Avaliação dos Indicadores Clínicos de Risco no Desenvolvimento Infantil ao longo da psicoterapia psicanalítica pais-bebês / Evaluation of Clinical Child Development Risk Indicators in the process of parentbaby psychoanalytic psychotherapy / Évaluation des indicateurs cliniques de risque dans le développement infantile durant une psychothérapie psychanalytique parent-bébé / Evaluación de los Indicadores de Riesgo para el Desarrollo Infantil a lo largo de la psicoterapia psicoanalítica de padres y bebé

O objetivo deste estudo é descrever os Indicadores Clínicos de Risco no Desenvolvimento Infantil ao longo da psicoterapia psicanalítica pais-bebê. Participaram da pesquisa um bebê de quatro meses no início da psicoterapia, com risco no desenvolvimento infantil — avaliado a partir do protocolo IRDI — e seus pais. Foram realizadas 30 sessões de psicoterapia pais-bebê que ocorreram ao longo de nove meses, registradas em áudio e vídeo. Foi realizada a observação dos vídeos para avaliação dos IRDIs, havendo um comparativo entre quatro momentos do processo psicoterápico: na avaliação inicial do bebê, aos três, seis e nove meses de tratamento. Os resultados apontaram que houve uma diminuição dos indicadores clínicos de risco para o desenvolvimento infantil ao longo do tratamento, e, ao final dos nove meses de psicoterapia, o bebê da pesquisa não apresentava mais indicadores de risco.

Resumos The aim of this study is to describe the Clinical Child Development Risk Indicators throughout a parent-baby psychoanalytic psychotherapy. A four-month-old baby at the beginning of psychotherapy, at risk for child development - assessed using the CDRI protocol - and his parents participated in the research. Thirty parent-baby psychotherapy sessions took place over nine months and were recorded in audio and video format. Videos were watched to assess the child development risk indicators by comparing four moments of the psychotherapeutic process: initial evaluation of the baby, at three, six and nine months of the treatment. Results showed that Clinical Child Development Risk Indicators decreased throughout the treatment and disappeared completely at the end of the nine months of psychotherapy.

L'objectif de cette étude est de décrire les Indicateurs Cliniques de Risque du Développement Infantile durant une psychothérapie psychanalytique parents-bébé. Un bébé âgé de quatre mois au début de la psychothérapie et qui présentait un risque du développement infantile — constaté à partir du protocole IRDI — ainsi que ses parents ont participé à la recherche. Trente séances de psychothérapie parents-bébé ont eu lieu pendant neuf mois et ont été enregistrées en audio et vidéo. Les vidéos ont été analysées afin d'évaluer les IRDIs en comparant quatre moments du processus psychothérapeutique : l'évaluation initiale du bébé, à trois, six et neuf mois de traitement. Les résultats mettent en évidence que les indicateurs cliniques de risque pour le développement infantile ont diminué durant le traitement, si bien qu'à la fin des neuf mois de psychothérapie, le bébé examiné ne présentait plus aucun indicateur de risque.

El objetivo de este estudio es describir los Indicadores de Riesgo para el Desarrollo Infantil a lo largo de la psicoterapia psicoanalítica de padres y bebé. Participaron en la investigación un bebé de cuatro meses, al inicio de la psicoterapia con riesgo para el desarrollo infantil - evaluado mediante el protocolo IRDI - y sus padres. A lo largo de nueve meses, se llevaron a cabo treinta sesiones de psicoterapia entre padres e bebé, grabadas en audio y video. Los videos fueron observados para la evaluación de los IRDI, con una comparación entre cuatro momentos del proceso psicoterapéutico: en la valoración inicial del bebé y a los tres, seis y nueve meses del tratamiento. Los resultados mostraron que, a lo largo del tratamiento, hubo una disminución en los indicadores de riesgo para el desarrollo infantil y, al final de los nueve meses de psicoterapia, el bebé investigado ya no presentaba indicadores de riesgo.

Impacto ambiental por uso de plaguicidas en tres áreas de producción de melón en la Comarca Lagunera, México / Environmental impact by usage of pesticides in three melon producing areas in the Comarca Lagunera, Mexico

RESUMEN El uso intensivo de plaguicidas altamente tóxicos, en la producción de cultivos hortofrutícolas especializados, conlleva riesgos ambientales y sociales, que pueden medirse mediante indicadores de riesgo de plaguicidas, para evaluar el potencial de impacto negativo de estos productos en los ecosistemas y comparar los logros de la implementación de prácticas agrícolas sustentables, en términos de reducción de riesgos, por la utilización de plaguicidas. El objetivo de esta investigación fue estimar el potencial impacto ambiental, por uso de plaguicidas, en las tres áreas de mayor producción de melón en la Comarca Lagunera. Se realizó un estudio descriptivo transversal, mediante la aplicación de una encuesta en 19 predios, seleccionados mediante muestreo no probabilístico. El Impacto Ambiental (IA) se evaluó mediante el modelo del Cociente de Impacto Ambiental (CIA), que se basa en el cálculo del CIA y el Cociente de Impacto Ambiental en Campo (CIAC). Los resultados muestran que los plaguicidas que contribuyeron con la mayor carga ambiental en las áreas de estudio fueron: clorotalonil (49 %), azufre elemental (11 %) y endosulfan (10 %), en Mapimí; carbofuran (19 %), endosulfan (18 %) y carbendazim (12 %), en Matamoros-Viesca; y oxicloruro de cobre (20 %), endosulfan (17 %) y mancozeb (17 %), en Tlahualilo. Los sistemas de producción, con los valores del IA más altos, se identificaron en fechas de siembra intermedias (199 a 500) y tardías (201 a 701), en Mapimí, y fechas tardías (132 a 383) en MatamorosViesca. El modelo del CIA permitió identificar a los plaguicidas y los sistemas de producción con el mayor impacto ambiental negativo en las tres principales áreas de producción de melón en la Comarca Lagunera, además de proporcionar una escala cuantificable, que permitirá evaluar y comparar futuros cambios en el uso regional de plaguicidas.

ABSTRACT The intensive use of highly toxic pesticides in the production of specialized horticultural crops entails environmental and social risks that can be measured through pesticide risk indicators to assess the potential negative impact of these products on ecosystems. In addition, this measurement enables the comparison of the achievements that result from the implementation of sustainable agricultural practices in terms of risk reduction due to the use of pesticides. The objective of this research was to estimate the potential environmental impact due to the use of pesticides in three melon production areas in the Comarca Lagunera. A cross-sectional descriptive study was carried out by applying a survey in 19 properties selected by non-probabilistic sampling. The Environmental Impact (EI) was evaluated using the Environmental Impact Quotient (EIQ) model, which is based on the calculation of the EIQ and the Environmental Impact Quotient in the Field (EIQF). The results show that the pesticides that contributed with the greatest environmental burden in the study areas were: Chlorothalonil (49 %), elemental sulfur (11 %) and endosulfan (10 %) in Mapimí; carbofuran (19 %), endosulfan (18 %) and carbendazim (12 %) in Matamoros-Viesca, and copper oxychloride (20 %), endosulfan (17 %) and mancozeb (17 %) in Tlahualilo. The production systems with the highest AI values were identified on intermediate (199 to 500) and late (201 to 701) sowing dates in Mapimí and late dates (132 to 383) in Matamoros-Viesca. The EIQ model allowed the identification of pesticides and production systems with the greatest negative environmental impact in the main areas of melon production in the Comarca Lagunera and provides a quantifiable scale that will allow the evaluation and comparison of future changes in the regional use of pesticides.

Auditory maturation and psychological risk in the first year of life / Maturação auditiva e risco psíquico no primeiro ano de vida

ABSTRACT Purpose To assess the potential association between psychological risk and limited auditory pathway maturation. Methods In this longitudinal cohort study, 54 infants (31 non-risk and 23 at-risk) were assessed from age 1 to 12 months. All had normal hearing and underwent assessment of auditory maturation through cortical auditory evoked potentials testing. Psychological risk was assessed with the Child Development Risk Indicators (CDRIs) and PREAUT signs. A variety of statistical methods were used for analysis of results. Results Analysis of P1 and N1 latencies showed that responses were similar in the both groups. Statistically significant differences between-groups were observed only for the variables N1 latency and amplitude at 1 month. Significant maturation occurred in both groups (p<0.05). There was moderate correlation between P1 latency and Phase II CDRIs, which demonstrates that children with longer latencies at age 12 months were more likely to exhibit absence of these indicators in Phase II and, therefore, were at greater psychological risk. The Phase II CDRIs also correlated moderately with P1 and N1 latencies at 6 months and N1 latencies at 1 month; again, children with longer latency were at increased risk. Conclusion Less auditory pathway maturation correlated with presence of psychological risk. Problems in the mother-infant relationship during the first 6 months of life are detrimental not only to cognitive development, but also to hearing. A fragile relationship may reflect decreased auditory and linguistic stimulation.

RESUMO Objetivo Avaliar a associação entre risco psíquico e maturação da via auditiva. Método Neste estudo de coorte longitudinal, 54 crianças ouvintes (31 sem risco e 23 em risco psíquico) de 1 a 12 meses foram avaliadas. Todas foram submetidas à avaliação da maturação auditiva através dos Potenciais Evocados Auditivos Corticais. O risco psíquico foi avaliado com os Indicadores de Risco de Desenvolvimento Infantil (IRDI) e Sinais PREAUT. Uma variedade de métodos estatísticos foi utilizada para análise de resultados. Resultados A análise das latências de P1 e N1 mostraram respostas similares entre os grupos. Diferenças estatisticamente significantes entre os grupos foram observadas somente para as variáveis latência e amplitude de N1 no primeiro mês. A maturação auditiva foi significante nos dois grupos (p<0,05). Houve correlação moderada entre latência de P1 e a fase II dos IRDI, demonstrando que crianças com maior latência aos 12 meses apresentaram maior probabilidade de exibir a ausência desses indicadores na Fase II, estando em maior risco psíquico. A fase II dos IRDI também teve correlação moderada com as latências de P1 e N1 aos 6 meses e latências de N1 ao 1 mês; novamente, crianças com latência mais longa estavam em maior risco. Conclusão A menor maturação auditiva correlacionou-se com a presença de risco psíquico. Problemas na relação mãe-filho durante os primeiros 6 meses de vida são prejudiciais não apenas ao desenvolvimento cognitivo, mas também à audição. Um relacionamento frágil pode refletir diminuição da estimulação auditiva e linguística.

Frecuencias e indicadores de riesgo de las recesiones gingivales en una muestra peruana / Frequencies and risk indicators of gingival recession in a Peruvian simple

RESUMEN: Objetivo: Evaluar la prevalencia, extensión, severidad e indicadores de riesgo de recesiones gingivales en Lima, Perú. Materiales y métodos: Una muestra representativa de 318 adultos entre 25-75 años fueron evaluados. Se formuló un cuestionario estructurado y un examen clínico en la zona vestibular de todas las piezas dentarias. La recesión gingival fue evaluada por sujetos de estudio, por piezas dentarias y por la profundidad de cada una de ellas (promedio). Los indicadores de riesgo evaluados fueron: nivel de educación, género, estado socioeconómico, movimiento del cepillado, frecuencia de cepillado, frecuencia del uso de hilo dental y los tratamientos periodontales y ortodóncicos previos. El modelo de regresión multivariada fue utilizado para establecer las asociaciones. Resultados: La prevalencia de recesiones gingivales fue del 94,3%, la extensión fue del 44,8%, siendo más comunes en la región mandibular (54,2%); la severidad promedio de las recesiones fue de 3,86±0,45mm. El género masculino evidenció una asociación significativa con la severidad de las recesiones (OR=2; IC: 1,09-3,68). Conclusión: Las recesiones gingivales son altamente prevalentes en una población peruana. Los principales indicadores de riesgo encontrados fueron el género, el movimiento del cepillado y el tratamiento ortodóncico previo.

ABSTRACT: Objective: To evaluate the prevalence, extent, severity and risk indicators of gingival recession in a population of Lima, Peru. Materials and methods: A representative sample of 318 adults aged 25-75 years was evaluated. A structured questionnaire was completed, and a clinical examination performed in the vestibular area of all teeth. Gingival recession was assessed by study subject, by tooth and depth of each (mean). The risk indicators assessed were: level of education, gender, socioeconomic status, brushing movement, brushing frequency, frequency of flossing, and previous periodontal and orthodontic treatments. A multivariate regression model was used to establish associations. Results: The prevalence of gingival recession was 94.3%, and the extension was 44.8%, being more common in the mandibular region (54.2%). The mean severity of recessions was 3.86±0.45mm. Males showed a significant association with the severity of recessions (OR=2, CI: 1.09-3.68). Conclusion: Gingival recessions were highly prevalent in this Peruvian population. The main risk indicators found were gender, brushing movement, and previous orthodontic treatment.

Tipo de reabilitação protética implantossuportada versus histórico de doença periodontal e higiene oral: estudo transversal com 916 implantes, com pelo menos um ano em função / Implant-supported rehabilitation type versus history of periodontal disease and oral hygiene levels: a cross-sectional study with 916 implants for at least one year in function

Objetivo: verificar se existe associação entre o tipo de reabilitação protética implantossuportada (unitária, parcial ou total), a presença de doença periodontal e o perfil do paciente para controle do biofilme. Material e métodos: pacientes tratados com implantes de titânio Implacil (De Bortoli, São Paulo, Brasil), na Fundecto-USP, no período de 1998 a 2012, foram incluídos neste estudo. As características da restauração protética, o histórico de doença periodontal, a dificuldade de higiene relatada pelo paciente e as consultas periódicas de manutenção profissional foram avaliados pelo teste qui-quadrado (nível de significância 5%). Resultados: foram examinados 183 pacientes (69 homens, 114 mulheres; média de 59 anos de idade). Dos 938 implantes colocados, 16 foram perdidos e seis foram sepultados pelo mau posicionamento (taxa de sobrevida: 98,28%). A média de acompanhamento foi de cinco anos (1-15 anos). A amostra final foi constituída de 916 implantes (723 implantes ≤ 3,75 mm de diâmetro; 193 implantes > 3,75 mm de diâmetro) em função por pelo menos um ano, distribuídos entre 413 restaurações (167 próteses unitárias, 202 próteses parciais e 44 próteses totais). Houve diferença estatística positiva para todas as variáveis. O histórico de doença periodontal foi progressivo para pacientes reabilitados com próteses unitárias (10,18%), parciais (17,82%) e totais (25,99%), respectivamente (p < 0,001). Pacientes com restaurações totais relataram maior dificuldade de higiene para desorganização do biofilme (p < 0,001), e realizaram menor número de consultas periódicas para profilaxia profissional em relação aos pacientes reabilitados com próteses unitárias e parciais (p < 0,001). Conclusão: o tipo de reabilitação protética pode estar associado ao maior risco de desenvolvimento das doenças peri-implantares.

Objectives: to verify whether associations regarding the type of implant-supported rehabilitation (single, partial or total), history of periodontal disease, and patient’s profile on biofilm control are positive. Material and methods: patients treated with titanium implants (Implacil De Bortoli, Sao Paulo, Brazil) installed at Fundecto (University of Sao Paulo, USP), from 1998 to 2012, were included in this study. The type of prosthetic rehabilitation, history of periodontal disease, hygiene difficulty reported by the patient, and the frequency of professional maintenance care were evaluated using the chi-square test (5% significance level). Results: 183 patients (69 men, 114 women; mean age of 59 years-old) were examined. Out of the 936 implants placed, 16 were lost and 6 buried due to mal-positioning. (survival rate: 98.28%). Mean follow-up period was 5 years (1-15 years). The final sample was composed of 916 implants (723 implants ≤ 3.75 mm diameter; 193 implants > 3.75 mm diameter) in function for at least one year, distributed among 413 restorations (167 single-, 202 partial-, and 44 total implant-supported prostheses). The history of periodontal disease was progressive for patients rehabilitated with single (10.18%), partial (17.82%), and total (25.99%) prostheses, respectively (p < 0.001). Also, patients with total implant-supported rehabilitations reported higher hygiene difficulties regarding biofilm removal (p < 0.001) and these had less professional maintenance care when compared with patients rehabilitated with single and partial prostheses (p < 0.001). Conclusion: the type of prosthetic rehabilitation may be associated with an increased risk of peri-implant diseases.

Psicoterapia de grupo para parejas como modelo de intervención en un instituto de tercer nivel / Group psychotherapy for couples as an intervention model in a tertiary institute

At the National Institute of Perinatology, a line of clinical psychological research is the study and treatment of patients with couple problems to generate strategies of intervention based on clinical research. Objective To identify risk indicators in a psychotherapy institutional group process. Material and method The qualitative-interpretative method was used. The sessions, in an open group form, were once a week during two hours. Attendance ranged between eight and 12 participants. 35 sessions were analyzed with the content analysis method. Results The mean age was 32.3 years for women and 35.1 for men. The information was systematized with the most significant stories. The indicators found in women were: impotence and trapping feelings, affective distancing from their couple, confusion of the origin of the relationship conflicts between external and/or internal origins, violent or confused communication, submissive or explosive character, resentment due to a perceived indifference from their couple, history of sexual abuse which difficults a satisfactory development of couple relationships, guilt, and resentment or anger feelings at their parents. The indicators in men were: trapping and impotence feelings due to the control exercised by their couples, violent behaviors on domestic environments, over-exigent and persecutory conducts, difficulty on the individuation process and unsolved conflicts with their primary figures which prevent a satisfactory relationship. Conclusions Marital problems deeply disturb the affective life of people and have familiar and social consequences. This paper is an incursion to understand a small part of the important facts regarding this universe, aiming to be more specific in the treatment plans for people suffering marital conflicts.

Una línea de investigación clínica de Psicología en el Instituto Nacional de Perinatología, es el estudio y atención a las pacientes con problema de pareja, para generar estrategias de intervención basadas en la investigación clínica. Objetivo Detectar indicadores de riesgo en un proceso de psicoterapia de grupo institucional. Material y método Se utilizó el método cualitativo-interpretativo. Las sesiones se llevan a cabo una vez a la semana, con dos horas de duración, en grupo abierto, con una fluctuación de entre ocho y 12 participantes. Se analizaron 35 sesiones con análisis de contenido. Resultados La edad promedio fue de 32.3 años para las mujeres y de 35.1 para los hombres, la sistematización de la información obtenida se realizó con las partes de los relatos más significativos. Algunos indicadores encontrados en las mujeres fueron: sensación de impotencia y atrapamiento, distanciamiento afectivo de su pareja, confusión al no ubicar si los conflictos en la relación son externos o internos, la comunicación es violenta o confusa, o son sumisas o son explosivas, hay resentimiento por percibir indiferencia de su pareja, hay relatos de abuso sexual que dificulta un desarrollo satisfactorio de la vida en pareja, culpa, resentimientos e ira hacia sus padres. En los hombres hay atrapamiento e impotencia por un control desmedido que ejerce su pareja hacia ellos, ejercen actos violentos en el ámbito doméstico, son muy exigentes y persecutorios, con dificultad en el proceso de individuación, conflictos no resueltos con sus figuras primarias, imposibilitan una relación satisfactoria. Conclusiones Los problemas maritales afectan profundamente la vida afectiva de las personas con consecuencias familiares y sociales. Este trabajo es una incursión para entender una pequeña parte de lo que incluye este universo y poder ser más específicos en los planes de tratamiento de las personas que sufren conflictos maritales.

Perfiles e indicadores psicológicos relacionados con la dispareunia y el vaginismo: Estudio cualitativo. Segunda parte / Profiles and psychological indicators related to dyspareunia and vaginismus: Qualitative study. Part two

One target of psychology of health is the quest for specificity when detecting factors related to psychological disorders, among which there are female sexual dysfunctions showing associated pain: dyspareunia and vaginismus (not caused by medical disease). Dyspareunia is the presence of genital pain during sexual intercourse and is related to psychological or relational factors. Vaginismus is characterized by spasms in the muscles of the vaginal entrance, making it difficult or impossible to perform coitus; the woman can be sexually aroused, responsive and enjoying sexual games, she can even reach her orgasm, as long as there is no penetration. Of all the causes mentioned, the following are recognized: incapacity to let go to the erotic experience, fear to failure, cultural influence predisposing sexual conflict, anxiety and shame, as well as couple problems. However, specificity is lacking in the factors related to each one of these sexual dysfunctions in order to provide elements generating intervention strategies. Objective The objective is to detect new indicators with the purpose of having a better understanding of why an individual exercises sexuality in such a way that it makes her have a proper sexual response and why, in other situations, the sexual response shows alterations leading to dyspareunia or vaginismus. Four are the specific objectives: 1. Identification of current indicators that have an influence in sexual dysfunctions of the participants. 2. Identification of indicators that have had an influence in the unsatisfactory development of sexuality of the participants. 3. Identification of elements of perception of the participants in the couple life of their parents that may have had an impact on their sexuality. 4. Identification of indicators that, within the sexual management provided by the family, had an impact in the sexual life of the participants. Material and methods The qualitative-interpretative method was used, in the form of an exploratory case-study. The institution where the study took place was the Department of Psychology of the National Institute of Perinatology (INPerlER). The sample was constituted by three participants, all of them patients from the institution; they had to comply with certain inclusion criteria of the study. Any physical problem that could have caused the sexual dysfunction was discarded. The first participant did not show any sexual dysfunction (NSD), the second one showed dyspareunia (D) and the third one showed vaginismus (V). We used a semi-structured, focalized, in-depth interview. Interviews took place after having signed a letter of informed consent, accordingly to the ethical institutional requirements, and we also got an approval of recording the interview. We used the analysis of content with an empiric, exploratory orientation. Categories were organized accordingly with the specific objectives. Results The three participants were: NSD: 32 years old, five years of marriage. No sexual dysfunction. V: 36 years old, six years of marriage. Diagnosis: vaginismus. D: 33 years old, one year in free union. Diagnosis: dyspareunia. Data systematization was performed dividing the units of analysis by every participant and the parts of the most significative stories of every specific objective within its respective categories. In the analysis of categories we detected two conditions: internal and relational, as well as two types of indicators: risk indicators and protective indicators. What marked the difference was the dominium of the protective indicators overthe risk indicators in the NSD participant. Among the more important risk indicators, we found feelings of disadvantage, uselessness and devaluating feelings, linked to a tendency to submissive behavior, as a consequence of remote causes such as having faced a double moral in the family: on the one hand erotized family bonds during infancy and, on the other hand, prohibitions and stiffness towards any sexual curiosity or manifestation, apart from a poor socialization. The conflict between desire and sexual prohibition generates confusion in the identification of sensations, setting a painful, fearful association to sexuality, even moreso if this landscape is complicated with other elements such as violence and carelessness. Other elements found as a consequence of the aforementioned include self-inflicted violence, annulment of desire, lack of self-care and interacting problems with the opposite sex in everyday life. All of this leads to an incapacity of exerting a satisfactory sexual life, drifting towards secondary fears when feeling disadvantageous while interacting with the couple; this, in great extent, determines the conflicts, which maybe either a cause or a consequence of the sexual problem. Confusion also arises when trying to identify whether problems are internal or external, thence conductual responses tend to complicate the relationship. In both sexual dysfunctions we find a specific type of frustration, since desire, excitement and orgasm are present, but coitus cannot be performed in a satisfactory way. The following are the more important protective indicators: conductual assertive responses, clarity in the affections, situation of the problems, search for sexual information, openness to family communication and with the couple, a couple's differential place, plus the search of satisfaction of sexuality and self care. Among the indicators shared we found: limited or null sexual education, poor communication in the family nucleus, and gender stereotypes highly polarized between parents, among others. Conclusions We corroborate in this study that it is the combination of specific elements which contributes to the presence of these two sexual dysfunctions, since the psychological world has many intertwined streams, intervention models cannot be centered only in sexual techniques, but they should also consider the indicators related to such alterations. Finally, it must be pointed out that the results of this phase are the product of an exploratory study, opening the gates to new lines of research.

Una de las metas de la psicología de la salud es la búsqueda de especificidad en la detección de factores relacionados con los trastornos psicológicos, entre los que se encuentran las disfunciones sexuales femeninas por dolor: la dispareunia y el vaginismo (no debidas a enfermedad médica). La dispareunia es la presencia de dolor genital en la relación sexual. El vaginismo se caracteriza por espasmos de la musculatura de la entrada vaginal que dificultan o hacen imposible la realización del coito. Entre las causas se mencionan la incapacidad de abandonarse a la experiencia erótica, temor al fracaso, etc. Sin embargo, hace falta especificar los factores relacionados con éstas disfunciones sexuales para obtener elementos generadores de estrategias de intervención. Objetivo de la segunda fase Detectar indicadores para tener una mayor comprensión de por qué una mujer tiene un ejercicio de la sexualidad que la lleva a tener una respuesta sexual adecuada y por qué en otra la respuesta sexual presenta alteraciones que dan como resultado la presencia de dispareunia o vaginismo. Los objetivos específicos son cuatro: 1. Identificar indicadores actuales que influyen en la presencia de disfunciones sexuales de las participantes. 2. Identificar indicadores que hayan influido en el desarrollo insatisfactorio de la sexualidad de las participantes. 3. Identificar elementos de la percepción que tienen las participantes de la vida en pareja de sus padres, que pudieron impactar en su sexualidad. 4. Identificar procesos que dentro de la dinámica familiar impactaron la vida sexual de las participantes. Material y método Se utilizó el método cualitativo-interpretativo, estudio de casos y exploratorio. El escenario fue el Departamento de Psicología del Instituto Nacional de Perinatología (INPerlER), se entrevistó a tres participantes pacientes de éste. La primera sin disfunción sexual (SDS), la segunda con dispareunia (D) y, la tercera con vaginismo (V). Se utilizó la entrevista en profundidad semi-estructurada y se trabajó con análisis de contenido. Las categorías se organizaron de acuerdo a los objetivos específicos. Resultados La sistematización de los datos se realizó dividiendo las unidades de análisis por cada participante de cada objetivo específico. Se detectaron dos condiciones: las internas y las relaciónales, así como dos tipos de indicadores: los de riesgo y los protectores. Lo que marcó la diferencia fue el predominio de los indicadores protectores sobre los de riesgo en la participante SDS. Entre los indicadores de riesgo se encuentran sentimientos de desventaja, de inutilidad y devaluatorios, ligados a una tendencia a la sumisión; ello como consecuencia de causas remotas, como haber enfrentado una doble moral familiar. El conflicto entre deseo y prohibición sexual genera confusión, estableciéndose una asociación doloroso y llena de temores hacia la sexualidad. Otro elemento encontrado, consecuencia de lo anterior, es la violencia al propio cuerpo, la anulación del deseo, falta de autocuidado y problemas en la interacción con el sexo opuesto en su vida actual. De los indicadores protectores están las respuestas conductuales asertivas, la claridad de sus afectos, ubicación de los problemas, búsqueda de información sexual, apertura en la comunicación familiar y con la pareja, búsqueda de satisfacción de su sexualidad y autocuidado. Entre los indicadores que comparten se encuentra una limitada educación sexual, pobre comunicación en el núcleo familiar y estereotipos de género muy polarizados de los padres. Conclusiones Es la combinación de elementos específicos que se presentan de manera cotidiana los que implican un mayor riesgo para desarrollar estas disfunciones sexuales, los modelos de intervención no pueden únicamente centrarse en las técnicas sexuales y deben contemplar los indicadores relacionados con estas alteraciones. Cabe señalar que los resultados son producto de un estudio exploratorio que abre las puertas para nuevas líneas de investigación y de los cuales no se pueden hacer generalizaciones.

Aplicación de una aproximación metodológica simple para el análisis de las desigualdades: El caso de la mortalidad infantil en Chile / Application of a simple methodological approach to analyze health inequalities: The case of infant mortality in Chile

Background: The infant mortality gradient by maternal education is a good indicator of the health impact of the social inequalities that prevail in Chile. Aim: To propose a systematic method of analysis, using simple epidemiological measures, for the comparison of differential health risks between social groups that change over time. Material and Methods: Data and statistics on births and infant deaths, obtained from the Ministry of Health, were used. Five strata of maternal schooling were defined and various measures were calculated to compare infant mortality, according to maternal education in the periods 1998-2001 and 2001-2003. Results: Of particular interest is the distinction between a measure of effect, Relative Risk (RR), which indicates the size of the gap between socioeconomic extremes and the etiological strength of low maternal schooling on infant mortality, and a measure of global impact, the Population Attributable Risk (PAR percent), which takes into account the whole socioeconomic distribution and permits comparisons over time independently of the variability in the proportions of the different social strata. The comparison of these measures in the two periods studied, reveals an increase in the infant mortality gap between maternal educational extremes measured by the RR, but a stabilization in the population impact of low maternal schooling. Conclusions: These results can be explained by a decline in the proportion of mothers in the lowest educational level and an increase in the proportion in the highest group.

The Relationship of Health Promoting Lifestyle, Health Risk Indicators, Activities of Daily Living, and Depression of the in-House Stroke Patients / 재활간호학회지

PURPOSE: This study was done to investigate correlations among Health Promoting Lifestyles, Health Risk Indicators, Activities of Daily Living, and Depression of the in-house stroke patients. METHOD: The subjects were 58 in-house stroke patients in a health center and two welfare centers. Data was collected using questionnaires and measuring health risk indicators such as blood pressure, total cholesterol, triglyceride, blood sugar, body fat rate. Data was analyzed using descriptive statistics, t-test, ANOVA, and Pearson correlation coefficients. RESULT: The health promoting lifestyle performance showed a significant negative correlation with health risk indicators and depression. There was a significant negative correlation between activities of daily living and depression. CONCLUSION: Health promoting lifestyle which focus on regular physical check-up, medication, diet management, exercise, smoking cessation, drinking abstinence, and stress management should be developed to improve health risk indicator and depression of the in-house stroke patients.