Cumplimiento de las medidas de restricción del uso residencial de leña en la ciudad de Valdivia / Compliance with the measures of restrict the residential use of firewood in Valdivia, Chile

BACKGROUND: Atmospheric pollution is a problem that causes great concern and health risks for the population and the earth, as it affects developed countries and third world countries. Locally, there are no studies that prove the fulfillment level of the restriction about the usage of residential firewood, considering that since 2014 there is a procedure called "The Environmental Decontamination Plan" in Valdivia (PDAV). Aim: To determine the fulfillment level of the restriction about residential firewood and its related factors. MATERIAL AND METHODS: The population study were 594 homes that were assigned randomly and proportionally according to 2 territorial areas (A and B) established in the PDAV. The sample's characteristics were described, comparison techniques were applied by subgroups (sociodemographic, home's structures and humidity's perception and percentage of the firewood) to identify factors related mainly with the fulfillment of measurements about firewood usage. RESULTS: 52% of households do not comply with the residential firewood use restriction measure, having sociodemographic factors related with this failure, such as schooling, health insurance and home structure. Besides, it is noted that the knowledge level of PDAV is associated with the accomplish level of restriction measures. When people know more about PDAV, there is a higher proportion of accomplishment. Conclusion: In more than half of the households, the restriction on the use of woodstove is not complied. The lack of knowledge of the population about the PDAV directly influences its compliance, which requires strategies to promote adherence to this program.

Humanized Care from the Perception of Oncology Patients from Southern Chile / Cuidado humanizado desde la percepción de pacientes oncológicos del sur de Chile / Cuidado humanizado a partir da percepção de pacientes com câncer no sul do Chile

Objective. This work sought to determine the perception of behaviors of humanized nursing care and its relation with sociodemographic and clinical variables in patients hospitalized in a Hemato-Oncology Department. Methods. Analytic cross-sectional study conducted with 51 patients hospitalized in the Hemato-Oncology Unit at Hospital Base Valdivia, Chile. A survey containing sociodemographic and clinical information was applied together with the questionnaire on Perception of Behaviors of Humanized Nursing Care 3rd version" -PBHNC 3v (32 items distributed in the categories: Qualities of nursing work, Openness to nurse-patient communication, and Willingness to care). Results. Of the participants, 51% were women, with mean age of 46.5±16.6 years; 54.9% were diagnosed with Lymphoma and 78.4% were in the treatment induction stage. In 30 of the 32 items of the instrument, > 90% of the participants evaluated compliance with the behavior of caring at level of "always". By categories, it was observed that for "Willingness to care" there was significantly lower score among patients from 18 to 49 years of age (p=0.0455). For the category "Openness to nurse-patient communication" lower median score existed in patients with Myeloma (p=0.0043) and in patients in the Remission-Consolidation stage (p=0.0084). Days of hospitalization were associated significantly with the category "Willingness to care", being lower with 16 days and more (p=0.0242). Conclusion. High frequency was observed of humanized-care behaviors and small differences in their assessment that were associated with demographic factors like age, and clinical factors, like diagnosis, treatment stage, and days of hospitalization.

Objetivo. Determinar la percepción de comportamientos de cuidados humanizados de enfermería y su relación con variables sociodemográficas y clínicas en pacientes hospitalizados en una Unidad de Hemato-Oncología. Métodos. Estudio transversal analítico realizado con la participación de 51 pacientes hospitalizados en la Unidad de Hemato-Oncología del Hospital Base Valdivia, Chile. Se aplicó un formulario que contenía información sociodemográfica, clínica y el instrumento Percepción de Comportamientos de Cuidados Humanizados de Enfermería 3ª versión" -PCHE 3v (32 ítems distribuidos en las categorías: Cualidades del hacer de enfermería, Apertura a la comunicación enfermera(o)-paciente y Disposición para la atención). Resultados. De los participantes, 51% fueron mujeres, con una edad media de 46.5±16.6 años. Un 54.9% presentó diagnóstico de Linfoma y 78.4% estaba en etapa de Inducción del tratamiento. En 30 de los 32 ítems del instrumento, sobre 90% de los participantes evaluaron el cumplimiento del comportamiento de cuidado en nivel "siempre". Por categorías se observó que para "Disposición para la atención" hubo significativa menor puntuación entre los pacientes de 18 a 49 años (p=0.0455). Para la categoría "Apertura a la comunicación enfermera(o)-paciente" existió menor puntaje mediano en pacientes con Mieloma (p=0.0043) y en los pacientes en etapa de Remisión-Consolidación (p=0.0084). Los días de hospitalización se asociaron significativamente con la categoría "Disposición para la atención", siendo menor con 16 días y más (p=0.0242). Conclusión. Hubo alta frecuencia de comportamientos de cuidados humanizados y pequeñas diferencias en su valoración que se asociaron con factores demográficos como la edad y a factores clínicos como el diagnóstico, la etapa de tratamiento y los días de hospitalización.

Objetivo. Verificar a percepção dos comportamentos de cuidado humanizado de enfermagem e sua relação com variáveis sociodemográficas e clínicas em pacientes internados em uma Unidade de Hemato-Oncologia. Métodos. Estudo transversal analítico realizado com a participação de 51 pacientes internados na Unidade de Hemato-Oncologia da Base Hospitalar de Valdivia, Chile. Foi aplicado um formulário que continha informações sociodemográficas e clínicas e o instrumento Percepção de Comportamentos da Assistência Humanizada de Enfermagem 3ª versão -PCHE 3v (32 itens distribuídos nas categorias: Qualidades do trabalho de enfermagem, Abertura à comunicação do enfermeiro (a) - Paciente e Disponibilidade para o cuidado). Resultados. Dos participantes, 51% eram mulheres, com média de idade de 46.5±16.6 anos. 54.9% apresentavam diagnóstico de Linfoma e 78.4% encontravam-se na fase de indução do tratamento. Em 30 dos 32 itens do instrumento, mais de 90% dos participantes avaliaram a adesão ao comportamento de cuidado no nível "sempre". Por categorias, observou-se que para "Disponibilidade para o cuidado" houve significativamente menor pontuação entre os pacientes de 18 a 49 anos (p=0.0455). Na categoria "Abertura à comunicação enfermeiro-paciente" houve menor pontuação mediana nos pacientes com Mieloma (p=0.0043) e nos pacientes em fase de Remissão-Consolidação (p=0.0084). Os dias de internação estiveram significativamente associados à categoria "Disponibilidade para o atendimento", sendo menos com 16 dias e mais (p=0.0242). Conclusão. Observou-se alta frequência de comportamentos de cuidado humanizado e pequenas diferenças na avaliação que estiveram associadas a fatores demográficos como idade e a fatores clínicos como diagnóstico, fase do tratamento e dias de internação.

Evolución de la mortalidad infantil en Chile y su reflejo en las publicaciones científicas entre 1980 y 2019 / Evolution of infant mortality in Chile and how it has been reflected in scientific publications between 1980 and 2019

Introducción. Los Objetivos de Desarrollo del Milenio incluyen la reducción de la tasa de mortalidad infantil (TMI), indicador que sigue vigente en las metas de los Objetivos de Desarrollo Sostenible (2015-2030). En paralelo, se requirieron investigaciones y reportes científicos para evaluar el comportamiento de la TMI y la efectividad de intervenciones para su abordaje. Objetivo. Describir el comportamiento de la TMI en Chile y su reflejo en las publicaciones científicas durante el período 1980-2019. Material y métodos. Aplicación del método de regresión lineal multivariable adaptiva (MARS, por su sigla en inglés) sobre las TMI entre 1980 y 2016, y búsqueda de artículos relacionados publicados entre 1980 y 2019 en SciELO, Lilacs, PubMed, Cochrane Library y Embase. Se analizó el comportamiento de la TMI y su reflejo en las publicaciones del período. Resultados. Hubo una reducción de la TMI de 28 ‰ a 7,2 ‰ nacidos vivos entre 1980 y 2016 (-74 %) y se identificaron 82 publicaciones en el período. Se registraron dos tipos de estudio sobre la TMI a partir de un punto de corte en 1996 En el primer período, los estudios abordaron patologías evitables e intervenciones, a la par de una reducción de la velocidad de descenso de la TMI. Posteriormente al punto de corte, los estudios se enfocaron en enfermedades no evitables y factores relacionados con inequidades y desigualdades. Conclusiones. La TMI prevalece como indicador sintético de las condiciones de salud. Las modificaciones en su evolución y sus causas se han reflejado en las publicaciones, que han variado sus énfasis y focos de atención según el cambio en este indicador

Introduction. One of the Millennium Development Goals is to reduce the child mortality rate (CMR), an indicator still present in the Sustainable Development Goals (2015-2030). At the same time, scientific investigations and reports were necessary to assess the behavior of the infant mortality rate (IMR) and the effectiveness of interventions to approach it. Objective. To describe IMR behavior in Chile and how it has been reflected in the scientific publications made in the 1980-2019 period. Material and methods. Implementation of the multivariate adaptive regression spline (MARS) method in relation to IMR between 1980 and 2016, and search for related articles published between 1980 and 2019 in SciELO, Lilacs, PubMed, Cochrane Library, and Embase. The analysis included IMR behavior and its reflection in the publications made in that period. Results. IMR decreased from 28 % to 7.2 % per 1000 live births between 1980 and 2016 (-74 %) and 82 publications were identified in this period. Two types of studies about IMR were reported as of the cutoff point of 1996. In the first period, studies focused on preventable diseases and interventions, while IMR showed a slowing down in its reduction. After the cutoff point, studies focused on non-preventable diseases and factors related to inequalities and inequities. Conclusions. IMR prevails as a synthetic indicator of health conditions. Changes in its evolution and causes have been reflected in publications, which have shifted their focus and areas of interest in accordance with the changes in this indicator.

Composición corporal y trastornos respiratorios del sueño en escolares de Valdivia, Chile / Relationship between body composition and sleep-disordered breathing in schoolchildren from Valdivia, Chile

Resumen: Introducción: La malnutrition por exceso en la infancia constituye una epidemia mundial y se asocia a múltiples enfermedades y complicaciones. Entre ellas, destacan los trastornos respiratorios del sueño (TRS), espectro de enfermedades que han emergido como un problema de salud relevante. Objetivo: Eva luar la relación entre la composición corporal y la presencia de TRS en escolares. Sujetos y Méto do: Estudio observacional analítico de corte transversal en 127 escolares de primero a octavo básico escogidos aleatoriamente de cinco establecimientos municipales de Valdivia, Chile. La incorporación al estudio ocurrió luego del proceso de consentimiento informado del responsable del escolar y asentimiento informado del menor. Se realizaron mediciones antropométricas y se determinó la presencia de TRS mediante el Pediatric Sleep Questionnaire (PSQ). Para el análisis se aplicó esta dística descriptiva, t de Student y test x2 para determinar asociación de variables con la presencia de TRS. Resultados: Destacó alta prevalencia de malnutrición por exceso (71,7%) y la obesidad alcanzó 39,4%. En tanto la prevalencia de TRS fue 32,3%. Hubo mayor proporción de niños con TRS en escolares obesos severos (56,3%), así como una media significativamente mayor en niños con TRS para los pliegues bicipital (14,6 mm ± 7,3 vs. 12,0 mm ± 6,6; p=0,002) y tricipital (19,8 ± 6,7 mm vs. 16,2 mm ± 6,0; p =0,04). Conclusiones: Existen altas prevalencias de malnutrición por exceso y TRS. De las medidas antropométricas, la presencia de TRS se asoció con mayor grosor de los plie gues bicipital y tricipital.

Abstract: Introduction: Overnutrition in childhood constitutes a global epidemic and has been associated with multiple di seases and complications. Among them, sleep-disordered breathing (SDB) stands out, a spectrum of diseases that have emerged as a relevant health problem. Objective: To evaluate the association bet ween nutritional status and SDB in schoolchildren. Subjects and Method: Cross-sectional analytical study of 127 schoolchildren randomly selected from five public schools in Valdivia, Chile. After the informed assent and informed consent process of the child and parents/guardian respectively, the students were incorporated into the study. Anthropometric measurements were performed and the presence of SDB was determined through the Pediatric Sleep Questionnaire (PSQ). For the data analysis, the t-test and x2 test were used to determine the association of variables with SDB. Re sults: There was a high prevalence of overnutrition (71.7%) and obesity reached 39.4%. Regarding the prevalence of SDB, it was 32.3%. There was a higher proportion of children with SDB in severely obese schoolchildren (56.3%), as well as, a significantly higher mean of biceps and triceps skinfold thickness in children with SDB (14.6 mm ± 7.3 vs. 12.0 mm ± 6.6, p = 0.002, and 19.8 ± 6.7 mm vs. 16.2 mm ± 6.0, p = 0.04, respectively). Conclusions: There is high prevalence of overnutrition and SDB. Out of the anthropometric measurements, the presence of SDB was associated with greater thickness of the biceps and triceps skinfolds.

Medidas declaradas por padres y cuidadores de lactantes y preescolares para prevenir la exposición a humo de tabaco ambiental / Measures stated by parents and caregivers of infants, toddlers, and preschoolers to prevent environmental tobacco smoke exposure

Introducción. La exposición a humo de tabaco ambiental constituye un problema de salud pública por sus potenciales riesgos en los niños. Objetivo. Determinar las acciones preventivas adoptadas por padres y/o cuidadores de lactantes y preescolares respecto de la exposición a humo de tabaco ambiental. Métodos. Estudio transversal analítico en padres y cuidadores de lactantes y preescolares escolarizados, residentes en la ciudad de Valdivia, Chile. Se aplicó un cuestionario sobre medidas preventivas del humo de tabaco ambiental. Se analizó con estadística descriptiva y de asociación usando el test exacto de Fisher y la regresión logística para calcular odds ratio (OR) y sus respectivos intervalos de confianza del 95% (IC95%) como estimación de riesgo de no adopción de medidas preventivas en el hogar. Resultados. Participaron 469 padres y cuidadores. La prevalencia de hogares con un miembro fumador fue 51,8%. La mayoría fumaba fuera del hogar (92,2%). La medida más adoptada fuera del hogar fue evitar lugares con gente fumando. En este ambiente, hubo diferencia significativa entre hombres y mujeres en no prevenir la exposición (7,6% vs. 2,2%; p= 0,040). Se constató mayor riesgo de no prevenir el consumo en el hogar (dentro o fuera) cuando hubo algún miembro fumador (OR 3,55; IC95%: 2,05-6,14). Y menor riesgo cuando hubo dos o más niños en el hogar (OR 0,46; IC95%: 0,26-0,83). Conclusiones. La mayoría de los padres y cuidadores piden que se fume fuera del hogar y evitan los lugares con gente fumando, aunque, en los hogares con miembros fumadores, la prevención es menor.

Introduction. The exposure to environmental tobacco smoke is a public health problem because of its potential risks for children. Objective. To determine the preventive actions taken by parents and/or caregivers of infants, toddlers, and preschoolers regarding environmental tobacco smoke exposure. Methods. Cross-sectional, analytical study in parents and caregivers of infants, toddlers, and preschoolers from Valdivia, Chile. A questionnaire on preventive measures regarding environmental tobacco smoke was administered. The questionnaire was analyzed with descriptive and association statistics using Fisher's exact test and logistic regression to calculate the odds ratios (ORs) and their corresponding 95% confidence intervals (95% CIs) as an estimation of the risk for not taking preventive measures at home. Results. A total of 469 parents and caregivers participated. The prevalence of households with one member who smoked was 51.8%. Most of them smoked outside the house (92.2%). The most common measure taken outside the household was to avoid places where people smoked. In this setting, a significant difference was observed between men and women in relation to avoiding exposure (7.6% versus 2.2%; p= 0.040). A higher risk for not avoiding tobacco use inside or outside the housewas confirmed when a household member smoked (OR: 3.55; 95% CI: 2.05-6.14). Also, a lower risk was observed when there were two or more children in the household (OR: 0.46; 95% CI: 0.26-0.83). Conclusions. Most parents and caregivers ask others to smoke outside and avoid places where people smoke; however, the level of prevention is lower among households with smokers.