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

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

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

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

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

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

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

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

Glosario anatómico etnográfico Rapa Nui / Rapa Nui ethnographic anatomical glossary

RESUMEN: La isla de Rapa Nui, también llamada Té Hé Pito o Té Henúa o el ombligo del mundo, alberga a uno de los pueblos hasta hace poco más aislados y enigmáticos del mundo con sus costumbres ancestrales caracterizados por la construcción de colosos llamados moai. Por ello, y como una forma de honrar a los pueblos originarios de nuestro país, los autores hemos querido acercar este pueblo en particular al conocimiento general de los anatomistas investigando sobre su vocabulario y lengua a través de la descripción de las palabras en diccionarios y entrevista directa con residentes de la isla, palabras que tienen relación con nuestra disciplina para la elaboración de este Glosario anatómico etnográfico, principalmente influenciado por lenguas polinésicas, así como francesa e inglesa, para finalizar con la influencia continental más recientemente. Iorana.

SUMMARY: The island of Rapa Nui, also called Té Hé Pito o Té Henúa or the navel of the world, is home to one of the, until recently, most isolated and enigmatic villages of the world, with their ancestral customs characterized by the construction of colossi called Moai. Therefore, as a way of honoring the native peoples of our country, the authors wanted to bring this particular people closer to the general knowledge of anatomists by researching their vocabulary and language through the description of words in dictionaries, and direct interview with residents of the island that have relationship with our discipline for the elaboration of this anatomical ethnographic Glossary, mainly influenced by Polynesian languages, as well as French and English, to finish with the more recent continental influence. Iorana. (Greeting Rapa Nui).

Asociación entre el polimorfismo rs9939609 del gen FTO y marcadores de adiposidad en población adulta chilena / Association between FTO (ns9939609) genotype and adiposity markers in Chilean adults

Background: Numerous studies have identified the role of Fat-mass-associated-gene (FTO) in the development of obesity. Aim: To investigate the association of FTO gene with adiposity markers in Chilean adults. Material and Methods: 409 participants were included in this cross-sectional study. The association between FTO (rs9939609) genotype and adiposity markers was determined using linear regression analyses. Adiposity markers included were: body weight, body mass index, fat mass, waist circumference, hip circumference and waist/hip ratio. Results: A fully adjusted model showed a significant association between FTO genotype and body weight (2.16 kg per each extra copy of the risk allele [95% confidence intervals (CI): 0.45 to 3.87], p = 0.014), body mass index (0.61 kg.m-2 [95% CI: 0.12 to 1.20], p = 0.050) and fat mass (1.14% [95% CI: 0.39 to 1.89], p = 0.010). The greater magnitude of association was found between the FTO gene and fat mass when the outcomes were standardized to z-score. Conclusions: This study confirms an association between the FTO gene and adiposity markers in Chilean adults, which is independent of major confounding factors.

La creencia epistemológica constructivista sobre el conocimiento científico varía en función del año de formación en los estudiantes de Medicina pero no en los estudiantes de otras carreras de la salud / The constructivist epistemological belief about scientific knowledge varies according to the year of training in medical students but not in students of other health careers

Background: To optimize the teaching-learning process it is fundamental to know the representations that students have regarding knowledge. Epistemological beliefs are implicit theories that guide the practical actions of people. Aim: To characterize and compare epistemological beliefs regarding the nature and acquisition of scientific knowledge of health career students. Material and Methods: Between 2012 and 2013, 726 students coursing first, third or fifth year from six health careers answered a validated questionnaire that includes closed and open questions aimed to characterize their epistemological beliefs about scientific knowledge. Results: Irrespective of the career, when students had to select predefined answers, most of them appeared as constructivists (61%). On the other hand, when they had to argue, the majority seemed objectivist (47%). First-year medical students have the highest frequency of constructivist epistemological beliefs (56%). Paradoxically, the lowest percentage is found (34%) in the fifth year. The students of the health careers, in particular those of Medicine, recognize that knowledge is not acquired immediately (83%) and that its distribution is shared (92%). Conclusions: Discordance between selections and arguments suggests that epistemological sophistication is achieved declaratively but not practically. The lower proportion of students who presented constructivist beliefs in the fifth year compared to first year of Medicine could be associated with the pedagogical approaches used in the different cycles of the career.

La familia como categoría difusa en la atención primaria del sistema de salud chileno / Family as an Unclear Category in Primary Care in Chilean Health System

Introducción: en salud, la constatación de que el individuo no es un ente exclusivamente biológico, se ha de incorporar en su análisis una dimensión psicosocial, la salud familiar releva la centralidad de la familia en la función reguladora de la salud. Sin embargo, se ha apuntado insistentemente en la dificultad de traducir estos planteamientos teóricos a la práctica clínica. Objetivo: analizar el "modelo de atención integral de salud familiar y comunitaria" chileno a partir de la distinción entre familiares y la familia como un todo. Métodos: revisión bibliográfica y análisis de contenido de documentos normativos producidos por el Ministerio de Salud chileno, referidos al "modelo de atención integral en salud", posteriores a la reforma de salud implementada en el año 2005. Conclusiones: el Modelo en uso en Chile se basa en la salud Familiar pero su accionar se centra fundamentalmente en los familiares más que en la familia misma. De los instrumentos analizados, la Visita Domiciliaria Integral es la que más se acerca al trabajo real con la familia como unidad de intervención(AU)

Introduction: In health terms, the realization that the individual is not a purely biological entity, has to be incorporated in a psychosocial dimension analysis. Family health relieves the centrality of family in the regulatory function of health. However, the difficulty of translating these theoretical approaches into clinical practice has been pointed out repeatedly. Objective: Study the Chilean model of the comprehensive primary health care for family and the community from distinguishing between members of a family and families as a whole. Methods: A literature review and content analysis was conducted on policy documents produced by the Chilean Ministry of Health, referred to the "model of comprehensive health care", after the health care reform implemented in 2005. Conclusions: the Chilean model is based on family health but its actions are mainly focus in the members of the family rather tan on the family itself. Out of the instruments used, Comprehensive Health Visiting is the closest to the actual work with the family as the unit of intervention(AU)

Dental morphological markers as a proxy for ethnicity in Robinson Crusoe Islanders / Marcadores morfológicos dentarios en la estimación de la etnicidad poblacional de la Isla Robinson Crusoe

Chilean Robinson Crusoe Island is a semi-isolated location with unusually high rates of both consanguinity and language disorder. The current population of 633 inhabitants is descended almost exclusively from the colonization at the end of the 19th century, as there were few preceding immigrations to the island. This study investigates the genetic composition and degree of miscegenation within the island population, using dental morphological markers. The universe of island children was studied (n= 128, 3 to 15 years of age) using clinical exams, dental cast, and identification of each individual within a previously-constructed extensive genealogy for the island. The frequencies for Carabelli's cusp (61.7%), shovel-shaped incisor (9.4%), and sixth cusp (2.3%), along with the absence of seventh cusp, are consistent with a primarily Caucasian population. The estimated degree of miscegenation suggests an Amerindian component of 4.3%, which is consistent with the extensive known genealogies of the founders. Characterizing the genetic profile of Robinson Crusoe Island, a location with a remarkably high prevalence of language disorder, facilitates the comparison of the genetic variants underlying this pathology with those identified in European populations.

La isla chilena Robinson Crusoe es un semiaislado geográfico de alta consanguinidad. Su población actual de 633 habitantes proviene de la última colonización ocurrida a finales del siglo XIX y pocas migraciones posteriores, en quienes recientemente se ha descrito una alta incidencia de trastorno de lenguaje. Este estudio estimó el componente genético y grado de miscegenación de la población isleña usando marcadores morfológicos dentarios. Se estudió al universo de niños isleños (n= 128, 3 a 15 años de edad) con exámenes clínicos, modelos dentales y ubicación de cada individuo en genealogías extensas confeccionadas previamente. La frecuencia de Tubérculo de Carabelli fue 61,7%, Diente en Pala 9,4%, tubérculo sexto 2,3% y ausencia del rasgo tubérculo séptimo, lo que concuerda con una población eminentemente caucásica. El grado de miscegenación estima que el componente amerindio de esta población es de 4,3%, que también se evidencia al analizar las genealogías extensas originadas por los colonizadores. La descripción del perfil genético de esta población, donde se han reportado altas prevalencias de trastorno de lenguaje, permitirá comparar con las variantes genéticas subyacentes a esta patología descritas para poblaciones europeas.

Factores de riesgo psicosocial y satisfacción laboral en trabajadoras estacionales de Chile / Psychosocial risk factors and work satisfaction in female seasonal workers in Chile

OBJETIVO: Caracterizar la relación entre los factores de riesgo psicosocial y la satisfacción laboral en trabajadoras estacionales agrícolas de la zona central de Chile. MÉTODOS: Estudio transversal en una muestra no probabilística de 106 trabajadoras de una empresa comercializadora y exportadora de frutas de la región del Maule, Chile. Las entrevistas se realizaron entre septiembre y octubre de 2013. Se empleó el cuestionario SUSESO ISTAS-21 para evaluar los riesgos psicosociales en el trabajo según cinco dimensiones (exigencias psicológicas, trabajo activo y posibilidades de desarrollo, apoyo social en la empresa y calidad del liderazgo, compensaciones, y doble presencia). Se utilizó el cuestionario S10/12 para medir la satisfacción laboral según tres dimensiones (satisfacción con las prestaciones recibidas, satisfacción con el ambiente físico de la empresa y satisfacción con la supervisión) y en general. RESULTADOS: El nivel de riesgo psicosocial fue alto en dos dimensiones (doble presencia, y trabajo activo y posibilidades de desarrollo) y medio en las otras; el nivel de satisfacción fue alto en las tres dimensiones. La percepción de factores de riesgo psicosocial se asoció negativamente con la satisfacción laboral en tres dimensiones: trabajo activo y posibilidades de desarrollo, apoyo social en la empresa y calidad del liderazgo, y compensaciones (en esta última, excepto con la satisfacción con el ambiente físico de la empresa). CONCLUSIONES: En las tres áreas identificadas se concentran los riesgos asociados con el trabajo estacional y los principales aspectos que las trabajadoras consideran que afectan a su satisfacción con el trabajo y, por extensión, a su bienestar en general.

OBJECTIVE: Characterize the relationship between psychosocial risk factors and work satisfaction in female seasonal agricultural workers in central Chile. METHODS: Cross-sectional study in a non-probability sample of 106 female workers for a fruit trading and export company in the region of Maule, Chile. The interviews were conducted in September and October 2013. The SUSESO ISTA-21 questionnaire was used to evaluate five areas of psychosocial risk in the workplace (psychological requirements, active work and opportunities for development, social support in the company and quality of leadership, compensation, and "double presence"). Questionnaire S10/12 was used to measure labor satisfaction in three areas (satisfaction with benefits received, satisfaction with the company's physical environment, and satisfaction with supervision) and satisfaction in general. RESULTS: The level of psychosocial risk was high in two areas (double presence, and active work and possibilities of development) and medium in the other areas; the level of satisfaction was high in all three areas. The perception of psychosocial risk factors was negatively associated with work satisfaction in three areas: active work and opportunities for development, social support in the company and quality of leadership, and compensation (compensation was negatively associated except for satisfaction with the company's physical environment). CONCLUSIONS: Risks associated with seasonal work and the main issues that workers consider to affect their satisfaction with work and, by extension, their general well-being, are concentrated mainly in the three areas identified.

Sexualidad(es) y colectividad. La vigilancia y el juzgamiento social como mecanismos de producción corporal / Sexualidade(es) e coletividade. A vigilância e o julgamento social como mecanismos de produção corporal / Sexualities and colectivity: The surveillance and the social judgment as mechanisms for the corporal production

Este artículo aborda la vigilancia y el juzgamiento social como mecanismos de producción y legitimación del cuerpo, claves para comprender los procesos de socialización de mujeres pertenecientes a la clase media de Santiago de Chile. Se basa en la revisión crítica de los resultados de un estudio empírico sobre significados que mujeres santiaguinas de estratos sociales medios construyen en relación a su cuerpo, a través de entrevistas acerca de sus prácticas sexuales, en particular, respecto del uso de juguetes sexuales. Los procesos de socialización de género que regulan el comportamiento sexual de dichas mujeres involucran prácticas de legitimación social de las corporalidades, así como de vigilancia y juzgamiento interpersonal en sus entornos inmediatos.

Este artigo aborda a vigilância e o julgamento social como mecanismos de produção e legitimação do corpo, que são chaves para compreender os processos de socialização de mulheres pertencentes à classe média de Santiago do Chile. Se baseia na revisão crítica dos resultados de um estudo empírico sobre significados que mulheres santiaguinas de estratos sociais médios constroem em relação ao seu corpo, atraves de entrevistas respeito de suas práticas sexuais, especificamente quanto ao uso de brinquedos sexuais. Os processos de socialização de gênero que regulam o comportamento sexual de tais mulheres envolvem práticas de legitimação social das corporalidades, assim como de vigilância e julgamento interpessoal nos seus entornos imediatos.

This article addresses surveillance and social judgment as mechanisms of female body production and legitimation, which play a key role in the gender socialization of middle-class women in Santiago, Chile. It is based on a critical review of the main findings of a study on the meanings produced by middle-class women about their bodies, while interviewed about their sexual practices, in particular about their use of sex toys. The socialization processes whereby women’s sexuality is regulated involve the legitimation of women’s bodies, as well as their surveillance and social judgment in everyday settings.

Estimadores de mezcla amerindia basados en métodos serológicos y moleculares / Amerindian admixture estimation based on serological and molecular methods

Background: Amerindian admixture is an important parameter to consider in epidemiological studies in American countries, to make a proper selection of cases and controls. Aim: To compare Amerindian admixture estimates obtained using ABO*A and ABO*O blood group alleles and ancestral identity markers (AIMs) in the mixed Chilean population. Subjects and Methods: Amerindian admixture rates were determined in 720 Chilean volunteers residing in Arica and born in the 15 regions of the country, using ABO*O and ABO*A alleles and 40 AIMs selected from more than 500,000 single nucleotide polymorphisms (SNP´s). Results: Mean admixture estimates obtained using ABO*O and ABO*A alleles and AIM s were 35, 47% and 48% respectively. There was concordance in estimates, with the exception of the admixture based on ABO*O allele and AIMs. Conclusions: In Chile, Amerindian admixture estimates obtained using ABO*A could be used as an alternative to AIMs in justified cases provided the sample size is reasonably large.

Prevalencia y características de mutaciones somáticas del gen KRAS en pacientes chilenos con cáncer colorrectal / KRAS gene somatic mutations in Chilean patients with colorectal cancer

Background: The molecular testing of KRAS mutation status in metastatic colorectal cancer patients is mandatory to identify patients eligible for anti-epidermal growth factor receptor monoclonal antibody therapy. Aim: To report the frequency of KRAS gene mutations in Chilean patients with colorectal cancer (CRC). Material and Methods: A cohort of 262 Chilean patients with CRC aged 26 to 90 years (53% males), was studied. KRAS mutation status was analyzed by real-time polymerase chain reaction and correlated with clinicopathological data. Results: Ninety-eight patients (37%) were positive for KRAS mutations. G12D was the most common mutation with a frequency of 36.7%, followed by G12V (25.5%), G13D (17.3%), G12A (7.1%), G12C (6.1%), G12S (5.1%) and G12R (2%). The frequency of the mutation in left, right colon and rectal tumors was 37.8, 32.6 and 44.9%, respectively. Among tumors with mutations, 86.7% were well or moderately differentiated tumors and the rest were poorly differentiated. No significant associations between KRAS gene mutations and other clinicopathological features of the tumor were observed. Conclusions: The frequencies of KRAS mutations reported in this study are similar to frequencies reported for European and North-American populations, lower than in a Spanish study and higher than in a Peruvian study.

Prevalencia de síndrome metabólico en individuos de etnia Mapuche residentes en zonas rurales y urbanas de Chile / Prevalence of metabolic syndrome in Mapuche individuals living in urban and rural environment in Chile

Background: Metabolic Syndrome (MS) increases the risk of diabetes and mortality associated with cardiovascular disease. However, the prevalence of MS could differ by ethnicity and lifestyle factors. Aim: To determine the prevalence of MS in Mapuche individuals living in urban and rural environments in Chile and to investigate whether the prevalence and risk of MS in urban and rural environments differs by sex, age and nutritional status. Material and Methods: A total of 1077 Mapuche participants were recruited from urban (MU = 288) and rural (MR = 789) settings. Body mass index, waist circumference and blood pressure were measured. A fasting blood sample was obtained to measure serum glucose, HDL cholesterol and triacylglycerol. The prevalence of MS was determined using the unified IDF and ATP-III criteria. Results: An environment and sex interaction was found for the prevalence of MS (p = 0.042). The prevalence was significantly lower in male MR (13%) compared to other groups (22, 23 and 25% among female MR, female MU and male MU respectively). Also, the prevalence of central obesity and low HDL-cholesterol were significantly lower in male MR. MU are at an increased risk of developing MS compared to MR, with an odds ratio of 1.59 (95% confidence intervals 1.1 to 2.2). This risk increases along with age or body mass index of the population. Conclusions: The adoption of an urbanized lifestyle increases the risk of developing MS in Mapuche individuals. This risk is enhanced by age and nutritional status.

Recomendaciones para viajeros chilenos a la Copa Mundial de la FIFA 2014 en Brasil / Recommendations for Chilean travelers to the FIFA World Cup 2014 in Brazil

This article provides a checklist of precautions and vaccines for Chilean travelers attending the FIFA World Cup 2014 in Brazil. It aims to help physicians to prepare visitors of this mass gathering and summarizes useful hints to avoid infectious diseases considering the circumstances and availabilities in Chile.

Este artículo proporciona una serie de precauciones a observar y vacunas recomendadas para viajeros chilenos que asistirán a la Copa Mundial de Fútbol 2014 en Brasil. Su propósito es ayudar a los médicos a preparar a los visitantes a este masivo evento y resume las recomendaciones útiles para evitar enfermedades infecciosas, teniendo en consideración las circunstancias y disponibilidad en Chile.

Geografía génica de Chile: Distribución regional de los aportes genéticos americanos, europeos y africanos / Gene geography of Chile: Regional distribution of American, European and African genetic contributions

Background: The geographical distribution of genes plays a key role in genetic epidemiology. The Chilean population has three major stem groups (Native American, European and African). Aim: To estimate the regional rate of American, European and African admixture of the Chilean population. Subjects and Methods: Forty single nucleotide polymorphisms (SNP´s) which exhibit substantially different frequencies between Amerindian populations (ancestry-informative markers or AIM´s), were genotyped in a sample of 923 Chilean participants to estimate individual genetic ancestry. Results: The American, European and African individual average admixture estimates for the 15 Chilean Regions were relatively homogeneous and not statistically different. However, higher American components were found in northern and southern Chile and higher European components were found in central Chile. A negative correlation between African admixture and latitude was observed. On the average, American and European genetic contributions were similar and significantly higher than the African contribution. Weighted mean American, European and African genetic contributions of 44.34% ± 3 9%, 51.85% ± 5.44% and 3.81% ± 0.45%, were estimated. Fifty two percent of subjects harbor African genes. Individuals with Aymara and Mapuche surnames have an American admixture of 58.64% and 68.33%, respectively. Conclusions: Half of the Chilean population harbors African genes. Participants with Aymara and Mapuche surnames had a higher American genetic contribution than the general Chilean population. These results confirm the usefulness of surnames as a frst approximation to determine genetic ancestry.

Evaluación de síntomas ansiosos y etnicidad en población escolar de la comuna de San Pedro de Atacama / Assessment of anxiety symptoms and ethnicity in students from the San Pedro de Atacama district

La comuna San Pedro de Atacama (SPA) tiene alta población rural y étnica, grupos vulnerables, según la literatura, a problemas de salud mental. El objetivo de este trabajo es conocer la prevalencia de síntomas ansiosos en escolares e investigar sus diferencias respecto de variables étnicas, de edad y género. Para ello se utilizó la escala de auto reporte de ansiedad para niños y adolescentes (AANA). La muestra quedó constituida por 416 alumnos, de ellos se analizaron 335 escalas, cuya media de edad fue de 10 años. Un 60,3 por ciento obtuvo sobre el punto de corte para sospecha de trastorno de ansiedad. El género femenino tenía mayor sintomatología ansiosa, junto con el grupo etario de 7 a 11 años. No existió diferencias significativas para la variable étnica. Respecto a las subescalas, la distribución etaria de la fobia social fue diferente a lo reportado en la literatura, lo que podría derivar del contexto sociocultural, necesario de investigaren futuros trabajos.

The San Pedro de Atacama (SPA) district has an important number of rural and ethnic population, which according to the literature, is more vulnerable to mental health problems. The aim of this research is to determine the prevalence of anxiety symptoms in school age children and to study its differences in relation to ethnicity, age and gender. The AANA (self report anxiety scale for children and adolescents) was applied in a sample of 416 students, from which 335 questionnaires were analyzed (mean age: 10 years). A 60.3 percent of the students were above the cut point for suspicion of an anxiety disorder. Females had a higher number of symptoms of anxiety, as did the group with ages 7 to 11 years. There were no statistically significant differences for ethnicity. In the subscales, the age distribution for social phobia was found to be different from the one previously reported; this could be explained by the sociocultural context, which remains to be studied in future research.

Severidad de caries y pérdida de dientes de una población pre-Hispánica del norte de Chile / Caries severity and tooth loss in an ancient pre-Columbian culture in the north of Chile

El conocer la historia natural de las patologías bucales sin intervenciones modernas, permite comparar el desarrollo de éstas con los datos actuales. Este estudio tiene como objetivo conocer la severidad de caries dental y de pérdida de dientes en una muestra de restos humanos de la cultura Atacameña (500 DC) en San Pedro de Atacama en el norte de Chile. Se estudiaron 139 restos humanos, en cada uno de ellos se realizó un examen clínico, consignado la información en una ficha individual donde se registró, el número de dientes presentes y perdidos pre y post mortem y el número de lesiones de caries. Estas variables permitieron calcular el índice CPD (Obturadas=0). El análisis estadístico incluyó una descripción de frecuencias y el cálculo de estadísticas de dispersión y tendencia central para las variables continuas. Los resultados muestran que el índice CPD mínimo, asume que las piezas perdidas post mortem estaban sanas fue 17.14 con un promedio de 3.93 lesiones de caries y 13.2 dientes perdidos en vida. Los restos humanos de la población estudiada presentan un gran daño de su salud bucal. Gran cantidad de piezas dentarias perdidas en vida y bajo número de dientes sanos.

The aim of this study was to determine the severity of dental caries and tooth loss in a sample of 139 human remains of the Atacama culture (500 AD) in San Pedro de Atacama, northern Chile. A clinical examination was performed on each remain by a calibrated examiner. The number of present and missing teeth in pre-and post-mortem stages and the number of carious lesions were recorded. The DMT index (filled = 0) was calculated. Statistical analysis included a description of frequency and calculation of statistical dispersion and central tendency for continuous variables. The results reveal a DMT of 17.14 with an average of 3.93 carious lesions and 13.2 teeth lost in life. The oral health situation of the studied population presented severe damage, high rate of tooth loss and DMT scores.

Edad de menarquia y ascendencia indígena: Un estudio poblacional en Chile / Age at menarche and indigenous ancestry: A population study in Chile

Background: The age at menarche may influence decisively health and disease in women. It also indicates the beginning of the reproductive period and, as a consequence, the possibility of biological continuity for the human species. Genetic and environmental determinants define the age of menarche and can explain differences found among different populations. Aim: To determine the age at menarche among adolescents with different levels of indigenous descent (parental indigenous surnames), considering the effect of socioeconomic and demographic factors. Material and Methods: An observational study of historic cohorts of8.624 girls from the Arauca-nía Region (central-southern Chile) was carried out. Data were collected by health professionals using a previously validated questionnaire. Occurrence of menarche was estimated through survival analysis and compared between groups (according to indigenous parental surnames) adjusted for parents' income and educational level and provenance (rural/urban). Results: Estimated median age of menarche was 151 months (95% Cl: 150-151). In female with four indigenous surnames, menarche occurred two months later than girls without indigenous surnames and with two indigenous surnames (p < 0,001). In girls whose parents had lowest level of schooling, the difference increased to eight months later (p < 0,005). Conclusions: Age at menarche in the group with higher indigenous descent is later even if socio-economic conditions remain stable. Genetic factors might play an important role, however conditions of vulnerability can influence and further delay the onset of reproductive competency.

Socioeconomic status and age at menarche in indigenous and non-indigenous Chilean adolescents / Nivel socioeconómico y edad de la menarquia en adolescentes chilenas indígenas y no indígenas

The objective was to analyze the relationship between socioeconomic status and age at menarche among indigenous and non-indigenous girls in the Araucanía Region of Chile, controlling for nutritional status and mother's age at menarche. A total of 8,624 randomly selected girls from 168 schools were screened, resulting in the selection of 207 indigenous and 200 non-indigenous girls who had recently experienced menarche. Age at menarche was 149.6±10.7 months in the indigenous group and 146.6±10.8 months in the non-indigenous group. Among the non-indigenous, the analysis showed no significant association between age at menarche and socioeconomic status. In the indigenous group, age at menarche among girls with low socioeconomic status was 5.4 months later than among those with higher socioeconomic status. There were no differences in nutritional status according to socioeconomic level. Obesity was associated with earlier menarche. Menarche occurred earlier than in previous generations. An inverse relationship between socioeconomic status and age at menarche was seen in the indigenous group only; low socioeconomic status was associated with delayed menarche, regardless of nutritional status or mother's age at menarche.

El objetivo fue analizar la relación entre nivel socioeconómico y edad de menarquia en adolescentes indígenas y no indígenas de la Región de la Araucanía, Chile, controlando el efecto del estado nutricional, y la edad de menarquia de las madres. Se estudiaron 8.624 niñas de 168 escuelas elegidas aleatoriamente, seleccionando 207 indígenas y 200 no indígenas que habían tenido recientemente la menarquia. La edad de menarquia ocurrió a los 149,6±10,7 meses en indígenas y a los 146,6±10,8 meses en no indígenas. En el grupo no indígena, hubo una relación significativa entre edad de menarquia y nivel socioeconómico. En el grupo indígena, edad de menarquia del nivel socioeconómico bajo fue de 5,4 meses más tarde que el nivel socioeconómico más alto. No se observaron diferencias de estado nutricional por nivel socioeconómico. La obesidad adelantó la menarquia y la edad de menarquia ocurrió antes que la de sus madres. Existe una relación inversa entre nivel socioeconómico y edad de menarquia sólo en el grupo indígena; en los niveles socioeconómicos más bajos la edad de menarquia se retrasa independiente del estado nutricional y de la edad de menarquia de la madre.