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[This corrects the article DOI: 10.1371/journal.pgph.0000763.].
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Individuals with non-communicable diseases (NCDs) are potentially at increased vulnerability during the Covid-19 pandemic and require additional help to reduce risk. Self-management is one effective strategy and this study investigated the effect of sociodemographic and health factors on the self-management of some non-communicable diseases, namely hypertension, type 2 diabetes mellitus and dyslipidemia, among Chilean adults during the Covid-19 pandemic. A cross-sectional telephone survey was carried out on 910 participants with NCDs, from Santiago, Chile. An adapted and validated version of the "Partners in Health" scale was used to measure self-management. Exploratory Factor analysis yielded five dimensions of this scale: Disease Knowledge, Healthcare Team Relationship, General Self-Management and Daily Routines, Drug Access and Intake, and Monitoring and Decision-Making. The average of these dimensions was calculated to create a new variable Self-Management Mean, which was used as a dependent variable together with the five separate dimensions. Independent variables included age, gender, years of schooling, number of diseases, the percentage of Multidimensional Poverty Index in the commune of residence, and self-rated health status. Beta regressions and ANOVA for the Beta regression residuals were utilized for analyses. Beta regression model explained 8.1% of the variance in Self-Management Mean. Age, years of schooling, number of diseases and self-rated health status were statistically associated with Self-Management Mean and dimensions related to daily routines and health decision making, such as Disease Knowledge, General Self-Management and Daily Routines, and Monitoring and Decision-Making. Gender and the percentage of Multidimensional Poverty Index in the commune of residence were insignificant. Strategies for self-management of NCDs during a crisis should consider age, years of schooling, number of diseases, and self-rated health status in their design.
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OBJECTIVE: To explore the perspectives of the decision makers and community members in primary health care (PHC) around the conceptualization of social participation (PS). DESIGN: An exploratory cross-sectional study with qualitative methodology. LOCATION: Health Centers of the Metropolitan Region (RM), Santiago, Chile. PARTICIPANTS: Eight informants from the management level (group 1), 13 from execution level in PHC (group 2), 28 community members and four community agents of health (group 3). METHOD: Interviews and discussion groups were conducted, which were recorded and transcribed. The organization and analysis of the data was done with Atlas.ti 8.1. The narratives were systematized using a thematic analysis. All the documents were codified, and we hold periodic meetings to review the existing codes, as well as discussing the inclusion of new codes. RESULTS: Group 1 refers to a more theoretical conception of PS. Group 2 expresses more concrete and operative dimensions. Group 3 indicates that PS is embodied in particular personal experiences. Groups 1 and 3 have more than one notion of social participation in health. CONCLUSIONS: An institutional conception of participation prevails transversally, rooted since the 1990s. At the community level, the narratives take the form of collective practices lived around the improvement of the quality of community life mediated by the level of execution.
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Primary Health Care , Social Participation , Chile , Community Participation , Cross-Sectional Studies , HumansABSTRACT
INTRODUCTION: Further discussions are needed regarding the magnitude of nutritional problems diagnosed using CDC or WHO, against the existence of new biological or statistical definitions of obesity. OBJECTIVE: To compare the evolution of the prevalence of nutritional status among schoolchildren in first grade, from 2005 to 2008, according to CDC and WHO. METHODS: Retrospective cohort study, of 140.265 students of both sexes of first grade, evaluated from 2005- 2008, whose anthropometric data (weight and height), were obtained from annual registration system of school nutrition. To classify the nutritional status of children, CDC and WHO patterns were used. RESULTS: The mean BMI was slightly different and lower in girls than in boys, in 2005 and 2006. During 2007 and 2008 the average BMI in girls reached the observed in males. There was a higher prevalence of underweight according to WHO (p=0,03), with a tendency to decrease in the subsequent years. The prevalence of normality was greater according to the CDC criteria, with a reduction between 2005 and 2007 and an increase in 2008 (P < 0,001). There was a lower prevalence of overweight according to CDC criteria (P < 0,001), with an increase between 2005 and 2007, both CDC and WHO. The prevalence of obesity was lower according to the WHO criteria, and there were not statistically significant differences when comparing the CDC pattern. CONCLUSIONS: By comparing both patterns, CDC tends to overestimate the normal and underestimate the overweight, while obesity was not significant differences.
Introducción: Es necesario realizar nuevas discusiones respecto a la magnitud de los problemas nutricionales diagnosticados, al usar CDC u OMS, frente a la existencia de nuevas definiciones biológicas o estadísticas de obesidad. Objetivo: Comparar la evolución de la prevalencia de estado nutricional en escolares de primero básico, desde el 2013 2005 al 2008, según CDC y OMS. Métodos: Cohorte retrospectiva, de 140.265 escolares de ambos sexos de primero básico, evaluados entre 2005- 2008, cuyos datos antropométricos (peso y talla), se obtuvieron del sistema anual de registro del estado nutricional escolar. Para clasificar el estado nutricional, se utilizaron los patrones CDC y OMS. Resultados: Los promedios de IMC fueron levemente diferentes y menores en la niñas que en los niños, en 2005 y 2006. Durante el 2007 y 2008 el promedio de IMC en las niñas alcanzó la cifra observada en los varones. Hubo mayor prevalencia de bajo peso según OMS (p=0,03), con una tendencia a la disminución en los 2013s posteriores. La prevalencia de normalidad fue mayor según el criterio CDC, con una reducción entre el 2005 y 2007 y un incremento 2008 (p<0,001). Hubo una menor prevalencia de sobrepeso según el criterio CDC (p<0,001), con aumento entre el 2005 y 2007, tanto CDC como OMS. La prevalencia de obesidad fue menor según el criterio OMS, no encontrándose diferencia estadísticamente significativa al comparar con el patrón CDC. Conclusiones: Al comparar ambos patrones, CDC tiende a sobreestimar la normalidad y subestimar el sobrepeso, mientras que en obesidad no se encontraron diferencias significativas.