ABSTRACT
bjetivo: analizar los factores asociados a la asistencia a citas médicas preventivas en la ciudad de Bogotá en el año 2014.Métodos: se ajustaron dos modelos de Ecuaciones de Estimación Generalizadas (GEE) con función de enlace Bernoulli y estructuras de correlación independiente y simétrica compuesta para la variable de asistencia a citas médicas preventivas.Resultados: el nivel de ingreso, el estrato socioeconómico y el nivel educativo alcanzado por el jefe de hogar generan un aumento en la probabilidad de asistir a citas médicas preventivas: la razón de probabilidad de asistencia y no asistencia es por lo menos 1,5 veces mayor en miembros de hogares de estratos distintos al 1 y por cada 100 mil pesos adicionales en el ingreso mensual del hogar dicha razón se incrementa en 1 %. Aquellos miembros pertenecientes a hogares, cuyo jefe alcanzó un nivel educativo superior a primaria tienen una razón de probabilidad de asistencia y no asistencia a citas preventivas hasta 2,3 veces mayor.Conclusiones: los resultados coinciden con los de Grossman (1972) y Kenkel (1990); sin embargo, aspectos como el nivel educativo individual, la presencia de adultos mayores e infantes o inclusive de un cónyuge en el hogar no están relacionados con la asistencia a citas médicas preventivas.
bjective: Analyze factors involved in preventive medical appointments attendance in Bogota year 2014.Methods: two models were adjusted under GEE using a Bernoulli link function with independent and exchangeable correlation structures for preventive medical appointments attendance.Results: Income and socioeconomic stratum increase probability of preventive appointments attendance: Odds ratio of attendance and not attendance is at least 1,5 times higher in stratum 2 or higher households. Also, for every $100.000 additional pesos in monthly household income the reason increases by 1%. Household members which head reached an educational level higher than primary have an odds ratio of attendance and not attendance up to 2,3 times higher.Conclusions: Results are similar to Grossman (1972) and Kenkel (1990) nevertheless, individual educational level, presence in household of elder people or children and even presence of spouse are not related with preventive medical appointments attendance.
ABSTRACT
El objetivo del trabajo que se informa fue estudiar la estructura y el lenguaje evaluativo en narrativas producidas por díadas niño-cuidador principal, durante el período comprendido entre los 2 años y 6 meses y 4 años. El corpus estuvo conformado por 81 narrativas producidas en distintos contextos conversacionales -situaciones de lectura de cuentos, conversaciones en torno a eventos pasados y conversaciones en torno a eventos futuros- en los que participaron en el hogar 6 niños pertenecientes a un grupo de sectores medios de Buenos Aires (Argentina). Se realizó un análisis de las narrativas con el fin de dar cuenta de su estructura y de los recursos evaluativos empleados por los niños y sus interlocutores. El estudio contempló también un análisis cuantitativo comparativo focalizado en la identificación de similitudes y diferencias en la estructura -atendiendo en particular el componente evaluativo en las mismas- y los recursos evaluativos entre las narrativas producidas longitudinalmente y en las diferentes situaciones (diferencia de medias y ANOVA). Los resultados mostraron el potencial de la elaboración de narrativas en colaboración para promover diferentes aspectos del desarrollo infantil, en particular aspectos relativos al desarrollo cognitivo y socioemocional de los niños. Tempranamente en la infancia y en los tres contextos estudiados los niños que participaron en el presente estudio elaboran junto con sus cuidadores, narrativas en donde se enfatiza la evaluación como componente estructural, esto es, la interpretación y el posicionamiento personal frente a los eventos.
The present study aims to analyze the structure and the evaluative language in narratives produced by child-caretaker dyads from Buenos Aires (Argentina), in different conversational contexts-storybook reading situations, conversations about past and future events- when children are 2 years and a half, 3 years, 3 years and a half and 4 years old. Narrative is not only a type of discourse that organizes communicative exchanges and the transmission and recreation of culture; it is also one of the most important ways in which thought is configured (Bruner, 1986; Nelson, 1996; Rosemberg, Silva & Stein, 2010). The narrative structure and the use of evaluative resources are particularly related to cognitive and socioemotional development (Fernández & Melzi, 2008). Narrative development begins during the preschool years (Nelson, 1996) and occurs through the social interactions that take place in diverse daily situations: play (Pellegrini, 1985), story-book reading (Snow, Porche, Tabors & Harris, 2007) and conversations about past (Nelson,1996) and future events (Hudson, 2002, 2006). A series of studies undertaken in the fields of Psychology and Psycholinguistics have analyzed the structure and the evaluative language in early narratives orally produced by mother-child dyads (Fivush, 1991; Haden, Haine & Fivush, 1997; Peterson & McCabe, 1992, 1994, among others). The results of these studies have shown a relationship between the type of information introduced by mothers when they produce narratives in collaboration with their children and the information provided by children in the production of independent narratives later on (Fivush, 1991; Peterson & McCabe, 1992, 1994). Other studies showed an increase of the information regarding actions as well as descriptive, orientative and evaluative components of the narratives as a function of children's age (Haden, Haine & Fivush, 1997). The great majority of this research has been done with English-speaking and Caucasian families. Although there are some studies with Spanish-speaking population in Latin America (Díaz Oyarce & Mendoza Saavedra, 2012; Fernández & Melzi, 2008; Romero Contreras & Gómez Martínez, 2013; Shiro, 2003) one can hypothesize there will be intra-group differences given the heterogeneity of Hispanic population. There are few studies focused on the comparative analysis of narratives produced in different conversational contexts (Curenton, Craig & Flanigan, 2008; Fernández & Melzi, 2008). The author did not find studies which analyzed the evaluative resources used during the production of narratives about future events. The corpus of the present study consists of 81narratives produced in different conversational contexts: storybook reading situations (34 narratives), conversations about past events (24 narratives) and conversations about future events (23 narratives). The situations, which took place in the homes of 6 middle-income children from Buenos Aires (Argentina), were audio-recorded and transcribed for their analysis. The narratives were analyzed regarding their structure and the evaluative resources used by the participants in order to answer the following questions: What are the characteristics of the narratives collaboratively produced by children-caretakers dyads? In particular, which is the relative weight of the evaluative component regarding the other structural components referred to orientation, action and description? Which evaluative resources are employed by the children and their interlocutors? Are there any longitudinal and between conversation al contexts differences regarding each of the aspects analyzed (structure of the narratives, evaluative component, evaluative resources)? The results showed that the evaluative component of the narratives is the most predominant since 2:6 years and in the different conversational contexts considered. The children who participated in the study jointly produced with their caretaker (primarily their mothers) narratives where the interpretation and the personal stance on the events were emphasized. This fact reveals the potential of collaboratively produced narratives to promote different aspects of child development, particularly those related to cognition and socioemotional development.
ABSTRACT
Abstract Objective: To explore the association between tooth loss and cognitive functioning among persons 65 years and older. Methods: Data from the Hispanic Established Populations for Epidemiologic Studies of the Elderly (Wave 1: 1993-1994, n= 3,032; Wave 2: 1995-1996, n= 2,424; and Wave 3: 1998-1999, n= 1,967). The dependent variables were the scores from the total Mini-Mental State Examination (MMSE: score 0-30) and its global domains (memory: score 0-6; and no-memory: score 0-24). Independent variables included the number of teeth (0-12 vs. 13-32), socio-demographic characteristics, last dental office visit, medical conditions, depressive symptoms, and functional limitations which were tested for associations with the dependent variables. Results: In bivariate analyses, participants with fewer teeth (0-12) tended to have significantly lower mean scores for memory, no-memory, and total MMSE when compared to those with more teeth (13-32), both at baseline and at follow-up. In fully adjusted longitudinal-mixed models, participants with fewer teeth had a greater decline in total MMSE through five years of follow-up with a decrease of 0.12 fewer points each year (SE ± 0.05, p <0.01), when compared to those with more teeth. Conclusion: Having fewer teeth was associated with greater cognitive decline over time.
Resumen Objetivo: Explorar la asociación entre pérdida de dientes y función cognoscitiva en las personas de 65 años o más. Métodos: Datos del estudio EPESE (Poblaciones Establecidas para los Estudios Epidemiológicos de los Ancianos) Hispano (Encuesta 1: 1993-1994, n= 3,032; Encuesta 2: 1995-1996, n= 2,424; y Encuesta 3: 1998-1999, n= 1,967). Las variables independientes fueron el Examen MiniMental total (MMSE, 0-30 de puntaje) y sus dominios globales (memoria: 0-6 de puntaje; y no-memoria: 0-24 de puntaje). Variables independientes fueron el número de dientes presentes en la boca (0-12 vs. 13-32), características sociodemográficas, última visita al odontólogo, condiciones médicas, síntomas depresivos, y limitaciones funcionales a las cuales se les hicieron pruebas de asociación con las variables dependientes. Resultados: En análisis bivariados, los participantes con pocos dientes (0-12) tenían promedios de puntajes mas bajos en memoria, no-memoria y el MMSE total, comparado con los participantes con mas dientes (13-32) en la encuesta inicial y al seguimiento. En modelos mixtos longitudinales ajustados por todas las variables, los participantes con menos dientes tenían un declive mayor en el MMSE total a través de los cinco años de seguimiento, con una disminución de 0.12 puntos cada año (ES ± 0.05, p <0.01), comparado con quienes tenían mas dientes. Conclusión: La presencia de pocos dientes estuvo asociada con un mayor declive cognoscitivo a través del tiempo.