and with a somatotype who show a relative skeletal muscle develop, with large bone diameters and joints, and moderate relative adiposity. (AU)

Impacto del terremoto más potente de la humanidad en el desarrollo profesional de la enfermería en el sur de Chile / Impacto do terremoto mais poderoso da humanidade no desenvolvimento profissional da enfermagem no sul do Chile / The Impact of humankind’s most powerful earthquake on the professional development of nursing in the South of Chile

Introduction: Natural catastrophes influence the progress of nursing. The largest recorded earthquake in the world occurred in the South of Chile and is documented as driving the development of nursing in the city of Valdivia, but not in similarly-affected places. Objective: To describe the impact of the mega-earthquake of 1960 in the development of professional nursing in Los Lagos. Methodology: qualitative-historical study. Snowball sampling. Data collection through semi-structured interviews and secondary sources. Inclusion criteria: belonging to the health team of the place and period studied. Informants with cognitive deterioration were excluded. Thematic analysis was carried out. Atlas Ti version 8.3.0 was used. Study approved by ethics committee. Results: in 1960 there were no nurses in Los Lagos and the only hospital in the area was incapacitated. A field hospital was installed, and a new hospital was built with national and international help, which led toarrival of the earliest nurses. Conclusion: the mega-earthquake drove the improvement of health infrastructure and the subsequent arrival of the earliest nurses, which contributed to more complex local health services and raised the quality of care. (AU)

Introducción: Las catástrofes naturales influyen en el progreso de la enfermería. En el surde Chile ocurrió el mayor terremoto registrado en el mundo y está documentado cómo impulsó el desarrollo de la enfermería en la ciudad de Valdivia, pero no en otras localidades igual de afectadas. Objetivo: Develar el impacto del mega terremoto de 1960 en el desarrollo de la enfermería profesional en Los Lagos. Metodología: Estudio cualitativo histórico. Muestreo bola de nieve. Recolección de datos mediante entrevistas semiestructuradas y fuentes secundarias. Criterio de inclusión: pertenecer al equipo de salud del lugar en el periodo estudiado. Se excluyó informantes con deterioro cognitivo. Se realizó análisis temático. Se utilizó software Atlas Ti versión 8.3.0. Estudio aprobado por comité de ética. Resultados: En 1960 no existían enfermeras en Los Lagos y el único hospital del lugar quedó inhabilitado. Se instaló un hospital de campaña y, gracias a ayuda nacional e internacional, se construyó un nuevo hospital lo que desencadenó la llegada de las primeras enfermeras. Conclusión: El mega terremoto impulsó la mejora de la infraestructura sanitaria y la consecuente llegada de las primeras enfermeras, lo que contribuyó a complejizar las prestaciones de salud local y elevó la calidad de los cuidados. (AU)

Introdução: Os desastres naturais influenciam o progresso da enfermagem. O maior terremoto registrado no mundo ocorreu no sul do Chile e está documentado como promoveu o desenvolvimento da enfermagem na cidade de Valdivia, mas não em outros locais igualmente afetados. Objetivo: Revelar o impacto do mega terremoto de 1960 no desenvolvimento da enfermagem profissional em Los Lagos. Metodologia: Estudo qualitativo histórico. Amostragem de bola de neve. Coleta de dados por meio de entrevistas semiestruturadas e fontes secundárias. Critérios de inclusão: pertencer à equipe de saúde do local no período estudado. Foram excluídos informantes com comprometimento cognitivo. Foi realizada análise temática. Foi utilizado o software Atlas Ti versão 8.3.0. Estudo aprovado por comitê de ética. Resultados: Em 1960 não havia enfermeiros em Los Lagos e o único hospital da região estava desativado. Foi instalado um hospital de campanha e, graças a ajudas nacionais e internacionais, foi construído um novo hospital, o que desencadeou a chegada dos primeiros enfermeiros. Conclusão: O megaterremoto promoveu a melhoria da infraestrutura de saúde e a consequente chegada dos primeiros enfermeiros, o que contribuiu para tornar os serviços de saúde locais mais complexos e elevar a qualidade do atendimento. (AU)

Analyzing the 2019 Chilean social outbreak: Modelling Latin American economies.

In this work, we propose a quantitative model for the 2019 Chilean protests. We utilize public data for the consumer price index, the gross domestic product, and the employee and per capita income distributions as inputs for a nonlinear diffusion-reaction equation, the solutions to which provide an in-depth analysis of the population dynamics. Specifically, the per capita income distribution stands out as a solution to the extended Fisher-Kolmogorov equation. According to our results, the concavity of employee income distribution is a decisive input parameter and, in contrast to the distributions typically observed for Chile and other countries in Latin America, should ideally be non-negative. Based on the results of our model, we advocate for the implementation of social policies designed to stimulate social mobility by broadening the distribution of higher salaries.

[Prevalence of asthma and associated risk factors in schoolchildren from an area of indigenous population]. / Prevalencia de asma y factores de riesgo asociados en escolares provenientes de una zona de pueblos indígenas.

INTRODUCTION: The prevalence of asthma in Chile ranges from 10.2 to 14.9%. In previous studies, the Araucanía Region has not been included. OBJECTIVE: To determine the prevalence of asthma in the school po pulation of the Araucanía Region. SUBJECTS AND METHOD: The ISAAC questionnaires were used for asthma symptoms in addition to a questionnaire for recording sociodemographic data, belonging to the Mapuche ethnicity, type of heating, exposure to indoor air pollution, and family history. The Binomial Regression Model was used to evaluate the effect of each of the different variables of inter est, adjusting by age groups (6-7 and 13-14 years). The model also evaluated the additive interaction between these variables and age. RESULTS: 823 surveys were applied, where the prevalence of asthma was 14.2% and 23.2% in the 6-7 year old group and the 13-14 year old group, respectively. 43.7% de clare to be Mapuche, 32.9% live in rural areas, and 81.4% use firewood as a heating method. Through binomial regression model analysis, where for the study group, living in the coastal commune was significantly associated with a lower prevalence of asthma (-13.2% [CI: -17.7 to -8.6]. The history of an asthmatic mother was significantly associated with a higher prevalence of asthma (17.9% [CI: 2.7 to 33.1]. Living in a rural area, to be Mapuche or the type of heating used, showed differences statistically significant (p 0.18, p 0.609 and p 0.480, respectively) Conclusion: 13-14 year-olds school children in the Araucanía Region presented a higher prevalence of asthma. There was an association with asthma in the mother where this increase is not associated with living in a rural area, to be Ma puche or type of heating.

Perceived discrimination and contextual problems among children and adolescents in northern Chile.

Discriminatory behaviors among inter-ethnic relations in schools have long been noted and studied, but there are several correlations between discriminatory behaviors and other constructs that need further investigation. As an example, the relation between perceived discrimination and contextual problems-which include family, school and peer problems-among children and adolescents in Latin America has received little attention from previous studies. Further, the mediating role of ethnic identification and collective self-esteem in this relation also needs to be considered as they could be proven as protective factors for discriminatory behavior and its outcomes. Therefore, this study aimed to, first, establish the relationship between perceived discrimination and contextual problems in inter-ethnic students aged 8-19 years living in Arica, Chile; and second, to identify the role that ethnic identification and collective self-esteem play within this relation. In order to investigate this matter, a cross-sectional study was carried out with 3700 students in 29 schools between the fourth year of primary education and the last year of secondary education, aged between 9-18 years, with 48.4% men and 51.6% women. The sample was divided into primary and secondary school groups. The scales utilized were the Everyday Discrimination Scale, Multi-Group Ethnic Identity Measure-Revised Scale, Collective Self-Esteem Scale and the dimensions of contextual family, school and peer problems, as well as the general index of contextual problems of the Child and Adolescent Assessment System. For data analysis, we tested a path analytic model at both the within and between levels to account for the relations between variables. In each group the models obtained an optimal fit. We found that perceived discrimination and ethnic identification were directly related to contextual problems (.23-.39), and collective self-esteem had only a mediating role. This study showed that strategized interventions focusing on ethnic identification and perceived discrimination should be utilized by schools to create a better developing environment.

Suicide attempt and suicide in refugees in Sweden - a nationwide population-based cohort study.

BACKGROUND: Despite a reported high rate of mental disorders in refugees, scientific knowledge on their risk of suicide attempt and suicide is scarce. We aimed to investigate (1) the risk of suicide attempt and suicide in refugees in Sweden, according to their country of birth, compared with Swedish-born individuals and (2) to what extent time period effects, socio-demographics, labour market marginalisation (LMM) and morbidity explain these associations. METHODS: Three cohorts comprising the entire population of Sweden, 16-64 years at 31 December 1999, 2004 and 2009 (around 5 million each, of which 3.3-5.0% refugees), were followed for 4 years each through register linkage. Additionally, the 2004 cohort was followed for 9 years, to allow analyses by refugees' country of birth. Crude and multivariate hazard ratios (HRs) with 95% confidence intervals (CIs) were computed. The multivariate models were adjusted for socio-demographic, LMM and morbidity factors. RESULTS: In multivariate analyses, HRs regarding suicide attempt and suicide in refugees, compared with Swedish-born, ranged from 0.38-1.25 and 0.16-1.20 according to country of birth, respectively. Results were either non-significant or showed lower risks for refugees. Exceptions were refugees from Iran (HR 1.25; 95% CI 1.14-1.41) for suicide attempt. The risk for suicide attempt in refugees compared with the Swedish-born diminished slightly across time periods. CONCLUSIONS: Refugees seem to be protected from suicide attempt and suicide relative to Swedish-born, which calls for more studies to disentangle underlying risk and protective factors.

Assessment of bullet holes through the analysis of mushroom-shaped morphology in synthetic fibres: analysis of six cases.

Textiles damage analysis is a very valuable tool in forensic investigations. However, to date, very little research has been carried out to understand the impact of bullet causing damages to clothing. According to the review of the most recent scientific papers, the frictional heating and crushing action of a bullet passing through synthetic fibres cause a unique transformation in their ends called mushroom-shaped morphology. In this study, the textile remains of six individuals executed during the first decade of the Chilean military dictatorship period (1973-1990) were analysed. The purpose was to examine their clothing in order to describe the fibre defects in the bullet holes. The fibres were directly observed using two different models of stereomicroscopy (MZ16A and EZ4D, Leica Microsystem Ltd., Wetzlar, Germany) and through a combination of transmitted, oblique and co-axial illumination (with Leica DFC500 Digital Camera), at × 230 and at a resolution of up to 840 Lp/mm. The mushroom-shaped morphology, along with rupturing of yarns, fibrillation or splitting of fibres, was observed in the bullet holes. Although the mushroom-shaped is a useful pattern for bullet hole identification in synthetic fibres, further research needs to be performed for developing a sounder interpretational framework of this type of forensic evidence.

Racismo y prejuicios encubiertos: Las luchas antirracistas de mujeres mapuche en Chile / Covert Racism and Prejudice: The Anti-Racist Struggles of Mapuche Women in Chile

La expresión de los prejuicios, en los últimos años, es más encubierta que manifiesta. Dicha expresión encubierta busca mantener las exclusiones sociales por razones de raza, clase y gé-nero. Algunas de las razones que las justifican responden a los contextos democráticos y a las sucesivas demandas por los derechos de los pueblos originarios en América Latina. En este con-texto, el objetivo que nos propusimos en este artículo fue analizar comprensivamente las expe-riencias de prejuicios manifiestos y sutiles de mujeres mapuche en Chile, a través de las cuales dichas mujeres crean luchas antiracistas, anticlasistas y antipatriarcales. Por medio de una et-nografía multisituada, con entrevistas en profundidad, damos cuenta de las experiencias de 20 mujeres de las regiones Metropolitana, Biobío, La Araucanía y Los Ríos. Los resultados nos muestran que el racismo manifiesto, y los prejuicios encubiertos, coexisten y varían de acuerdo a las condiciones sociales de las mujeres. (AU)

The expression of prejudice in recent years is more covert than overt. Such covert expression seeks to maintain social exclusions on the basis of race, class and gender. Some of the reasons that justify them respond to democratic contexts and the successive demands for the rights of native peoples in Latin America. In this context, the objective of this article is to comprehen-sively analyse the experiences of overt and subtle prejudices of mapuche women in Chile, through which these women create anti-racist, anti-classist and anti-patriarchal struggles. Through a multi-site ethnography, with in-depth interviews, we report on the experiences of 20 women from the Metropolitan, Biobío, La Araucanía and Los Ríos regions. The results show that overt racism and hidden prejudices coexist and vary according to women’s social conditions. (AU)

Alexia and agraphia in Spanish.

BACKGROUND: Every language has certain specific idiosyncrasies in its writing system. Cross-linguistic analyses of alexias and agraphias are fundamental to understand commonalities and differences in the brain organization of written language. Few reports of alexias and agraphias in the Spanish language are currently available. AIMS: To analyse the clinical manifestations of alexias and agraphias in Spanish, and the effect of demographic variables. METHODS & PROCEDURES: Spanish versions of the Western Aphasia Battery (WAB) and Boston Diagnostic Aphasia Examination (BDAE) were used for language assessment. Lesion localization was obtained by using computed axial tomography and magnetic resonance imaging. The final sample included 200 patients: 195 (97.5%) right-handed and five (2.5%) left-handed; 119 men and 81 women with a mean age of 57.37 years (SD = 15.56), education of 13.52 years (SD = 4.08), and mean time post-onset of 6.58 months (SD = 12.94). Using the WAB, four quotients were calculated: aphasia quotient (AQ), reading-writing quotient (RWQ), language quotient (LQ) and cortical quotient (CQ). OUTCOMES & RESULTS: The types of aphasia were: global = 11 patients (5.5%), Broca = 31 (15.5%), Wernicke = 30 (15.0%), conduction = 22 (11.0%), transcortical sensory = 17 (8.5%), transcortical motor = 3 (1.5%), amnesic or anomic = 54 (27.0%) and mixed non-fluent = 32 (16.0%). The degree of oral and written language impairment differed across the various aphasia types. Most severe reading and writing difficulties were found in global, mixed non-fluent and transcortical motor aphasia; fewer difficulties were observed in amnesic, Broca and conduction aphasia. The severity of the written language impairments paralleled the severity of the oral language disturbances. Age negatively, while schooling positively, correlated with the scores in reading and writing tests. No effect of sex and time since onset was found. CONCLUSIONS & IMPLICATIONS: In Spanish-speaking aphasia patients, difficulties in reading and writing are similar to oral language difficulties. This similarity of performance is mostly based on severity rather than the participants' patterns of errors. What this paper adds What is already known on the subject There is limited information about alexia and agraphia in Spanish. What this paper adds to existing knowledge An extensive study with a large sample of patients. What are the potential or actual clinical implications of this work? The study contributes to the clinical management of patients with reading and writing disturbances.

Time Discipline and Health/Communicative Labor in Pediatric Primary Care.

In rural Southern Chile, native Mapuche families receive care mostly from non-indigenous clinicians. Parents and doctors alike orient to the importance of timely medical care, but clinical and communication norms also result in misunderstandings and tension. Parents find it hard to communicate about structural obstacles, and valued practices of care in families may conflict with normative expectations for timely presentation. Parents' disclosures about the duration of their children's illnesses can expose them to clinical censure, which in turn reinforces pernicious negative stereotypes about this racialized and marginalized community.

Relationships between social stigma, stigma experience and self-stigma and impaired quality of life in schizophrenia across three Latin-American countries.

The relationships between stigma and quality of life in schizophrenia (QoL) have been extensively explored but have mostly focused on self-stigma and self-esteem and have never been explored in Latin-America. The objective of this study was to determine which stigma dimensions were associated with QoL in a sample of community-dwelling SZ subjects of three Latin-American countries. Stabilized outpatients with SZ were recruited in three Mental Health Services in three Latin-American countries: Bolivia (N = 83), Chile (N = 85) and Peru (N = 85). Stigma and Qol-SZ were evaluated by self-administered questionnaires, the Internalized Stigma of Mental Illness scale (ISMI-12) and the SQoL-18. 253 participants were included. In multivariate analyses, QoL has been associated with each stigma dimension (social stigma, stigma experience and self-stigma), independently of age, gender, education level, ethnicity, age at illness onset, illness symptomatology and mental health treatment. More specifically, social stigma was significantly associated with impaired psychological and physical well-being, self-esteem and friendship. Self-stigma was significantly associated with impaired psychological well-being, self-esteem and autonomy. The present results confirm the importance of stigma in QoL of SZ subjects and identify new targets to develop stigma-orientated programs. Most of the previous programs have focused on self-stigma while social stigma has shown to be associated with a wide range of impaired QoL areas. Stigma and QoL may have a bidirectional relationship and targeting some specific QoL areas (like autonomy through self-empowerment approaches) may also improve the effectiveness of these programs to reduce stigma impact on the quality of life of subjects with schizophrenia. Future studies should also explore differences across countries as subjects from Bolivia were more frequently Aymara and reported higher stigma and lower QoL than SZ subjects from other countries.

Inequalities in the Age of Universal Health Coverage: Young Chileans with Diabetes Negotiating for Their Right to Health.

While universal health coverage (UHC) has been praised as a powerful means to reduce inequalities and improve access to health globally, little has been said about how patients experience and understand its implementation locally. In this article, we explore the experiences of young Chileans with type 1 diabetes when seeking care in Santiago, within Chile's UHC program, which sought to improve people's access to health care. We argue that the implementation of UHC, within a structurally fragmented health system, did not lead to the promised equitable health care delivery. Although UHC aimed to equitably provide universal care, locally it materialized in heterogeneous configurations forcing individuals into positions of precarity and generating new inequalities. Furthermore, for the young people in the study, UHC intersected with their health insurance and socioeconomic status, impacting on the health care they could access, consequently making diabetes care and management a difficult challenge.

Randomized cluster trial of a parenting program in Chile: Key mediators in the decrease in behavior problems in preschool children.

BACKGROUND: Parenting training is a proven strategy for the promotion of positive parenting practices and for the prevention and treatment of behavior problems in children. The processes that explain this efficacy are less clear. The aim of this study was to assess the mediating role of parenting practice modification, encouraged through the implementation of a universal parenting training program, for the decrease of behavior problems in 3- to 6-year-old children. METHOD: A cluster randomized trial was carried out in 19 educational centers in low and middle socioeconomic areas. A total of 178 families received the program and 154 of them were the control group. The following parenting practices were assessed: positive reinforcement, involvement, inconsistency, unsuitable treatment behaviors and physical punishment, as well as hostility and humiliation behaviors. Parent-child interaction was also assessed using an observational instrument. A multiple mediation analysis was carried out, identifying the indirect effects. RESULTS: Reduction of harsh discipline and physical punishment, and parental inconsistency mediated the effects observed in the reduction of child behavior problems during the program. CONCLUSION: Within Chilean families, harsh discipline, physical punishment, and parental inconsistency are important aspects to be considered in the implementation of universal parenting training programs.

La paradoja de la inmigración: las madres haitianas y latinoamericanas en Chile / The Immigration Paradox: Haitian and Latin American Mothers in Chile

Introducción: Existe información internacional sobre las diferencias en parto prematuro y peso al nacer para madres migrantes de diferentes etnias originarias. El objetivo de este trabajo es evaluar parto prematuro y peso al nacer de madres de nacionalidad diferente, cuyos partos ocurrieron en Chile. Materiales y métodos Se utilizó la base de datos nacional del Departamento de Informática del Ministerio de Salud de Chile. Se incluyeron los recién nacidos del período Septiembre 2012 a Diciembre 2016. Se evaluaron los datos perinatales básicos, parto prematuro, bajo peso al nacer y su relación con la edad gestacional de nacidos de madres chilenas y de otras nacionalidades. Resultados En el periodo estudiado hubo 1.048490 nacimientos, de los cuales 50995 son de madres extranjeras. El porcentaje de nacidos antes de 37 semanas en madres de Bolivia, Colombia, Ecuador, Perú y Venezuela es entre un 4.8 y 7.3 %, versus 8% en madres chilenas. Los percentiles 10 para el peso al nacer entre 30 y 40 semanas para madres chilenas y Haitianas (en paréntesis) expresados en gramos: 1045 (1102), 1195 (1160), 1360 (1370), 1550 (1503), 1750 (1508), 2000 (1669), 2235 (1982), 2500 (2237), 2810 (2607), 2970 (2710), 3080 (2858). Los z-score de madres Haitianas fueron significativamente menores después de las 35 semanas. Conclusiones La paradoja de la inmigración se verifica en la experiencia nacional, con tasas de natalidad prematuras y bajo peso al nacer más favorables para las madres extranjeras en comparación con las mujeres chilenas y con sus países de origen. Las madres afro-caribeñas tuvieron nacimientos con peso menor, en edades gestacionales donde se toman decisiones frecuentes, con diferencias de hasta un 20 % entre las 35- 37 semanas.

SUMMARY The immigration paradox: Haitian and Latin American mothers in Chile Introduction There is international information on the differences in preterm birth and birth weight for migrant mothers of different ethnicities. The objective is to evaluate prematurity and birth weight of mothers of different national origin, whose deliveries occurred in Chile. Materials and methods The national database of the Department of Informatics of the Ministry of Health of Chile was used. Newborns from the period of September 2012 to December 2016 were included. Basic perinatal data, preterm birth, low birth weight and their relationship with the gestational age of babies born to mothers of local origin and other nationalities were evaluated. Results 1,048,490 births, 50,995 foreign mothers were studied. The percentage of those born before 37 weeks of mothers from Bolivia, Colombia, Ecuador, Peru, and Venezuela is between 4.8 and 7.3%, compared to nationals with 8%. The 10th percentiles for birth weight from 30 to 40 weeks for Chilean and Haitian mothers (in parentheses) were (g): 1045 (1102), 1195 (1160), 1360 (1370), 1550 (1503), 1750(1508 ), 2000 (1669), 2235 (1982), 2500 (2237), 2810 (2607), 2970 (2710), 3080 (2858). The z-scores of Haitian mothers were significantly lower. Conclusions The immigration paradox is verified in the national experience, with preterm birth rates and low birth weight more favorable to foreign mothers compared to chileans Afro-Caribbean mothers had births with a lower weight, at gestational ages where relevant decisions are made, with differences of up to a 20% between 35-37 weeks.

Use of TEVI-R to describe passive vocabulary in children belonging to a Mapuche community. / Uso del TEVI-R para describir el vocabulario pasivo en niños de la etnia Mapuche.

PURPOSE: To describe the level of passive vocabulary in boys and girls belonging to the Mapuche ethnic group, using the Vocabulary Test in Images Revised version (TEVI-R). METHODS: A cross-sectional study was carried out. Twenty-six children, both gender, between 4 to 7 years old participated in the study. The performance of passive vocabulary was measured through the application of the TEVI-R, analyzing the variables age and gender, as well as performing an analysis of the items and the number of errors. RESULTS: The performance of these children is not influenced by gender or age. There are potential sources of error in the items of the instruments related to the cultural, geographical relevance and graphic quality of them. CONCLUSION: No association was observed by gender or differences by age in the study population. The possibility of developing new instruments or revising the available ones is discussed, given the characteristics of their native language, obtaining reliable results and respecting the elements that are part of their culture.

OBJETIVO: Describir el nivel de vocabulario pasivo en niños y niñas pertenecientes a la etnia mapuche, utilizando el Test de Vocabulario en Imágenes versión Revisada (TEVI-R). MÉTODO: Se llevó a cabo un estudio de corte transversal. Participaron 26 niños, de ambos géneros cuyas edades fluctuaron entre 4 y 7 años de edad. Se midió el desempeño de vocabulario pasivo mediante la aplicación del TEVI-R, analizando las variables edad y género, además de realizar un análisis de los ítems con mayor cantidad de errores. RESULTADOS: El rendimiento de estos niños no se ve influenciado ni por género, ni por edad. Existen potenciales fuentes de error en los ítems de los instrumentos relacionados a la pertinencia cultural, geográfica y a la calidad gráfica de los mismos. CONCLUSIÓN: No se observó asociación por género ni diferencias por edad en la población estudiada. Se discute la posibilidad de elaborar nuevos instrumentos o revisar los disponibles, dadas las características de su lengua materna, con la finalidad de recabar resultados fiables y respetar los elementos que forman parte de los marcadores propios de su cultura.

Frequencies and significance of HLA genes in Amerindians from Chile Cañete Mapuche.

Mapuche Amerindians live now widespread in Central South Chile and Argentina and speak "Mapudungun", an unclassified language. A group of Chilean Mapuche was studied for HLA genes using standard techniques. Typical Amerindian HLA genes and haplotypes are found in the population, like HLA-DRB1*14:02, -08:02 and class II haplotype DRB1*08:02-DQB1*04:02. However, these and other genes are also common in Pacific Islanders. Thus, relatedness of First America Inhabitants with some Pacific Islanders is stressed. Evidences of Pacific and Atlantic cultural and genetic exchange, probably in both directions, and California Man settlements found since 130,000 years ago makes it necessary a revision of Americas peopling. This study may be also useful for medical Mapuche use in Transplantation and HLA and disease Epidemiology.

[Health care effects of cultural beliefs about physicians and perceived discrimination]. / Creencias culturales sobre los médicos y percepción de discriminación: El impacto en la continuidad de la atención.

BACKGROUND: Healthcare inequities may hamper physical and mental health. AIM: To examine perceived discrimination in healthcare services in relation to socio-structural and cultural antecedents as well as their effect on psychological processes and health. MATERIAL AND METHODS: Questionnaires on beliefs about physicians, perceived discrimination, emotions and affective states and avoidance consequences in health were answered by 337 child caregivers (85% women) attending preventive health care appointments at primary health care centers. RESULTS: Negative beliefs about healthcare professionals are directly associated with avoidance behaviors in health and perceived discrimination. The latter perception has no direct effects on avoidance behaviors, but it has an indirect effect through negative emotions associated with discrimination. CONCLUSIONS: There is an association between cultural, psychological and structural factors in health care. These results contribute to understand the phenomenon of discrimination and its negative consequences.

Creencias culturales sobre los médicos y percepción de discriminación: El impacto en la continuidad de la atención / Health care effects of cultural beliefs about physicians and perceived discrimination

Background: Healthcare inequities may hamper physical and mental health. Aim: To examine perceived discrimination in healthcare services in relation to socio-structural and cultural antecedents as well as their effect on psychological processes and health. Material and Methods: Questionnaires on beliefs about physicians, perceived discrimination, emotions and affective states and avoidance consequences in health were answered by 337 child caregivers (85% women) attending preventive health care appointments at primary health care centers. Results: Negative beliefs about healthcare professionals are directly associated with avoidance behaviors in health and perceived discrimination. The latter perception has no direct effects on avoidance behaviors, but it has an indirect effect through negative emotions associated with discrimination. Conclusions: There is an association between cultural, psychological and structural factors in health care. These results contribute to understand the phenomenon of discrimination and its negative consequences.

Differences on Quality of Life of Patients with Schizophrenia: A Multicentric Study from Three Latin-America Countries.

The aim of the study is to explore the variation on patient's Quality of Life (QoL) across three Latin-Americans countries. The study included 253 stabilized outpatients with schizophrenia from three Mental Health Services in Bolivia (N = 83), Chile (N = 85) and Peru (N = 85). Patients' were assessed using Schizophrenia Quality of Life Questionnaire (SQoL18). We collected socio-demographic information and clinical data, while recognizing the cultural complexity/dynamics of each country, and the influence of cultural contexts on how people experience the health systems. There are differences in QoL according to each country. Peru reports better levels of QoL at the Total Score Index and in most of the dimensions of the SQoL18. Bolivia shows the lowest indicators of QoL, except, interestingly, for the Resilience dimension where it reaches the highest scores. Even when the studied regions in the three Latin American countries share several cultural characteristics, there are also some important differences between them on patients' QoL. Possible disparities at investment in mental health by the Governments of each country are discussed while possible influences of (inter)cultural contexts are taken into account.