International Delphi Expert Consensus on Safe Return to Surgical and Endoscopic Practice: From the Coronavirus Global Surgical Collaborative.

OBJECTIVE: The aim of this work is to formulate recommendations based on global expert consensus to guide the surgical community on the safe resumption of surgical and endoscopic activities. BACKGROUND: The COVID-19 pandemic has caused marked disruptions in the delivery of surgical care worldwide. A thoughtful, structured approach to resuming surgical services is necessary as the impact of COVID-19 becomes better controlled. The Coronavirus Global Surgical Collaborative sought to formulate, through rigorous scientific methodology, consensus-based recommendations in collaboration with a multidisciplinary group of international experts and policymakers. METHODS: Recommendations were developed following a Delphi process. Domain topics were formulated and subsequently subdivided into questions pertinent to different aspects of surgical care in the COVID-19 crisis. Forty-four experts from 15 countries across 4 continents drafted statements based on the specific questions. Anonymous Delphi voting on the statements was performed in 2 rounds, as well as in a telepresence meeting. RESULTS: One hundred statements were formulated across 10 domains. The statements addressed terminology, impact on procedural services, patient/staff safety, managing a backlog of surgeries, methods to restart and sustain surgical services, education, and research. Eighty-three of the statements were approved during the first round of Delphi voting, and 11 during the second round. A final telepresence meeting and discussion yielded acceptance of 5 other statements. CONCLUSIONS: The Delphi process resulted in 99 recommendations. These consensus statements provide expert guidance, based on scientific methodology, for the safe resumption of surgical activities during the COVID-19 pandemic.

Improving the sensitivity of gastrointestinal helminth detection using the Mini-FLOTAC technique in wild birds.

High-performance-validated tests are essential for successful epidemiological monitoring, surveillance of parasitic infections, and comparative studies in wildlife populations. The Mini-FLOTAC is a novel flotation-based technique for the sensitive detection and quantification of gastrointestinal parasites that is recently being explored for use in wildlife. A limitation of any flotation-based copromicroscopic method is the selection of the flotation solution (FS), which might influence the performance of the test. However, no study has compared the influence of using different FS in the Mini-FLOTAC technique for parasite detection in wild birds. Here, we evaluated the diagnostic performance of the Mini-FLOTAC in three waterbird host species using two widely used FS: saturated salt (NaCl; specific gravity 1.20) and saturated zinc sulfate (ZnSO4; specific gravity 1.35). One hundred fresh fecal samples were analyzed for parasite fecal egg counts (FEC). Regardless of the host species, fecal samples evaluated with the Mini-FLOTAC method using ZnSO4 resulted in a significantly higher detection rate and higher FEC of strongylid, capillarid, cestode, and trematode parasites, than samples analyzed with the NaCl solution. Our concise study demonstrated the importance of using an appropriate FS for the identification of parasite eggs in wildlife species, especially in hosts with an expected aggregated distribution and low parasite load such as waterbird hosts. The higher analytical sensitivity of the Mini-FLOTAC technique achieved with ZnSO4, and its applicability to fieldwork, highlights this method as a promising tool for the quantitative surveillance of parasite infections in wild bird populations.

Brain lesions associated with eosinophilia. A useful clue for neurotoxocariasis. Report of one case.

Neurotoxocariasis is uncommon. Its manifestations include events of meningitis, encephalitis and less frequently vasculitis, which manifest as headache, seizures, focalization, confusion, cognitive alterations and /or fever. Peripheral eosinophilia with clinical and neurological imaging elements, allow its early suspicion. We report a 48-year-old agricultural worker, admitted in our hospital for one week of gastrointestinal complaints, headache, progressive left hemiparesis and impaired consciousness. He had leukocytosis (13,530/µL) with peripheral eosinophilia (25%, absolute count 3,400 /µL). CSF analysis revealed no abnormalities and brain CT showed poorly defined hypodense lesions on subcortical areas and semioval centers. Magnetic resonance imaging showed multiple foci with increased signals predominantly in the white matter in both hemispheres, especially at frontal and occipital regions and at semioval centers. Lesions reinforced after paramagnetic contrast. Serological studies found specific IgG antibodies by ELISA against antigens of the genus Toxocara, which were confirmed by a positive IgG Western Blot. The patient was treated with albendazole (800 mg/d) for 14 days associated with parenteral and then oral corticosteroids with a favorable response and gradual complete recovery.

Recovery of endoscopy services in the era of COVID-19: recommendations from an international Delphi consensus.

The COVID-19 pandemic has had a profound impact on provision of endoscopy services globally as staff and real estate were repurposed. As we begin to recover from the pandemic, a cohesive international approach is needed, and guidance on how to resume endoscopy services safely to avoid unintended harm from diagnostic delays. The aim of these guidelines is to provide consensus recommendations that clinicians can use to facilitate the swift and safe resumption of endoscopy services. An evidence-based literature review was carried out on the various strategies used globally to manage endoscopy during the COVID-19 pandemic and control infection. A modified Delphi process involving international endoscopy experts was used to agree on the consensus statements. A threshold of 80% agreement was used to establish consensus for each statement. 27 of 30 statements achieved consensus after two rounds of voting by 34 experts. The statements were categorised as pre-endoscopy, during endoscopy and postendoscopy addressing relevant areas of practice, such as screening, personal protective equipment, appropriate environments for endoscopy and infection control precautions, particularly in areas of high disease prevalence. Recommendations for testing of patients and for healthcare workers, appropriate locations of donning and doffing areas and social distancing measures before endoscopy are unique and not dealt with by any other guidelines. This international consensus using a modified Delphi method to produce a series of best practice recommendations to aid the safe resumption of endoscopy services globally in the era of COVID-19.

Treatment of post-cholecystectomy biliary strictures with fully-covered self-expanding metal stents - results after 5 years of follow-up.

BACKGROUND: Endoscopic treatment of post-cholecystectomy biliary strictures (PCBS) with multiple plastic biliary stents placed sequentially is a minimally invasive alternative to surgery but requires multiple interventions. Temporary placement of a single fully-covered self-expanding metal stent (FCSEMS) may offer safe and effective treatment with fewer re-interventions. Long-term effectiveness of treatment with FCSEMS to obtain PCBS resolution has not yet been studied. METHODS: In this prospective multi-national study in patients with symptomatic benign biliary strictures (N = 187) due to various etiologies received a FCSEMS with scheduled removal at 6-12 months and were followed for 5 years. We report here long-term outcomes of the subgroup of patients with PCBS (N = 18). Kaplan Meier analyses assessed long-term freedom from re-stenting. Adverse events were documented. RESULTS: Endoscopic removal of the FCSEMS was achieved in 83.3% (15/18) of patients after median indwell of 10.9 (range 0.9-13.8) months. In the remaining 3 patients (16.7%), the FCSEMS spontaneously migrated and passed without complications. At the end of FCSEMS indwell, 72% (13/18) of patients had stricture resolution. At 5 years after FCSEMS removal, 84.6% (95% CI 65.0-100.0%) of patients who had stricture resolution at FCSEMS removal remained stent-free. In addition, at 75 months after FCSEMS placement, the probability of remaining stent-free was 61.1% (95% CI 38.6-83.6%) for all patients. Stent or removal related serious adverse events occurred in 38.9% (7/18) all resolved without sequalae. CONCLUSIONS: In patients with symptomatic PCBS, temporary placement of a single FCSEMS intended for 10-12 months indwell is associated with long-term stricture resolution up to 5 years. Temporary placement of a single FCSEMS may be considered for patients with PCBS not involving the main hepatic confluence. TRIAL REGISTRATION NUMBERS: NCT01014390; CTRI/2012/12/003166; Registered 17 November 2009.

Successful management of benign biliary strictures with fully covered self-expanding metal stents.

BACKGROUND & AIMS: Fully covered self-expanding metal stents (FCSEMS) are gaining acceptance for the treatment of benign biliary strictures. We performed a large prospective multinational study to study the ability to remove these stents after extended indwell and the frequency and durability of stricture resolution. METHODS: In a nonrandomized study at 13 centers in 11 countries, 187 patients with benign biliary strictures received FCSEMS. Removal was scheduled at 10-12 months for patients with chronic pancreatitis or cholecystectomy and at 4-6 months for patients who received liver transplants. The primary outcome measure was removal success, defined as either scheduled endoscopic removal of the stent with no removal-related serious adverse events or spontaneous stent passage without the need for immediate restenting. RESULTS: Endoscopic removal of FCSEMS was not performed for 10 patients because of death (from unrelated causes), withdrawal of consent, or switch to palliative treatment. For the remaining 177 patients, removal success was accomplished in 74.6% (95% confidence interval [CI], 67.5%-80.8%). Removal success was more frequent in the chronic pancreatitis group (80.5%) than in the liver transplantation (63.4%) or cholecystectomy (61.1%) groups (P = .017). FCSEMS were removed by endoscopy from all patients in whom this procedure was attempted. Stricture resolution without restenting upon FCSEMS removal occurred in 76.3% of patients (95% CI, 69.3%-82.3%). The rate of resolution was lower in patients with FCSEMS migration (odds ratio, 0.22; 95% CI, 0.11-0.46). Over a median follow-up period of 20.3 months (interquartile range, 12.9-24.3 mo), the rate of stricture recurrence was 14.8% (95% CI, 8.2%-20.9%). Stent- or removal-related serious adverse events, most often cholangitis, occurred in 27.3% of patients. There was no stent- or removal-related mortality. CONCLUSIONS: In a large prospective multinational study, removal success of FCSEMS after extended indwell and stricture resolution were achieved for approximately 75% of patients. ClincialTrials.gov number, NCT01014390.

Usefulness of vancomycin treatment individualization via Bayesian algorithms: a 5-year study in critical patients.

Aim: Compare two vancomycin dosing strategies in critical patients with methicillin-resistant Staphylococcus aureus (MRSA) infections, considering the heterogeneity of the dosing regimens administered and their implications for toxicity and efficacy. Materials & methods: Longitudinal retrospective observational study in two patient cohorts (standard dosing vs dosing via Bayesian algorithms). Results: The group of Bayesian algorithms received substantially higher and significantly heterogeneous doses, with an absence of nephrotoxicity. The speed of decrease observed in CRP and PCT was greater for the Bayesian strategy (p = 0.045 and 0.0009, respectively). Conclusion: Applying Bayesian algorithms to vancomycin dosage individualization allows for administering much higher doses than with standard regimens, facilitating a quicker clinical response in the absence of nephrotoxicity.

[Box: see text].

[Palliative treatment for locally advanced or metastatic gallbladder cancer: conclusions of the Latin American Consensus meeting for the management of gallbladder cancer]. / Manejo paliativo del cáncer de vesícula biliar irresecable o metastásico: conclusiones del Consenso Latinoamericano de Manejo del Cáncer de Vesícula Biliar.

Gallbladder cancer is a rare disease in Western developed countries, but it is a highly prevalent and lethal disease in Chile and other countries in Latin America. No randomized controlled trials have been performed in gallbladder cancer to establish standard treatments. We therefore performed the first Latin American consensus meeting for the management of gallbladder cancer. In this article we present the conclusions of the panel of experts for the palliative treatment of unresectable or metastatic gallbladder cancer based on a review of the literature, the discussion of the participating experts and the opinion of the assistants. The topics reviewed included: (1) Gallbladder cancer and cholangiocarcinoma--are they the same disease?; (2) Palliative chemotherapy: indications, drugs and schedules; (3) Palliative radiotherapy; (4) Palliative Surgery; (5) Management of malignant biliary obstruction.

Parental Stress and Satisfaction in Parents With Pre-school and School Age Children.

Parenting is a transforming experience for the life of parents that brings joy and satisfaction as well as challenges, frustration, and demands. The aim of this study was to determine the relationship between "parental stress and satisfaction" and work-home conflict, perceived social support, and global satisfaction with life, and to determine the moderating role of the parent's gender. A sample of 244 participants was studied: 49.6% (121) mothers and 50.4% (123) fathers with children between 2 and 12 years of age. The data was analysed by means of multiple linear regression models and Beta regression for stress and parental satisfaction, respectively, and they were complemented with general and conditional dominance analyses to estimate the relevance of the predictors. Mothers presented higher levels of parental stress and satisfaction than fathers. Being female, having two children, and home-work conflict were predictors of a higher parental stress. Age was also a predictor, as younger parents and also those older than 37 years of age showed more parental stress. Having no partner and being male was associated to lower parental satisfaction. In conclusion, parental stress and satisfaction emerge as clearly differentiated dimensions of parenting experience. The gender gap in parental stress could be linked to the persistence of traditional roles regarding the care of the children, in agreement with the findings in other research.

Professors' Expectations About Online Education and Its Relationship With Characteristics of University Entrance and Students' Academic Performance During the COVID-19 Pandemic.

Due to COVID-19, universities have been facing challenges in generating the best possible experience for students with online academic training programs. To analyze professors' expectations about online education and relate them to student academic performance during the COVID-19 pandemic, and considering the socio-demographic, entry, and prior university performance variables of students. A prospective longitudinal design was used to analyze the expectations of 546 professors (54.8% male) in T1. In T2, the impact of the expectations of 382 of these professors (57.6% men) was analyzed, who taught courses during the first semester to a total of 14,838 university students (44.6% men). Professors' expectations and their previous experience of online courses were obtained during T1, and the students' academic information was obtained in T2. A questionnaire examining the Expectations toward Virtual Education in Higher Education for Professors was used. 84.9% of the professors were considered to have moderate to high skills for online courses. Differences in expectations were found according to the professors' training level. The professors' self-efficacy for online education, institutional engagement, and academic planning had the highest scores. The expectations of professors did not directly change the academic performance of students; however, a moderating effect of professor's expectations was identified in the previous student academic performance relationship on their current academic performance.

[Endoscopic argon plasma coagulation in recurrent tracheoesophageal fistula. Clinical series and review of the literature]. / Tratamiento endoscópico con argón plasma en fístula traqueoesofágica recurrente. Serie clínica y revisión de la literatura médica.

INTRODUCTION: Recurrent tracheoesophageal fistula (RTEF) is a complication that occurs in up to 15% of patients after esophageal atresia repair. The clinical features include coughing, aspiration, recurrent pneumonia and failure to thrive. Surgical treatment is recommended. However, since 1980, the endoscopic route has been used as a therapeutic alternative. Distinct techniques have been employed with an overall success rate of 63%. PURPOSE: To evaluate a new endoscopic treatment for RTEF with argon plasma coagulation (APC). METHODS: Six patients with RTEF treated with endoscopic APC between 2003 and 2007 at a single institution (Clinica Alemana, Santiago, Chile) were included. We also performed a systematic literature search. Nineteen articles were selected, with a total of 77 patients treated through the endoscopic route. RESULTS: Treatment was successful in 66% of the patients with a follow-up of more than 12 months. On average, the patients required two applications of APC. This success rate was similar to that reported in published series. CONCLUSION: Endoscopic treatment with APC in RTEF seems to be useful and easily applied. Because of the complexity of surgical treatment, we recommend endoscopic treatment as the first approach in patients with RTEF.

Child-to-parent Violence Questionnaire (CPV-Q): Validation among Spanish adolescents.

Background/Objective: Child-to-parent violence has generated great interest on the part of professionals and researchers in recent years. Consequently, there is a need to provide an assessment instrument that includes a wide range of child-to-parent violence behaviours and all of elements that define this type of violence. Thus, the purpose of the current study was to analyse the structure, reliability and validity of the CPV-Q, an instrument to assess child-to-parent violence behaviours, including the reasons for aggression against parents. Method: A total of 1,386 Spanish adolescents (55.2% females; M age = 14.7, SD = 1.7) were assessed using the CPV-Q. We obtained descriptive statistics of the items, the internal structure of the scale using both exploratory and confirmatory factor analysis, its reliability, and external evidence of its validity. Results: Data indicated a matrix of 4 factors with 14 parallel items (for the father and for the mother). Reasons for child-to-parent violence were grouped into instrumental and reactive reasons. Conclusion: The CPV-Q presents adequate psychometric properties; thus, it is proposed as a useful instrument to assess child-to-parent violence in both professional and research settings.

Antecedentes/Objetivo: La violencia filio-parental ha generado un gran interés por parte de profesionales e investigadores en los últimos años. En consecuencia, es necesario contar con un instrumento de evaluación que incluya un amplio rango de conductas de violencia filio-parental y todos los elementos que definen este tipo de violencia. De esta forma, el objetivo del presente estudio fue analizar la estructura, fiabilidad y validez del C-VIFIP, un instrumento para evaluar conductas de violencia filio-parental, incluyendo los motivos de las agresiones. Método: Se evaluó a un total de 1.386 adolescentes españoles (55,2% chicas; M edad = 14,7; DT = 1,7) con el C-VIFIP. Se obtuvieron los estadísticos descriptivos de los ítems, la estructura interna de la escala mediante análisis factorial exploratorio y confirmatorio, fiabilidad y evidencias externas de validez. Resultados: Los resultados indicaron una matriz de cuatro factores con 14 ítems paralelos (para el padre y para la madre). Los motivos de las agresiones se agruparon en instrumentales y reactivos. Conclusión: El C-VIFIP presenta adecuadas propiedades psicométricas, de forma que se propone como un instrumento útil para evaluar la violencia filio-parental, tanto en contextos profesionales como de investigación.

[Inverted colonic diverticula: an uncommon endoscopic finding]. / Divertículo colónico invertido: un hallazgo endoscópico infrecuente.

BACKGROUND: The appearance of inverted colonic diverticula (ICD) is similar to that of elevated polypoid lesions. The aim of this study was to describe the endoscopic characteristics of ICD with a view to avoiding misdiagnosis, and to report the frequency of these lesions. MATERIAL AND METHOD: Using an endoscopic database, we retrospectively analyzed all patients who underwent colonoscopy at our institution between July 2001 and July 2004. Patients diagnosed with ICD were identified and both patient and ICD characteristics were recorded, including location, endoscopic characteristics, and the presence of synchronous colon polyps. RESULTS: Among the 4508 colonoscopies performed in the selected period, 33 patients (0.7%) were diagnosed with ICD. The mean age was 62.3 years, with a male-to-female ratio of 1:1.2. Most ICD (89%) were in an area of multiple colonic diverticula and 75% were located in the sigmoid colon. One patient had active bleeding directly from the inverted diverticulum and was treated with injection therapy. The endoscopic characteristics of ICDs were described. There were no complications in this series. CONCLUSIONS: ICD is a rare endoscopic finding that can be complicated by local bleeding. Misdiagnosis can be dangerous and biopsy or endoscopic resection could lead to serious complications. The endoscopic criteria described should be considered to avoid the complications associated with biopsy or resection.

[Endoscopic pancreatic sphincterotomy: when and how]. / Esfinterotomía pancreática: cuándo y cómo?

Endoscopic pancreatic sphincterotomy (EPS) has fallen into disuse for some time because of the risk of severe complications. More recently, EPS has been advocated as an effective treatment modality for several pancreatic disorders, including severe chronic pancreatitis, pancreatic pseudocyst, ampulloma, pancreas divisum, and pancreatic sphincter dysfunction. Favorable outcomes in patients undergoing EPS to facilitate further interventions, in whom long-term follow-up was available, was 70%; complications occurred in 14% and reintervention was required in 23%. The results were as good as those of surgery after long-term follow-up. Patients who underwent some form of pancreatic drainage after sphincterotomy had fewer complications (p = 0.03). Approximately 75% of patients with pancreas divisum who presented with idiopathic acute recurrent pancreatitis improved after endoscopic therapy, but only 25% of patients experienced pain reduction of at least 50%. The National Institutes of Health Consensus recommends EPS in patients with type I sphincter of Oddi dysfunction (SOD). In patients with type II SOD, prior manometry should be performed. In our series of 17 patients, we obtained results similar to those of other studies, although the number of patients was small. EPS appears to be a safe and effective technique, but further, well-designed, multicenter, prospective and long-term studies are required to evaluate these results and settle current controversies.

Brain lesions associated with eosinophilia. A useful clue for neurotoxocariasis. Report of one case / Lesiones cerebrales asociadas con eosinofilia. Una clave útil en neurotoxocariasis

ABSTRACT Neurotoxocariasis is uncommon. Its manifestations include events of meningitis, encephalitis and less frequently vasculitis, which manifest as headache, seizures, focalization, confusion, cognitive alterations and /or fever. Peripheral eosinophilia with clinical and neurological imaging elements, allow its early suspicion. We report a 48-year-old agricultural worker, admitted in our hospital for one week of gastrointestinal complaints, headache, progressive left hemiparesis and impaired consciousness. He had leukocytosis (13,530/μL) with peripheral eosinophilia (25%, absolute count 3,400 /μL). CSF analysis revealed no abnormalities and brain CT showed poorly defined hypodense lesions on subcortical areas and semioval centers. Magnetic resonance imaging showed multiple foci with increased signals predominantly in the white matter in both hemispheres, especially at frontal and occipital regions and at semioval centers. Lesions reinforced after paramagnetic contrast. Serological studies found specific IgG antibodies by ELISA against antigens of the genus Toxocara, which were confirmed by a positive IgG Western Blot. The patient was treated with albendazole (800 mg/d) for 14 days associated with parenteral and then oral corticosteroids with a favorable response and gradual complete recovery.

La neurotoxocariasis es infrecuente. Sus manifestaciones incluyen eventos de meningitis, encefalitis y con menor frecuencia vasculitis, que se manifiestan como cefalea, convulsiones, focalización, confusión, alteraciones cognitivas o fiebre. La eosinofilia periférica, junto a elementos clínicos e imágenes compatibles, permiten su sospecha. Informamos el caso de un trabajador agrícola de 48 años que ingresó por una semana de molestias gastrointestinales, cefalea, hemiparesia izquierda progresiva y deterioro de conciencia. Los exámenes revelaron leucocitosis (13.530/μL) con eosinofilia periférica (25%, recuento absoluto 3.400/μL). El análisis del LCR sin anomalías y la tomografía computada cerebral mostró lesiones hipodensas mal definidas en áreas subcorticales y centros semiovales. La resonancia magnética mostró múltiples focos con aumento de la señal predominantemente en la sustancia blanca en ambos hemisferios. Las lesiones presentaron refuerzo tras contraste paramagnético. Los estudios serológicos indicaron anticuerpos IgG específicos por ELISA contra antígenos del género Toxocara. El paciente fue tratado con albendazol (800 mg /día) durante 14 días asociado a corticoides con respuesta favorable y una recuperación gradual completa.

Impacto del maltrato infantil en la prevalencia de trastornos mentales en niños y adolescentes chilenos

RESUMEN Introducción: La mala salud mental está fuertemente asociada con la violencia interpersonal. El maltrato infantil es un problema cultural y global de salud pública que atenta contra los derechos de los niños. Objetivo: Examinar la asociación entre la experiencia de maltrato y presentación de trastornos mentales en niños y adolescentes. Material y Método: Estudio cuantitativo, no experimental, analítico de corte transversal, dirigido a niños y adolescentes chilenos. La muestra estuvo compuesta por 1558 participantes entre 4 y 18 años, el instrumento recolector de datos estuvo compuesto por la entrevista diagnóstica estructurada para niños, versión computarizada DISC-IV, un cuestionario de maltrato infantil y datos sociodemográficos. El análisis estadístico se realizó mediante regresión logística con el programa R versión 3. Resultados: En el grupo de los niños, los trastornos ansiosos y disruptivos prevalentes y subumbral se relacionaron con abuso sexual, maltrato psicológico y físico. En el grupo de los adolescentes, los trastornos del ánimo se asociaron con maltrato psicológico y abuso sexual, los trastornos disruptivos prevalentes y subumbrales se asociaron con todos los tipos de maltrato, y el trastorno por consumo de drogas se asoció con abuso sexual. Conclusión: Existe relación significativa entre el maltrato en sus diferentes categorías, especialmente abuso sexual con la expresión de trastornos mentales en niños y adolescentes. Es importante detectar tempranamente los niveles subumbrales para tratar de reparar el problema, educar a la población, procurar comunidades menos violentas y ambientes tranquilos para el crecimiento de niños y adolescentes.

ABSTRACT Introduction: Poor mental health is strongly associated with interpersonal violence. Child abuse is a cultural and global public health problem that violates children's rights. Objective: To examine the relation between experience of abuse and presence of mental disorders in children and adolescents. Materials and methods: Quantitative, non-experimental, cross-sectional analytical study, aimed at Chilean children and adolescents. The sample consisted of 1558 participants who were between 4 and 18 years old. The data-collection instrument included the Structured Diagnostic Interview for Children, computerized version DISC-IV, a child abuse questionnaire and sociodemographic data. Statistical analysis was performed by logistic regression using the R program version 3. Results: In the group of children, prevalent and sub-threshold anxiety and disruptive disorders were related to sexual abuse, psychological and physical abuse. In the adolescent group, mood disorders were associated with psychological and sexual abuse; prevalent and sub-threshold disorders were associated with all types of abuse, and drug use disorder was associated with sexual abuse. Conclusion: There is a significant relationship between abuse in its different categories, especially sexual abuse, and the occurrence of mental disorders in children and adolescents. It is important to detect early sub-threshold levels in order to try to solve the problem, educate the population, and have less violent communities and quiet environments for the growth of children and adolescents.

RESUMO Introdução: A saúde mental precária está fortemente associada à violência interpessoal. O abuso infantil é um problema cultural e global de saúde pública que compromete os direitos da criança. Objetivo: Examinar a associação entre a experiência de abuso e a apresentação de transtornos mentais em crianças e adolescentes. Material e Método: Estudo analítico quantitativo, não experimental, transversal, destinado a crianças e adolescentes chilenos. A amostra foi composta por 1558 participantes, entre 4 e 18 anos, o instrumento de coleta de dados foi composto pela Entrevista Diagnóstica Estruturada para Crianças, versão computadorizada DISC-IV, questionário de abuso infantil e dados sociodemográficos. A análise estatística foi realizada por meio de regressão logística com o programa R versão 3. Resultados: No grupo de crianças, os transtornos ansiosos e disruptivos prevalentes e abaixo do limiar estavam relacionados ao abuso sexual, psicológico e físico. No grupo de adolescentes, os transtornos do humor foram associados a abuso psicológico e abuso sexual, os transtornos disruptivos predominantes e inferiores ao limiar foram associados a todos os tipos de abuso, e o transtorno por uso de drogas foi associado ao abuso sexual. Conclusão: Existe uma relação significativa entre os abusos em suas diferentes categorias, principalmente o abuso sexual com a expressão de transtornos mentais em crianças e adolescentes. É importante detectar precocemente níveis inferiores ao limiar para tentar solucionar o problema, educar a população, para conseguir comunidades menos violentas e ambientes calmos para o crescimento de crianças e adolescentes.

Construction and psychometric characteristics of the self-concept scale of interaction in the classroom.

BACKGROUND: Both construction and psychometric characteristics of a self-concept scale associated with observable behaviors by students and teacher, useful to guide a pedagogic intervention in the classroom are presented. METHOD: A total of 1,385 primary school students, aged between 8 and 12 years, from 24 high-social vulnerability schools of the Province of Concepción, Chile, participated in the study. The scale was constructed, including a theoretical review of the construct, pilot application with students and interjudge reliability. For the study of psychometric characteristics, exploratory factorial analysis (EFA), confirmatory factorial analysis (CFA), factorial invariance and recurrent validity were performed. RESULTS: A self-report instrument with 22 items shows a three-factor structure, with an explained variance of 44.71% and a high level of fi t for the model. CFA in two different samples showed fi t indicators for configural invariance. It also has concurrent validity. CONCLUSIONS: The scale has good psychometric properties to assess the academic self-concept in the dimensions of Capacity, Work Procedure, and Participation in class. This can be useful to guide an educational intervention in the context of the teacher-student interaction in the classroom, in primary schools with high socio-economic vulnerability.

Cross-Cultural Adaptation of the Children's Emotion Regulation Processes Survey (CERP) in Chilean Preschoolers / Adaptação Transcultural do Questionário de Processos de Regulação Emocional (CERP) em Pré-Escolares Chilenos / Adaptación Transcultural del Cuestionario de Procesos de Regulación Emocional (CERP) en una Muestra de Preescolares Chilenos

Abstract Emotion regulation is an important aspect for the adaptation of human beings that influences their development and mental health. In actuality, it is an important challenge to have culturally valid instruments that allow to evaluate this construct. In this study, an analysis of the psychometric properties of the Children's Emotion Regulation Processes Survey (CERP) in a sample of Chilean preschoolers is presented. CERP is a third-party report questionnaire that assesses the strategies of emotion regulation in children, providing a vision based on development. The instrument was applied to mothers and fathers of 483 children, between the ages of 4 and 6 that attended preschool. Factorial structure, internal consistency and the relation with the Child Behavior Checklist (CBCL) as indicator of convergent validity was analyzed. The results showed a four factor structure, coherent with the empirical evidence. Also, all of the factors presented adequate reliability indexes and correlation with the internalization and externalization scales of CBCL. It is concluded that CERP exhibits positive reliability and validity indicators to be used in this population.

Resumo A regulação emocional é um aspecto de relevância para a adaptação dos indivíduos que influencia em seu desenvolvimento e saúde mental. Na atualidade, um desafio importante é contar com instrumentos válidos culturalmente que permitam avaliar este constructo. Neste estudo se apresenta a análise das propriedades psicométricas do Questionário de Processos de Regulação Emocional Infantil (CERP) em uma amostra de pré-escolares chilenos. O CERP é um questionário de relatórios de terceiros que avaliam estratégias de regulação emocional em crianças, entregando uma visão baseada no desenvolvimento. O instrumento foi aplicado a pais e mães de 483 crianças, entre 4 e 6 anos que cursavam a educação pré-escolar. Foi analisada a estrutura fatorial, consistência interna e o relacionamento com o Inventario de Condutas Infantis (CBCL) como indicador de validade convergente. Os resultados evidenciaram uma estrutura de quatro fatores, coerentes com a evidencia empírica. Além disso, todos os fatores apresentaram índices adequados de confiabilidade e correlações com as escalas de internalização e terceirização do CBCL. Se conclui que o CERP mostra indicadores de confiabilidade e validez positivos para serem usados nesta população.

Resumen La regulación emocional es un aspecto de relevancia para la adaptación de los individuos que influye en su desarrollo y salud mental. Actualmente, es un desafío contar con instrumentos válidos culturalmente para evaluar este constructo. En este estudio, se presenta el análisis de las propiedades psicométricas del Cuestionario de Procesos de Regulación Emocional Infantil (CERP) en una muestra de preescolares chilenos. El CERP es un cuestionario de reporte de terceros que evalúa las estrategias de regulación emocional en niños/as, entregando una visión basada en el desarrollo. Se aplicó el instrumento a padres y madres de 483 niños/as de edades entre 4 y 6 años que cursaban educación preescolar. Se analizó la estructura factorial, consistencia interna y relación con el Inventario de Conductas Infantiles (CBCL) como indicador de validez convergente. Los resultados evidenciaron una estructura de cuatro factores, coherentes con la evidencia empírica. Además, todos los factores presentaron adecuados índices de confiabilidad y correlaciones con las escalas de internalización y externalización del CBCL. Se concluye que el CERP muestra indicadores de confiabilidad y validez positivos para ser usado en esta población.

Child-to-parent Violence Questionnaire (CPV-Q): Validation among Spanish adolescents / Cuestionario de Violencia Filio-parental (C-VIFIP): validación en adolescentes españoles

Background/Objective: Child-to-parent violence has generated great interest on the part of professionals and researchers in recent years. Consequently, there is a need to provide an assessment instrument that includes a wide range of child-to-parent violence behaviours and all of elements that define this type of violence. Thus, the purpose of the current study was to analyse the structure, reliability and validity of the CPV-Q, an instrument to assess child-to-parent violence behaviours, including the reasons for aggression against parents. Method: A total of 1,386 Spanish adolescents (55.2% females; Mage = 14.7, SD = 1.7) were assessed using the CPV-Q. We obtained descriptive statistics of the items, the internal structure of the scale using both exploratory and confirmatory factor analysis, its reliability, and external evidence of its validity. Results: Data indicated a matrix of 4 factors with 14 parallel items (for the father and for the mother). Reasons for child-to-parent violence were grouped into instrumental and reactive reasons. Conclusion: The CPV-Q presents adequate psychometric properties; thus, it is proposed as a useful instrument to assess child-to-parent violence in both professional and research settings

Antecedentes/Objetivo: La violencia filio-parental ha generado un gran interés por parte de profesionales e investigadores en los últimos años. En consecuencia, es necesario contar con un instrumento de evaluación que incluya un amplio rango de conductas de violencia filio-parental y todos los elementos que definen este tipo de violencia. De esta forma, el objetivo del presente estudio fue analizar la estructura, fiabilidad y validez del C-VIFIP, un instrumento para evaluar conductas de violencia filio-parental, incluyendo los motivos de las agresiones. Método: Se evaluó a un total de 1.386 adolescentes españoles (55,2% chicas; Medad = 14,7; DT = 1,7) con el C-VIFIP. Se obtuvieron los estadísticos descriptivos de los ítems, la estructura interna de la escala mediante análisis factorial exploratorio y confirmatorio, fiabilidad y evidencias externas de validez. Resultados: Los resultados indicaron una matriz de cuatro factores con 14 ítems paralelos (para el padre y para la madre). Los motivos de las agresiones se agruparon en instrumentales y reactivos. Conclusión: El C-VIFIP presenta adecuadas propiedades psicométricas, de forma que se propone como un instrumento útil para evaluar la violencia filio-parental, tanto en contextos profesionales como de investigación