¿Es la homofobía un concepto necesario? Análisis histórico-conceptual e implicancias psicosociales para la comunidad LGBTIQ / Is homophobia a necessary concept? Historical-conceptual analysis and psychosocial implications for the LGBTIQ community

El concepto de homofobia ha sido relevante para el estudio de las minorías sexuales y ha tenido un impacto positivo en el desarrollo de teorías académicas y efectos en la visibilidad de la homosexualidad. A pesar de esto, su reduccionismo al campo exclusivo de la homosexualidad masculina y la sobregeneralización de su uso significa la reproducción de asimetrías de poder que invisibilizan a otros sub-grupos de las minorías sexo-genéricas. Entre estos otros grupos están lesbianas, trans, queer, intersex, así como también, invisibiliza factores interseccionales como raza, etnia, género, clase. Es por esto, que este artículo tiene como intención realizar un análisis crítico del surgimiento del concepto de homofobia, sus implicancias y aportes para el campo de la psicología y las ciencias sociales en general

The concept of homophobia has been relevant to the study of sexual minorities and has had a positive impact on theory development academic, as well as effects on the visibility of the homosexuality. Despite this, his reductionism to the exclusive field of homosexuality masculine and the overgeneralization of its use means the reproduction of power asymmetries that make other minority sub-groups invisible sex-generic. Among these other groups are lesbian, trans, queer, intersex, as well as intersectional factors, such as race, ethnicity, gender, class. This is why this article intends to carry out a critical analysis of the emergence of the concept of homophobia, its implications and contributions for the field of psychology and the social sciences in general

Sexual and gender minority health in Chile: findings from the 2016-2017 Health Survey

ABSTRACT OBJECTIVE To expose visibility of the health concerns of sexual and gender minority groups in Chile, as well as to provide a platform to advocate for policies that support the health and well-being of sexual and gender minority people in the country. METHODS The health conditions and risk factors of participants identified as sexual and gender minority were compared to those identified as cisgender heterosexual using data from the 2016-2017 National Health Survey. RESULTS Despite reporting higher self-rated health than heterosexual men, gay men had a higher risk of lifetime diagnosis of sexually transmitted infections. Compared to heterosexual women, the prevalence of depression was higher among bisexual women, who were also less likely to have been tested for HIV. Moreover, transgender participants were more likely to report depression and worse self-rated health than cisgender heterosexual participants. CONCLUSION Small sample sizes of sexual and gender minority subgroups might have obscured some differences that would have been observable in larger samples. Despite this, we found statistically significant sexual and/or gender identity differences in several health areas, especially mental, sexual, and overall health.

Recomendaciones para la investigación psicológica con personas transgénero: Una aproximación desde una experiencia en Chile / Recommendations for psychological research with transgender people: an approach from an experience in Chile

Resumen El presente trabajo expone y fundamenta recomendaciones basadas en la experiencia de investigación en personas transgénero, con la intención de que puedan ser útiles a quienes realicen estudios con dicha población. Estas recomendaciones incluyen orientaciones conceptuales, metodológicas y éticas, aplicables a lo largo del proceso de investigación. En particular, las orientaciones cubren los siguientes temas: definir con precisión el colectivo con el que se trabaja, registrar la variedad de identificaciones de género posibles al interior del mismo, utilizar métodos de muestreo aptos para poblaciones de difícil acceso, retribuir la participación, incluir líderes e investigadores transgéneros como expertos, pilotar los instrumentos en la población que será investigada, optar por modalidades de recolección grupal de datos, ofrecer asistencia individualizada durante la recolección, utilizar un lenguaje no estigmatizante e inclusivo, convocar la participación en conjunto con organizaciones transgénero, atender a la movilidad geográfica de la población, realizar una escucha comprometida y contemplar protocolos de derivación, considerar las diferentes trayectorias de transición, realizar sesiones de interanálisis y, finalmente, difundir apropiadamente los hallazgos al interior de la población transgénero. Se discuten estas proposiciones en términos de sus efectos en las comunidades trans, su utilidad y alcances éticos, su articulación con exigencias generales de toda investigación y sus implicaciones para el activismo.

Abstract Prejudice and discrimination have important effects on the well-being and quality of life of trans people. Hence, investigating with said population implies, in addition to actions to obtain relevant and truthful information, having the necessary actions to attend to their needs and peculiarities. These are populations that are difficult to access (hard-to-reach), stigmatized, in which there is no defined sampling frame, that have physical and mental health indicators lower than those of any other group with which we have worked and that, therefore, it is necessary to take extreme the precautions not to reproduce types of relationships that may be harmful or offensive. The purpose of the present article was to systematize part of our field experience with transgender people, so that it can be useful for those who study with this population. These recommendations aim to provide some conceptual, methodological and ethical guidelines, useful throughout the research process. In particular, we made a series of recommendations that cover from the moment of taking conceptual decisions about the design of the study, through contact with the organizations, until the completion of the field work and subsequent stage of dissemination of results. In particular, a series of recommendations are made regarding: specifying the definition of the group with which one works, recording the variety of gender identifications as people present them, using to sampling methods for hard-to-reach populations or hidden populations, deliver a retribution for the participation (consider participants as experts to be compensated for their work), including activists as experts in every stage of the study (study design, field work, data analysis and dissemination of results), piloting the instruments in specific population, preferably opt for group applications modality and continue with a debriefing, have specific assistance for participants during the application (special needs derived from their age, educational level, reduced mobility, among others), use non-stigmatizing and inclusive language, call together with trans organizations (in order to establish greater trust in the population), attend to a mobility of the population (so as not to replicate the sample in different places), carry out a committed listening and contemplate referral protocols (if necessary given the type of situations described by the participants and their current degree of elaboration), consider different trajectories of transition, conduct inter-analysis sessions and disseminate appropriately within the transgender population. These propositions are discussed in terms of their effects on trans communities, their usefulness and ethical scope, their articulation with the general requirements of all research, and their implications for activism. On the other hand, these recommendations can serve as criteria for evaluating the ethical dimension of research projects with trans people. It may therefore be important to project reviewers, editors, and reviewers of manuscripts submitted for publication. The perspective that we assume in this work is aligned with those called "evidence-based activism", which implies articulating a variety of knowledge, scientifically accredited and of an "experiential" type, in order to explore situations in which the team members Research staff are part of networks that involve them personally in their study topics. It is precisely the relationship with groups that work for the rights of minorities, activists and members of these groups is essential, since they have knowledge acquired through their experience as part of discriminated groups and they can contribute to the mobilization of knowledge in the governance of health issues.

Efectos del prejuicio sexual en la salud mental de personas transgénero chilenas desde el Modelo de Estrés de las Minorías: Una aproximación cualitativa / Sexual prejudice effects on Chilean transgender individuals' mental health from Minority Stress Model: A qualitative approach

Resumen El Modelo de Estrés de las Minorías (Meyer, 2003) ha permitido explicar de qué forma el prejuicio sexual produce efectos negativos en la salud y bienestar de personas pertenecientes a las minorías sexuales, a través de la identificación de estresores de tipo distales y proximales. Este estudio buscó indagar los efectos del prejuicio sexual en la salud mental de personas transgénero en Chile desde un enfoque cualitativo. Se realizaron entrevistas semi-estructuradas a 17 personas transgénero femeninas y masculinas en cuatro ciudades del país. Los resultados nos permite identificar la presencia de factores distales asociados a discriminación manifiesta y factores proximales asociados a la vivencia del estigma y su relación con el autoconcepto. Finalmente, se describen efectos en la salud mental, entre los que destacan la presencia de sintomatología ansioso-depresiva, ideación e intentos suicidas, conductas autolesivas y consumo de alcohol y otras sustancias.

Abstract The Minority Stress Model (Meyer, 2003) has made it possible to explain how sexual prejudice produces negative effects on the health and wellbeing of people belonging to sexual minorities, through distal and proximal stressors. A qualitative study was conducted to investigate the effects of sexual prejudice on the mental health of transgender adults in Chile. Semi-structured interviews were conducted with 17 transgender people, both male and female, in four cities of the country. The results allow us to identify the presence of distal factors associated with overt discrimination, as well as, proximal factors associated with the experience of stigma and its effects on self-concept. Finally, effects on mental health are described, among which the presence of anxious-depressive symptomatology, suicidal ideation and attempts, self-injurious behavior and consumption of alcohol and other substances.

Violencia de pareja en hombres gay y mujeres lesbianas chilenas: Un estudio exploratorio / Intimate partner violence in chilean gay men and lesbian women: An exploratory study

La violencia en las relaciones de pareja del mismo sexo es un tema poco explorado. Históricamente, esta problemática ha sido estudiada en el marco de relaciones heterosexuales ubicando a las mujeres como víctimas y a los hombres como principales agresores. El propósito de este estudio fue describir las experiencias de violencia de pareja (VP) en una muestra de 268 hombres gay y 199 mujeres lesbianas. Se utilizó un muestreo tipo bola de nieve para reclutar la muestra en cuatro ciudades chilenas (Antofagasta, Valparaíso, Santiago y Concepción). Para la recolección de datos se aplicó un cuestionario especialmente diseñado para este estudio. Se realizaron análisis descriptivos y Chi-cuadrado para indagar posibles relaciones por sexo y características sociodemográficas. Entre los principales resultados se puede señalar que del total de la muestra (N = 467) sólo 80 personas (17.25%) reportaron haber sido receptoras de algún tipo de VP. Se encontraron diferencias estadísticamente significativas en el reporte de violencia psicológica entre hombres gay y mujeres lesbianas [χ²(1) = 6.37, p = .01, w =.64]. Los hombres gay reportaron mayor frecuencia de violencia psicológica (87.5%) en comparación con las mujeres lesbianas (65.8%). También se encontró una asociación estadísticamente significativa entre experiencias de VP y nivel educativo [χ²(3) = 10.53, p = .01, w = .51]. Las personas con mayor nivel educativo reportan frecuencias menores de VP. Finalmente, se encontró una relación estadísticamente significativa entre haber sido víctima de VP y haber sido perpetrador de VP. Los resultados son discutidos y se plantean implicaciones para futuras investigaciones.

The recognition of same-sex relationships has increased, but same-sex intimate partner violence has been less studied. Historically, this problem had been studied in heterosexual relationships, women being victims and men main aggressors. This heteronormative approach to intimate partner violence (IPV) often neglects same-sex relationships (Finneran, Chard, Sineath, Sullivan, & Stephenson, 2012; Russell, 2015). For this study, IPV is defined as every act causing psychological, physical or sexual damage, within the context of intimate relationships (Harvey et al., 2007) perceived as such. To our knowledge, there are no studies about IPV in same-sex relationships in Chile. Data about this topic is scarce in the Latin American context (Ferreira et al., 2015). Therefore, it is necessary to provide contextualized knowledge about IPV in same-sex relationships to face this psychosocial problem. The aim of this study was to describe IPV in same-sex relationships in gay men and lesbian women and its sociodemographic characteristics. In addition, results are compared to detect possible differences between groups. LGBT populations are considered a difficult-to-reach or hidden population (Paz-Bailey et al., 2013). For this reason, a snowball sampling procedure was used. The sample consists of 467 participants who identify themselves as gay men (57.4%) or lesbian women (42.6%), aging from 18 to 67 years (M = 27.9; SD = 7.9). The sample was recruited in four Chilean cities (Antofagasta, Valparaíso, Santiago, and Concepción). A specially designed questionnaire was administered to collect data for this study. Results were obtained through descriptive and comparative analyses with a Chi-square Test. Analyses indicate that 80 subjects (17.2%) had experienced some form of IPV (psychological, physical, or sexual); 87.7% of them reported psychological violence; and about half of them (47.5%) physical violence. Likewise, 19.3% respondents reported that there had been an IPV perpetrator. For group analysis, 20.1% of lesbian women and 19.3% of gay men reported some IPV experience. Statistically significant differences between gay men and lesbian women respondents were detected for psychology violence perpetrated [x²(1) = 6.37, p = .01, w = .64]. Gay men reported a higher percentage perpetrating psychological violence in their relationship (87.5%), as compared to the group of lesbian women (65.8%). Also, a statistically significant relation was found between IPV experiences and educational levels [x²(3) = 10.53, p = .01, w = .51]. Subjects with higher educational levels report less IPV frequency. Finally, a statistically significant relation was found between IPV victims and IPV perpetrators. This study represents the first approach to describe and characterize IPV in gay men and lesbian women, thus creating a baseline for making comparisons with future findings on LGBT issues in Chile and Latin America. Results support evidence concerning greater prevalence of psychological violence in both gay men and lesbian women, as compared to other types of violence such as physical and sexual (Barrett & St. Pierre, 2013; Finneran y Stephenson, 2013; Hellemans et al., 2015; Messinger, 2011). In addition, this resultis similar to those of previous studies on general population (Russell, 2015). An important result is IPV mutuality in the sample, namely, IPV occurs in two directions: persons experiencing partner violence concurrently perpetrate violence against their partners. Findings support the view that, in general, violence in same-sex relationships takes place gradually from relation al dynamics marked by violence (Barrientos, Rodríguez-Caballería, Escartín & Longares, in press). In this context, although data from this study are exploratory-descriptive, they make up a good approach to the problem since they include gay men and lesbian women from different Chilean areas of varied sociodemographic characteristics. If similar findings are reported in other studies, they could help direct psychosocial interventions, public policies, and future research. In any case, results must be carefully considered since they are non-representative samples and, in theory, not comparable with each other. Limitations and implications for future IPV research in same-sex relationships are discussed.

Identidad sexual en jóvenes gay del norte de Chile / The sexual identity of gay youths in Northern Chile / Identidade sexual em jovens gay do norte do Chile

Resumen La investigación en la que se funda este artículo tuvo como objetivo comprender cómo se construye la identidad sexual en hombres gay jóvenes, entre 18 y 29 años de edad, de la ciudad de Antofagasta, en el norte de Chile. El enfoque de la investigación fue cualitativo y la selección de los participantes fue de carácter intencional. La técnica de producción de información fue la entrevista semi-estructurada. Se identificaron tres categorías que inciden en la construcción de la identidad sexual de los jóvenes entrevistados: a) la socialización de género; b) la discriminación; y c) la "salida del armario" (revelación de la orientación sexual a otros). Los ejes mencionados son importantes en cómo los entrevistados perciben, viven y aceptan (o no) su orientación sexual. Igualmente, un hallazgo importante es la significación otorgada por los jóvenes entrevistados a la homofobia internalizada, proceso que se sustenta en la construcción e internalización de rígidos roles de género, siendo este tipo de homofobia una de las causas de la discriminación y auto-discriminación que existe entre homosexuales.

Abstract This study discusses how sexual identity is constructed among young gay men of 18-29 years-old from Antofagasta in northern Chile. The study uses a qualitative approach and the selection of participants was intentional. Data was collected via semi-structured interviews. Three categories influencing youth's sexual identity were identified: a) gender socialization, b) discrimination; and c) "coming out of the closet" (revealing sexual orientation to others). Those indicators are important in relation to how interviewees perceive, experience, and accept or not their sexual orientation. In addition, an important finding is the significance given by participants to internalized homophobia. This process is based on the construction and internalization of rigid gender roles. This type of homophobia is one of the causes of discrimination and self-discrimination among homosexuals.

Resumo A investigação em que se baseia este artigo teve como objetivo compreender como se constrói a identidade sexual em homens gay jovens, entre 18 e 29 anos de idade, da cidade da Antofagasta, no norte do Chile. O enfoque da investigação foi qualitativo e a seleção dos participantes foi de caráter intencional. A técnica de produção de informação foi a entrevista semiestruturada. Identificaram-se três categorias que incidem na construção da identidade sexual dos jovens entrevistados: a) a socialização de gênero; b) a discriminação; c) a "saída do armário" (revelação da orientação sexual a outros). Os eixos acima mencionados são importantes em relação a como os entrevistados percebem, vivem e aceitam (ou não) sua orientação sexual. Igualmente, um achado importante é a significação outorgada pelos jovens entrevistados à homofobia internalizada, processo que se sustenta na construção e na internalização de rígidos papéis de gênero, sendo este tipo de homofobia uma das causas da discriminação e da autodiscriminação que existem entre homossexuais.

Efficacy and tolerability of two single-day regimens of triclabendazole for fascioliasis in Peruvian children

The therapeutic scheme of triclabendazole (TCBZ), the recommended anthelmintic against Fasciola hepatica , involves 10mg/kg of body weight administered in a single dose; however, clinical trials in children are scarce. We evaluated the efficacy and tolerability of 2 schemes of TCBZ.

Sexual satisfaction in couples in the male and female climacteric stage / Satisfacción sexual en parejas durante el climaterio femenino y masculino / Satisfação sexual nos casais durante o climatério feminino e masculino

The objective was to describe the sexual life satisfaction of couples in the climacteric stage and determine whether there are differences between the perception of satisfaction and the sex life of each partner. We studied 142 couples obtained by stratified sampling of family health centers, Concepción, Chile. 66% of women and 84% of men reported being very or somewhat satisfied with their sex lives. Slight concordance was found between the responses of the partners in relation to satisfaction with their sexual life. Moreover, a slight degree of agreement was found between the sexual life satisfaction reported by women and their partners' perceptions of the women's sexual life satisfaction. Additionally, a slight degree of agreement was reported between the sexual life satisfaction reported by men and their partners' perceptions of the men's sexual life satisfaction. This study provides new information about Chilean couples in the climacteric stage in relation to self-reported sexual satisfaction and perceived satisfaction in couples.

O objetivo foi descrever a satisfação com a vida sexual dos casais no período do climatério e determinar se existem diferenças entre as percepções da satisfação com a vida sexual de cada membro do casal. Foram seleccionados cento e quarenta e dois casais por meio de uma amostragem estratificada dos centros de saúde familiar em Concepción, Chile. Sessenta e seis porcento das mulheres e 84% dos homens relataram ser muito ou moderadamente satisfeitos com suas vidas sexuais. Verificou-se uma leve concordância entre as respostas de cada membro do casal em relação à satisfação com a vida sexual. Também identificou-se um leve grau de concordância entre a satisfação com a vida sexual referida pela mulher e a percepção da satisfação com a vida sexual que seu parceiro tem dela. Da mesma forma, verificou-se um discreto grau de acordo para a referida pelo homem e a percepção da satisfação com a vida sexual que sua companheira tem dele. É oferecida uma nova informação a respeito dos casais chilenos no período do climatério, em relação à satisfação sexual autoinformada e a satisfação percebida no parceiro, evidenciando-se a diferença da percepção entre os casais.

El estudio describe la satisfacción con la vida sexual de parejas en etapa de climaterio, además de determinar si existen diferencias entre las percepciones de satisfacción con la vida sexual de cada miembro de la pareja. Se estudiaron 142 parejas, obtenidas mediante muestreo estratificado en centros de salud familiar de Concepción, Chile. Un 66% de mujeres y un 84% de hombres informaron sentirse muy o algo satisfechos con su vida sexual de pareja. Se encontró una concordancia leve entre las respuestas de cada miembro de la pareja, en relación con la satisfacción en la vida sexual. También, se encontró un grado de acuerdo leve entre satisfacción con la vida sexual informada por la mujer y la percepción de satisfacción con la vida sexual que su pareja tiene de ella. Asimismo, se reportó un grado discreto de acuerdo para la satisfacción con vida sexual referida por el hombre y la percepción de satisfacción con la vida sexual que su pareja tiene de él. Este estudio proporciona nueva información respecto a parejas chilenas en etapa de climaterio, en relación con la satisfacción sexual autoinformada y percibida en la pareja.

Estructura factorial de la escala de soporte social subjetivo: validación en una muestra de estudiantes universitarios chilenos / Factor structure of the subjective social support scale: validation with a sample of university students in Chile / Estrutura fatorial da escala de suporte social subjetivo: validação em uma mostra de estudantes universitários chilenos

El objetivo de este artículo es adaptar y validar la Escala de Apoyo Social Subjetivo (EASS, de Vaux et al., 1986), a la vez que describir su estructura factorial. Esta escala está compuesta por 10 ítems distribuidos en dos dimensiones: apoyo familiar y apoyo de los amigos. Se examinan las propiedades psicométricas de la escala y la dimensionalidad de la misma en una muestra de estudiantes universitarios chilenos (N = 681). Los resultados indican que el EASS constituye un instrumento fiable (α = .86) y válido para la medición del apoyo social subjetivo. Las dimensiones de la EASS obtienen entre sí una correlación significativa y moderada (r = .41; p < .001). Las cargas factoriales para los ítems en el análisis factorial confirmatorio fluctuaron entre .40 y .93, mostrando buenos índices de ajuste para el modelo de dos factores de primer orden correlacionados (CFI = .97, TLI = .93, RFI = .97, IFI = .97, NFI = .96 y RSMEA = .08).

The purpose of this paper is to adapt and validate the Subjective Social Support Scale (Vaux et al, 1986) and to describe its factor structure. The scale consists of 10 items distributed in two dimensions measured in the original instrument: family support and support from friends. The psychometric properties and dimensionality of the scale are examined in a sample of Chilean college students (N = 681). Results show that the scale is a reliable instrument (α = .86) and valid for measuring subjective social support. Its two dimensions show a moderate and significant correlation (r = .41; p < .001). The factor loadings of the items in the confirmatory factor analysis varied between .40 and .93, showing good fit indices for the correlated first order two factor model (CFI = .97, TLI = .93, RFI = .97, IFI = .97, NFI = .96 and RSMEA = .08).

O objetivo deste artigo é adaptar e validar a Escala de Apoio Social Subjetivo (EASS, de Vaux et al., 1986), e ao mesmo tempo descrever sua estrutura fatorial. Esta escala está composta por 10 itens distribuídos em duas dimensões: apoio familiar e apoio dos amigos. Examinam-se as propriedades psicométricas da escala e a dimensionalidade da mesma em uma mostra de estudantes universitários chilenos (N = 681). Os resultados indicam que o EASS constitui um instrumento fiável (α = .86) e válido para a medição do apoio social subjetivo. As dimensões da EASS obtêm entre si uma correlação significativa e moderada (r = .41; p < .001). As cargas fatoriais para os itens na análise fatorial confirmatória flutuaram entre .40 e .93, mostrando bons índices de ajuste para o modelo de dois fatores de primeira ordem correlacionados (CFI = .97, TLI = .93, RFI = .97, IFI = .97, NFI = .96 e RSMEA = .08).

Características sociodemográficas, bienestar subjetivo y homofobia en una muestra de hombres gay en tres ciudades chilenas / Socio-demographic characteristics, subjective well-being, and homophobia experienced by a sample of gay men from three cities in Chile / Características sociodemográficas, bem-estar subjetivo e homofobia em uma amostra de homens gays em três cidades chilenas

Este artículo describe y caracteriza sociodemográficamente a una muestra de hombres gay en tres ciudades de Chile. Además, describe sus niveles de homofobia y bienestar subjetivo. Mediante un muestreo en cadena tipo bola de nieve se encuestó a 325 hombres que se autodefinieron como gay. Entre los principales hallazgos se encontró altos niveles de discriminación y victimización percibida. Además en comparación con estudios similares efectuados en el país, los encuestados presentan niveles mayores de bienestar social. La edad de los encuestados aporta diferencias para los niveles de bienestar social y no para las otras medidas. También, las personas con estudios superiores reportan mayores niveles de victimización y un mayor impacto vital de las situaciones de discriminación. Asimismo, si bien las personas que residen en Santiago reportan un mayor impacto relativo de los hechos de agresión, presentan mejores niveles de bienestar social y felicidad en comparación a las personas que viven en otras regiones.

This article describes the socio-demographic characteristics of a sample of gay men in three cities in Chile, as well as experience with homophobia and subjective well-being. Snowball sampling was used to interview 325 gay men. The main findings included high levels of perceived discrimination and victimization, but interviewees reported higher levels of social well-being compared to studies elsewhere in the country. Age was related to differences in levels of social well-being, but not other variables. Individuals with university education reported higher levels of victimization and greater impact of discrimination on their lives. Gay men in Santiago reported a higher relative impact from incidents of aggression, but better levels of social well-being and happiness compared to those in other regions of Chile.

Este artigo descreve e caracteriza sociodemograficamente uma amostra de homens gay em três cidades do Chile, abordando também seus níveis de homofobia e bem-estar subjetivo. Por meio de uma amostra em série do tipo bola de neve foram entrevistados 325 homens autoidentificados como gay. Entre os principais achados evidenciaram-se altos níveis de discriminação e vitimização percebida, em comparação com estudos similares realizados no país. Os entrevistados apresentaram níveis maiores de bem-estar social. A idade dos entrevistados aporta diferenças para os níveis de bem-estar social e não para as outras medidas. As pessoas com estudos superiores reportam também maiores níveis de vitimização e um maior impacto vital das situações de discriminação. Adicionalmente, embora as pessoas que residem em Santiago reportem um maior impacto de agressões, eles apresentam melhores níveis de bem-estar social e felicidade em comparação com pessoas que moram em outras regiões.

A confirmatory factor analysis of the Spanish language version of the Attitudes Toward Lesbians and Gay Men Scale (ATLG) / Análisis factorial confirmatorio de la versión en español del Cuestionario de Actitudes hacia Lesbianas y Hombres Gais (ATLG)

This paper intends to validate the Attitudes toward Lesbians and Gay Men Scale (Herek, 1988). The starting point is the five dimensions reported in previous studies (Cárdenas & Barrientos, 2008). No research has confirmed the hypothesized ATLG factor structure with a Spanish-language sample. This study tested three factor structures, results indicating that the two-factor second-order model provides the best description of ATLG items. Additionally, psychometric properties were examined using a sample of 518 college students. ATLG proved reliable (a = 0.93) and valid for Chilean population.

Este artículo busca validar la Escala de Actitudes hacia Lesbianas y Hombres Gais ([ATLG], Herek, 1988). El punto de partida son las cinco dimensiones reportadas en estudios anteriores (Cárdenas & Barrientos, 2008). Ninguna investigación ha confirmado la estructura factorial hipotética de la ATLG con una muestra de hispanoparlantes. El estudio examinó tres estructuras factoriales, y los resultados indican que el modelo de dos factores proporciona la mejor descripción de los ítems de la ATLG. Además, se examinaron las propiedades psicométricas con una muestra de 518 estudiantes universitarios. La ATLG se mostró confiable (a = 0.93) y válida para una población chilena.

Efectos del prejuicio sexual en la salud mental de gays y lesbianas, en la ciudad de Antofagasta, Chile / Efeitos do prejuízo sexual na saúde mental de gay e lésbicas, na cidade da Antofagasta, Chile / The effects of sexual prejudice on the mental health of gays and lesbians in Antofagasta, Chile

Este artículo caracteriza diferencias en relación al prejuicio sexual en la salud mental de personas homosexuales y heterosexuales. En el estudio se incluyeron medidas de Bienestar Psicológico y Bienestar Social, así como medidas de Distrés Psicológico (SCL-90-R). La muestra con la que se ha trabajado está compuesta por 110 personas (55 homosexuales y 55 heterosexuales), cuyas edades fluctuan entre 18 y 49 años. Si bien no se encontraron diferencias en la salud mental de personas homosexuales y heterosexuales, sí se reportaron diferencias en los análisis segmentados por sexo y orientación sexual. Por su parte, en este estudio, el prejuicio sexual apareció relacionado significativamente con algunas de las dimensiones de salud mental indagadas.

Este artigo caracteriza diferenças em relação ao prejuízo sexual na saúde mental de pessoas homossexuais e heterossexuais. No estudo, incluíram-se medidas de Bem-estar Psicológico e Bem-estar Social, assim como medidas de Distrés Psicológico (SCL-90-R). A mostra com a qual se trabalhou foi formada por 110 pessoas (55 homossexuais e 55 heterossexuais), cujas idades variam de 18 a 49 anos. Embora não tenham sido encontradas diferenças na saúde mental de pessoas homossexuais e heterossexuais, foram reportadas diferenças nas análises segmentadas por sexo e orientação sexual. Por sua vez, neste estudo, o prejuízo sexual apareceu relacionado significativamente a algumas das dimensões de saúde mental indagadas.

This article explores mental health indicators among homosexuals and heterosexuals. The study involved Psychological and Social Well-Being, as well as Psychological Distress dimensions (SCL-90-R). The sample comprised 55 homosexual and 55 heterosexual individuals, ages 18 to 49 years old. Although no mental health differentials were among either homosexuals or heterosexuals, differences were reported in the analysis by sex and sexual orientation. The correlation between sexual prejudice and some mental health dimension was found to be statistically relevant.

Reflexiones sobre el papel del profesional de la medicina en el sistema general de seguridad social colombiano / Thoughts about the physician's role in the Colombian general social security system

El Sistema General de Seguridad Social en Salud de Colombia ha sido objeto de múltiples controversias, y desde hace años el sistema bajo el cual se rige la prestación de los servicios de salud se encuentra en una crisis de la que aún se está buscando la salida. Dentro de este panorama, es necesario analizar el papel de los profesionales de la medicina, como uno de los actores vinculados en el sistema. Restricciones, limitados tiempos de consulta y remuneración injusta son problemas que aparecieron con la Ley 100 de 1993 y que analizando la nueva reforma de 2011 no parece que se esté planteando una solución definitiva a dichas problemáticas. Por lo tanto, se necesita que los profesionales de la medicina tomen conciencia del rol que les corresponde y bajo este, procuren el cambio que se necesita tomar para lograr un verdadero sistema de seguridad social que sea integral y que garantice la salud de la población. [Vásquez LE, Delgado V, Cadena LP. Reflexiones sobre el papel del profesional de la medicina en el sistema general de seguridad social colombiano. MedUNAB 2012; 15:89-97].

The Health System in Colombia has been the subject of multiple controversies, and it has been on crisis many years without finding a way to recover. Within this scenario, it is necessary to analyze the role of physicians as one of the actors involved in the system. Restrictions, limited consultation times and unjust compensation are issues that appeared with Law 100 of 1993, and the new legal reform of 2011, doesn't seem to be a definitive solution to such problems. Additionally, health professionals are not always informed on the nature of the system itself and they end up being uninformed critics instead of playing an active role in improving the provision of health services to the community. Therefore, physicians need to become aware of their proper role and start seeking the change that needs to be taken in order to achieve a real social security system that is comprehensive and beneficial for the health of the Colombian population. [Vásquez LE, Delgado V, Cadena LP. Thoughts about the physician's role in the Colombian general social security system. MedUNAB 2012; 15:89-97].

Enfermedad diverticular complicada: Manejo quirúrgico en el Hospital Español de Veracruz / Complicated diverticular disease: Surgical management at the Hospital Español de Veracruz

Objetivo: Evaluar los resultados del tratamiento quirúrgico de pacientes con enfermedad diverticular complicada en un periodo de 9 años. Sede: Hospital Español de Veracruz (tercer nivel de atención). Diseño: Observacional, descriptivo, transversal, retrospectivo. Análisis estadístico: Medidas de frecuencia relativa y tendencia central. Pacientes y métodos: Estudio de 41 pacientes operados por enfermedad diverticular del colon complicada. Variables analizadas: Características sociodemográficas, factores de riesgo, indicaciones quirúrgicas, técnica quirúrgica empleada, complicaciones y evolución postoperatoria. Resultados: La edad promedio fue 66 ± 12.3 años, con predominio del género femenino (51.22%). Las principales indicaciones quirúrgicas fueron: perforación (43.90%), diverticulitis de repetición (21.95%), hemorragia (19.51%), fístula de colon a vejiga y vagina (9.76%) y obstrucción (4.88%). La obesidad fue el factor de riesgo más frecuente (24.39%). En el 56.10% de los casos la cirugía fue electiva. En el 92.69% se efectuó resección primaria con anastomosis y en 7.31% procedimiento de Hartmann. La evolución de los pacientes fue satisfactoria en el 78.05%. La mortalidad del grupo fue de 2.44%. Conclusiones: La experiencia de nuestro grupo en el manejo de la enfermedad diverticular complicada revela una elevada morbilidad, con mortalidad similar a la reportada en la literatura mundial. Es recomendable que el manejo sea realizado por cirujanos expertos y en hospitales de concentración.

Objective: To assess the results of surgical treatment of patients with complicated diverticular disease in a 9-year period. Setting: Hospital Español de Veracruz (third level health care). Design: Observational, descriptive, cross-sectional, retrospective study. Statistical analysis: Relative frequency and central tendency measures. Patients and methods: We studied 41 patients with complicated colonic diverticular disease. Analyzed variables were: sociodemographic characteristics, risk factors, surgical indications, surgical technique used, complications, and postoperative evolution. Results: Average age was of 66 ± 12.3 years, predominating women (51.22%). The main surgical indications were: perforation (43.90%), recurring diverticulitis (21.95%), hemorrhage (19.51%), colon fistula toward the bladder and vagina (9.76%), and obstruction (4.88%). Obesity was the most frequent risk factor (24.39%). Surgery was elective in 56.10% cases. Primary resection with anastomoses was performed in 92.69% of the cases and Hartman's procedure in 7.31%. Evolution of patients was satisfactory in 78.05%, and mortality in the group was of 2.44%. Conclusions: Our experience in the management of complicated diverticular disease reveals a high morbidity, with mortality similar to that reported in the worldwide literature. It is advisable that management be performed by experienced surgeons and at concentration hospitals.

Tumores de mesenterio: como diagnóstico diferencial de masas abdominales estudio clínico de 4 casos en adultos / Mesentery tumors: as experimental diagnosis differential

Los tumores originados de las hojas del mesenterio son relativamente raros, pero se deben incluir como uno de los diagnósticos diferenciales en aquellos pacientes que se presentan con una tumoración abdominal. Reportamos 4 casos de tumores de mesenterio en adultos (3 quistes y 1 fibroma), que fueron diagnosticados y tratados en el Hospital Ricardo Baquero González de Caracas, siendo estos casos los únicos observados en nuestra institución, en un períodode 15 años (1978-1993). Los procedimientos quirúrgicos utilizados fueron, resección completa (2 pacientes), excisión completa más resección intestinal (1 paciente) y marzupialización (1 paciente). La única complicación de nuestra serie de obstrucción intestinal ocurrió después del drenaje. Revisamos la incidencia, clínica, métodos diagnósticos y tratamiento quirúrgico, aportando así con nuestra descripción una guía que en conjunto con los demás casos publicados en la literatura hispano-anglo-francesa, sirva de parámetro para el diagnóstico y manejo preciso de esta patología.

Estudio descriptivo del programa de diabetes mellitus del Hospital de Constitución: año 1996 / Descriptive study of the mellitus diabetes programme at Constitución Hospital: year 1996

Con el objeto de conocer la realidad actual del programa de diabetes mellitus del Hospital de Constitución, se llevó a cabo un estudio de tipo descriptivo que abarcó al universo de los pacientes diabéticos del programa del adulto. Se encontraron 234 pacientes en control y mediante revisión de tarjetas y fichas clínicas se analizaron las variables de sexo, edad, tipo, estado nutritivo según IMC, glicemia, estudio de pérfil lipídico, presión arterial, control por HTA y tipo de tratamiento. Se encontró un predominio de mujeres en control por diabetes tipo II, predominio de pacientes con estado nutritivo anormal, ya sea obesidad o sobrepeso, una insuficiente solicitud de exámenes de pérfil lipídico, un alto porcentaje de pacientes con glicemias anormales y con presiones arteriales anormales con y sin control por HTA y finalmente, que el tipo de tratamiento predominante para los diabéticos tipo II fue el uso asociado de régimen e hipoglicemiantes orales

La operación cesárea en un hospital tipo II: estudio descriptivo de 347 casos de operación cesárea en el Hospital de Constitución durante el año 1995 / The caesarean surgery at a type III hospital: descriptive study of 347 cases of caesarean surgery at Constitución hospital during year 1995

Se revisaron 347 casos registrado de pacientes en las que se practicó la operación cesárea en el Hospital de Constitución durante el año 1995. Se observó que un alto porcentaje de los casos recibió una indicación electiva para el procedimiento. De las cesáreas indicadas electivamente, en el 57 por ciento de los casos lo fueron por causa de cicatriz de cesárea anterior o diagnóstico de pelvis viciosa. En el caso de la indicación de urgencia la principal causa la constituyó el sufrimiento fetal agudo. El resultado desde el punto de vista del estado del RN fue satisfactorio, superando los promedios regionales de RN de agpar y peso adecuados