ABSTRACT
Los trastornos ansiosos en la población chilena infantojuvenil son de alta prevalencia y frecuentemente subdiagnosticados. Han existido variados intentos para crear instrumentos que ayuden a su tamizaje, dentro de estos el SCARED es uno de los más utilizados. Para la población hispanoamericana se adaptó este autoreporte de niños y adolescente (AANA) con características psicométricas adecuadas. El objetivo del presente trabajo es analizar la capacidad para discriminar entre Trastorno ansioso y sus distintas dimensiones (pánico/somático, ansiedad de separación, ansiedad generalizada, fobia social y fobia escolar) del AANA en población infantojuvenil chilena no consultante. Los resultados obtenidos mostraron que el instrumento estudiado es capaz de determinar un único constructo (ansiedad) y que los distintos ítems logran determinar las 5 dimensiones encontradas en el estudio original. De acuerdo a los resultados es posible concluir que el AANA es un instrumento adecuado para pesquisar trastornos ansiosos en la población infantojuvenil chilena estudiada. Palabras Claves: Trastornos ansiosos, ansiedad, infantojuvenil, AANA, Análisis factorial exploratorio.
Anxiety disorders in chilean children and adolescents are highly prevalent and often underdiagnosed. Various attempts have been made to design tools which contribute in the screening of these conditions, among these the SCARED is one of the most popular ones. An adaptation of this instrument has been developed for hispanic population, the AANA (anxiety self-report for children and adolescents), which has proven adequate psychometric characteristics. The aim of this article is to analyzethe AANA's discriminant capacity for anxiety disorders and its various dimensions (panic / somatic, separation anxiety, generalized anxiety, social phobia and school phobia) in Chilean non consulting children and adolescents. Our results showed that this instrument was able to determine a single construct (anxiety) and its items succeeded in identifying the 5 dimensions found in the original study. According to these results, we can conclude that the AANA is a suitable instrument for anxiety disorders screening in the chilean child and adolescent population studied. Key words: Anxiety disorders, self-reporting, SCARED, exploratory factor analisys,children and adolescents.
ABSTRACT
Background: Profound changes have been observed in medical practice during the last thirty years. This may be understood as a result of the influence of economic variables in health services management, among other probable causes. At the same time, doctors' work has been diversified, and a tendency to work in several paid jobs simultaneously has been observed. Aim: To describe the characteristics of employment in a representative sample of Chilean physicians. Material and Methods: A probabilistic sample of 414 physicians residing in Metropolitan Santiago answered a survey about their number and type of jobs and completed the BIS UMED questionnaire that measures the subjective wellbeing of physicians. Results: Forty percent of surveyed physicians had three or more jobs (36.3% of men and 47.5% of women). There was a significant inverse association between the number of jobs, general wellbeing and facing medicine from a new perspective. Conclusions: The number of jobs is inversely related to the general wellbeing of physicians.
Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Employment/statistics & numerical data , Job Satisfaction , Medical Staff/statistics & numerical data , Workload/statistics & numerical data , Chile , Cross-Sectional Studies , Employment/psychology , Medical Staff/psychology , Surveys and Questionnaires , Socioeconomic Factors , Workload/psychology , WorkplaceABSTRACT
Objetivo: Divulgar entre los investigadores en salud pública algunas propuestas de gráficos estadísticos multivariantes, tales como las caras de Chernoff, los gráficos de estrella, las curvas de Andrews y gráficos de radar. Material y método: Los gráficos estadísticos multivariantes propuestos son aplicados para describir los Sistemas de Salud Públicos de Chile, año 2010, (n=29) en base a información cuantitativa de dimensión p=7; ellos son procesados usando software estadísticos standard como R, STATA y SAS. Resultados: La descripción de los 29 Sistemas de Salud Públicos de Chile en base a información cuantitativa de dimensión siete, representados en cada uno de los gráficos multivariantes exhibidos, permite determinar conglomerados, estándares y tendencias. Conclusiones: La disponibilidad de eficientes software estadísticos sugiere complementar las indispensables estrategias de análisis exploratorio de nuestra información con representaciones gráficas adecuadas al contexto multidimensional que pueden ayudar a alcanzar una mejor comprensión del problema de interés. La síntesis gráfica generada por la aplicación de gráficos estadísticos multivariantes para describir los Sistemas de Salud Públicos de Chile complementa nuestro conocimiento de este aspecto de la realidad nacional, puede sugerir algunas hipótesis, refutar otras y ayudar en la interpretación de resultados complejos. Naturalmente esto es extensible a muchas otras situaciones de interés para el investigador salubrista.
Objective: To inform public health researches about some proposal of multivariate statistical graphics, such as Chernoff faces, star charts, Andrews curves and radar graphs. Its use is now possible thanks to recent software development. Material and method: Proposed multivariate statistical graphics are used to describe the Systems of Public Health of Chile, year 2010 (n = 29), using quantitative information with dimension p =7; these graphics are processed using standard statistical software such as R, STATA and SAS. Results: The description of the 29 systems of public health of Chile based on quantitative information from dimension seven, represented in each of multivariate graphs, allow to determine clusters, standards and trends. Conclusions: The availability of efficient statistical software indispensable suggests to complement strategies of exploratory analysis of our data with appropriate graphical representations of multidimensional context that can help us to achieve a better understanding of the problem of interest. The graphical summary generated by the application of multivariate statistical graphs to describe Public Health Systems of Chile complements our knowledge of this aspect of national life, may suggest hypotheses, refute others and assist in the interpretation of complex results. Naturally this can be extended to many other situations of interest to the health care professional.
Subject(s)
Humans , Health Systems , Research/methods , Models, Statistical , Public Health/statistics & numerical data , Chile , Computer Graphics , Facial Expression , Multivariate AnalysisABSTRACT
Background: A change in the social structure of medicine and its impact on clients has occurred in the last decades. Aim: To perform a survey about subjective wellbeing among physicians. Material and Methods: A physician’ professional satisfaction survey consisting in 90 questions, was applied to 580 physicians (70 percent males), working in Metropolitan Santiago. Results: Physicians perceive changes in all the examined professional domains and approximately 50 percent of the changes are evaluated as negative. Change perception is a general phenomena among physicians, since there were no differences in relation to gender and only in few aspects with respect to age and medical specialty. There was a predominant positive attitude, based on the profession, to face changes. Conclusions: The positive evaluation of changes and the frequent use of managing strategies are associated with a higher satisfaction among physicians.
Subject(s)
Female , Humans , Male , Middle Aged , Job Satisfaction , Physicians/psychology , Professional Autonomy , Chile , Epidemiologic MethodsABSTRACT
Background: The recent and ongoing changes in the structure and social organization of medicine have deeply transformed medical practice. Aim: To study the perception of these changes by physicians, the impact of these changes in their subjective wellbeing and their strategies of adjustment. Material and Methods: A scale, consisting of 54 items grouped in nine dimensions to measure physicians subjective wellbeing was devised. It was applied to a random sample of 580 physicians residing in Metropolitan Santiago and affiliated to the Colegio Médico de Chile (the Chilean Medical Association). Results: The internal consistency analysis in the instrument showed a global Cronbach´s alpha of 90 percent. Conclusions: These results support our methodological approach based on an initial qualitative identification of relevant topics in our local context, which afterwards were included as items in the scale to measure specific components of subjective wellbeing.
Subject(s)
Female , Humans , Male , Job Satisfaction , Practice Patterns, Physicians'/trends , Physicians/psychology , Surveys and Questionnaires/standards , Chile , Quality of LifeABSTRACT
Se realizó un estudio transversal- explicativo de las propiedades psicométricas y la validación estructural de estandarizar la Escala de Ansiedad en niños y adolescentes (SCARED) traducida y posteriormente validada en México, en población infanto-juvenil entre 8 y 15 años de edad (AAA). Se aplicó la escala a 128 niños escolarizados de ambos sexos entre los 7 y 17 años, consultantes a un centro privado de salud mental en Santiago, Chile. El plan de análisis consideró la evaluación de la consistencia interna (alfa de Cronbach), la capacidad discriminativa de cada ítem y la validez de constructo, usando el análisis factorial a partir de los componentes principales con rotación Varimax. Se determinó la adecuación del modelo factorial mediante el índice de Kaiser-Meyer-Olkin (KMO). Se consideró, además, que la distribución de frecuencia para las opciones de respuesta de cada ítem de la escala fuera homogénea.La escala queda finalmente conformada por 38 ítems, los cuales cumplen todos con el criterio de discriminación y homogeneidad. La consistencia interna de la escala obtenida fue 0.88. Con el análisis se formaron 6 factores que agrupan características clínicas. Conclusión: la escala de ansiedad AAA es un instrumento útil por ser breve y de fácil aplicación, permitiendo identificar síntomas de ansiedad en la muestra infanto-juvenil estudiada.
We perfomed a cross-sectional analytical study of psychometric characteristics and structural validation of the anxiety scale for children and adolescents (SCARED) translated and validated in Mexico, on a population of children and adolescents aged between eight to fifteen years old (AAA) .The scale was applied on 128 students, males and females, aged seven to seventeen years old, attending to a private center of mental care in Santiago, Chile. The plan of analysis considered to assess the internal consistency (Cronbach alpha), discriminative capacity of each item and the validation of construct using factorial analysis based on principal components with varimax rotation We evaluated the factorial model by means of Kaiser-Meyer-Olkin index (KMO). We also considered the homogeneity, frequency distribution of the answers of each item. The final scale was made up of 38 items that satisfied the discriminative and homogeneity criteria. Internal consistency for the total scale was high (Cronbachs á = 0.88).The factorial analysis found 6 factors that explain 79.9 per cent of the total variability. Each factor is related to one specific clinical characteristic Coclusions: The anxiety scale for children and adolescents (AAA) would be a good instrument for measuring and identifying clinical characteristics of anxiety in children and adolescents.
Subject(s)
Humans , Male , Adolescent , Female , Child , Anxiety/diagnosis , Anxiety/psychology , Psychiatric Status Rating Scales , Chile , Sex Distribution , Cross-Sectional Studies , Psychometrics , Reproducibility of ResultsABSTRACT
Longitudinal studies aimed at evaluating patients clinical response to specific therapeutic treatments are frequently summarized in incomplete datasets due to missing data. Multivariate statistical procedures use only complete cases, deleting any case with missing data. MI and MIANALYZE procedures of the SAS software perform multiple imputations based on the Markov Chain Monte Carlo method to replace each missing value with a plausible value and to evaluate the efficiency of such missing data treatment. The objective of this work was to compare the evaluation of differences in the increase of serum TNF concentrations depending on the ¡308 TNF promoter genotype of rheumatoid arthritis (RA) patients receiving anti-TNF therapy with and without multiple imputations of missing data based on mixed models for repeated measures. Our results indicate that the relative efficiency of our multiple imputation model is greater than 98 percent and that the related inference was significant (p-value < 0.001). We established that under both approaches serum TNF levels in RA patients bearing the G/A ¡308 TNF promoter genotype displayed a significantly (p-value < 0.0001) increased ability to produce TNF over time than the G/G patient group, as they received successively doses of anti-TNF therapy.
Subject(s)
Humans , Antibodies, Monoclonal/therapeutic use , Antirheumatic Agents/therapeutic use , Arthritis, Rheumatoid/drug therapy , Models, Statistical , Promoter Regions, Genetic , Tumor Necrosis Factor-alpha , Arthritis, Rheumatoid/blood , Genotype , Monte Carlo Method , Multivariate Analysis , Polymerase Chain Reaction , Polymorphism, Genetic , Polymorphism, Restriction Fragment Length , Promoter Regions, Genetic , Tumor Necrosis Factor-alphaABSTRACT
Several single-nucleotide polymorphisms have been identified in the human TNF gene promoter. The polymorphism at position-308 (TNF-308), which involves substituting G for A and designing the TNF2 allele, leads to a higher rate of TNF gene transcription than the wild-type TNF1 allele in in vitro expression studies. It has also been linked to increased susceptibility to a variety of illnesses. Using PCR-RFLP analysis we detected significant differences in the TNF-308 genotypes of Chilean and other populations. We conclude that there is a gradient in the distribution of the TNF2 allele according to ethnicity; we have also hypothesized that populations bearing a higher proportion of the TNF2 allele may have an increased predisposition toward or incidence of several chronic metabolic, degenerative, inflammatory and autoimmune diseases.
Subject(s)
Humans , Alleles , Gene Frequency , Genetic Predisposition to Disease , Polymorphism, Genetic , Promoter Regions, Genetic , Tumor Necrosis Factor-alpha , Chile , Genetic Predisposition to Disease , Genotype , Polymerase Chain Reaction , Polymorphism, Restriction Fragment LengthABSTRACT
Se estudia la relación entre elección temática espontánea de un individuo, su género y su nivel socioeconómico, aplicando el método de análisis de datos discretos conocido como "Análisis de Correspondencias". 377 individuos, 115 mujeres y 262 hombres, clasificados por la Escala Social de Graffar según nivel socioeconómico (medio alto, medio y medio bajo) fueron invitados a narrar espontáneamente alguna circunstancia o suceso importantes de sus vidas. Los temas aludidos fueron reducidos a una lista de doce. Los primeros "valores propios" 0.11 y 0.05 de este análisis, explican más del 70 por ciento de la asociación total de las variables. La presentación de la informaciónen el plano vincula la elección de temas con el nivel socioeconómico de género de los individuos. los del nivel socioeconómico medio alto con los temas recreación, Trabajo y enfermedad en posición a los del nivel socioeconómico bajo que se relacionarian con los temas accidentes y servicio militar. Las mujeres del nivel socioeconómico medio se identificarian con los temas : Religión, Familia de Origen y otros, en contraste con las mujeres pertenecientes al nivel socioeconómico medio alto, que se vincularian con temas relacionados con la familia: Muerte natural y accidental, educación, Paternidad-Maternidad y Relación de pareja
Subject(s)
Social Class , Sex , Socioeconomic Survey , Correspondence as TopicABSTRACT
Este trabajo describe similitudes en las variables del Cuestionario de Conducta Alimentaria (Restricción, Desinhibición, Hambre), el Cuestionario de Personalidad de Eysenck (EPQ_R) (Neuroticismo, Extraversión, Psicoticismo y Escala de Mentira) y la Escala de Alexitimia de Toronto en 11 díadas madre-hija primogénitas, una de cuyos integrantes consultó por sobrepeso. Se usó la prueba de Wilcoxon para muestras pareadas y los coeficientes de correlación de rangos de Spearman. No hay diferencias estadísticamente significativas entre las medias de estas evaluaciones. Las correlaciones significativas entre las variables coinciden en ambos grupos. El estudio multidimencional se basó en un análisis de componentes principales no paramétrico con individuos suplementarios. Las tres primeras componentes principales resumen el 80,4 por ciento de la variabilidad de los datos ordenados según rangos en el grupo de las madres, que se correlacionan con las respectivas evaluaciones en las hijas
Subject(s)
Humans , Female , Feeding Behavior/psychology , Obesity/genetics , Personality Disorders/psychology , Anxiety Disorders/psychology , Body Mass Index , Hunger/physiology , Obesity/psychology , Affective Symptoms/psychology , Socioeconomic Factors , Surveys and Questionnaires/statistics & numerical dataABSTRACT
Este trabajo describe la expresión verbal de hostilidad mediante el método de análisis de contenido de Gottschalk y cols. en 96 mujeres que presentaban el antecedente de intento de suicidio, dividiendo este grupo en mujeres que reiteran una tentativa autolítica (n=56) y las que efectúan el intento por primera vez (n=40). Los resultados muestran que el mayor promedio corresponde a Hostilidad dirigida hacia adentro y el menor a Hostilidad dirigida haca afuera encubierta. Las medias de expresión de hostilidad en los grupos de repetidoras versus no repetidoras no mostraron diferencias significativas. En los análisis ed correlaciones aparece como relevante que en el grupo de las no repetidoras, la Hostilidad hacia afuera manifiesta se correlaciona en forma directa con: no arrepentimiento frente al intento y la Escala de Intención Suicida;...