Validación de un cuestionario para evaluar riesgos psicosociales en el ambiente laboral en Chile / Validation of a questionnaire for psychosocial risk assessment in the workplace in Chile

Background: The measurement of psychosocial risk among workers is becoming increasingly important. Aim: To adapt, validate and standardize a questionnaire to measure psychosocial risks in the workplace. Material and Methods: The Spanish version of the Copenhagen Psychosocial Questionnaire was adapted and evaluated. Its contents were first validated with a panel of experts. Afterwards a semantic adaptation of the questionnaires was carried out applying it to a pilot sample. Finally, it was applied to 1,557workers (65% men). Results: A preliminary questionnaire containing 97 questions was constructed. A good item-test correlation was found, the factorial structure was similar to the original questionnaire and it had a good internal consistency, convergent validity with the Goldberg Health Questionnaire and test-retest correlation. Ranges for the different dimensions and sub-dimensions of psychosocial risk were calculated by tertiles. Conclusions: The resulting questionnaire is useful for measuring psychosocial risk factors at work, with good psychometric properties.

[Validation of a questionnaire for psychosocial risk assessment in the workplace in Chile]. / Validación de un cuestionario para evaluar riesgos psicosociales en el ambiente laboral en Chile.

BACKGROUND: The measurement of psychosocial risk among workers is becoming increasingly important. AIM: To adapt, validate and standardize a questionnaire to measure psychosocial risks in the workplace. MATERIAL AND METHODS: The Spanish version of the Copenhagen Psychosocial Questionnaire was adapted and evaluated. Its contents were first validated with a panel of experts. Afterwards a semantic adaptation of the questionnaires was carried out applying it to a pilot sample. Finally, it was applied to 1,557 workers (65% men). RESULTS: A preliminary questionnaire containing 97 questions was constructed. A good item-test correlation was found, the factorial structure was similar to the original questionnaire and it had a good internal consistency, convergent validity with the Goldberg Health Questionnaire and test-retest correlation. Ranges for the different dimensions and sub-dimensions of psychosocial risk were calculated by tertiles. CONCLUSIONS: The resulting questionnaire is useful for measuring psychosocial risk factors at work, with good psychometric properties.

Caries and fluorosis in the Santiago metropolitan region in Chile: The impact of the fluoridation of the water / Cárie e fluorose na região metropolitana de Santiago, Chile: impacto da fluoretação da água

PURPOSE: To assess the damage and the prevalence of caries and fluorosis in children and adolescents in the metropolitan area after 8 years of drinking water fluoridation and to compare them with the baseline study. METHODS: This was a prevalence study. The sample was selected using two-step probability sampling and stratified according to socioeconomic level. Subjects included 2,323 schoolchildren aged 6 to 8 years and 12 years living within the metropolitan region. The parents of all students provided consent and were previously included in the study. The subjects were clinically examined by calibrated dentists, who used World Health Organization (WHO) screening criteria and indicators to determine the presence of caries and dental fluorosis. RESULTS: No cavity damage was found in 23.68 percent of the children. The average dmft was 3.18 for children aged 6 to 8 years. The DMFT was 0.59 in children aged 6 to 8 years and 2.6 in children 12 years compared with the baseline study. These differences were statistically significant. There were also significant differences in the DMFT index for each socioeconomic status group. The average number of dams was higher among children of low socioeconomic status. Of the studied children, 14.3 percent of children had dental fluorosis. Fluorosis was very mild in 12.35 percent of the cases, mild in 1.98 percent and moderate in 0.26 percent. There were no cases of severe fluorosis (classified according to Dean's index). CONCLUSION: We conclude that after 8 years drinking water fluoridation in the metropolitan area, the number of children with no history of caries has increased by approximately 100 percent. The number of cases significantly affected by caries has also decreased significantly. The incidence of dental fluorosis has increased, but to milder degrees.

OBJETIVO: Avaliar o dano e a prevalência de cárie e fluorose em crianças e adolescentes na região metropolitana do Chile, após oito anos de fluoretação da água potável, em comparação com o estudo de base em 1996. METODOLOGIA: Desenho: estudo de prevalência. A amostra probabilística, estratificada por nível socioeconômico, constituiu-se de 2.323 escolares de 6-8 e 12 anos na Região Metropolitana. Todos os alunos foram clinicamente examinados por dentistas calibrados, utilizando critérios de seleção e indicadores propostos pela OMS para determinar cárie e fluorose dentária. RESULTADOS: Cerca de 24 por cento das crianças estavam livres de cáries. A média de CPOD foi de 3,18 em escolares de 6 a 8 anos. O CPOD foi de 0,59 em crianças de 6 a 8 anos e de 2,6 em crianças de 12 anos em relação ao estudo de base, sendo essas diferenças estatisticamente significativas. Houve diferenças significativas devido ao nível socioeconômico, sendo que os valores médios foram maiores em crianças de baixo nível socioeconômico. Cerca de 14 por cento das crianças apresentaram fluorose dentária, em geral de grau muito leve. CONCLUSÃO: Após 8 anos de fluoretação da água potável na região metropolitana, observou-se um aumento de 100 por cento de crianças sem história de cárie e significativa diminuição de danos. A fluorose dentária aumentou, mas em graus mais leves.

Clinical attachment loss in Chilean adult population: First Chilean National Dental Examination Survey.

BACKGROUND: Data from national surveys regarding the periodontal status of the adult population in Latin America are scarce. The aim of this study assesses the prevalence and extension of clinical attachment loss (AL) in the adult population of Chile. Age, sex, and sociodemographic and behavioral differences in the prevalence of clinical AL are also examined. METHODS: A stratified, multistage probability design formula was used to separate the adult Chilean population into two age cohorts. The first group consisted of 1,092 young adults (age range: 35 to 44 years), and the second group consisted of 469 adult seniors (age range: 65 to 74 years). All subjects were examined to measure clinical AL. The research also included an evaluation, conducted through oral interviews, of social and health aspects of the subjects. Clinical AL was measured in all teeth surfaces, excluding third molars. Results were analyzed using a multivariable model and logistic regression. RESULTS: A total of 93.45% of the young adults had ≥ 1 site with clinical AL >3 mm compared with 97.58% of the adult seniors, with an average of 6.51 and 15.81 missing teeth, respectively (P <0.05). The number of sites with severe clinical AL (>6 mm) was 38.65% in young adults and 69.35% in senior adults (P <0.05). Clinical AL was significantly higher in males than in females (P <0.05). The multivariate analyses identified that the main risk indicators for clinical AL >6 mm in ≥ 1 site were: age (65 to 74 years), sex (male) low education level (

Valvuloplastía mitral percutánea: experiencia del Hospital San Juan de Dios / Percutaneous mitral valvuloplasty: the San Juan de Dios Hospital experience

Objetivo: Evaluar los resultados alejados de la valvuloplastía mitral percutánea (VMP), y analizar los factores asociados con eventos y reestenosis tardía. Métodos y resultados: De 252 VPM realizadas entre diciembre de 1987 y diciembre de 2006, 245 pacientes tuvieron un mínimo de 6 meses de seguimiento y evaluación ecocardiográfica antes y después del procedimiento (97 por ciento). La edad media fue de 46,3 +/- 11,37 años, las mujeres fueron 83,6 por ciento. La media de seguimiento fue de 35,25 +/- 28,84 meses, rango 6-132. La muerte cardiovascular, y el reemplazo de la válvula mitral o una segunda VMP fueron considerados como marcadores de peor resultado. El área de la válvula mitral aumentó de 1,0 +/- 0,17 cm2 a 1,71 +/- 0,31 cm2 (p <0,0001) después del procedimiento. Durante el seguimiento, 53 pacientes (21,6 por ciento) presentaron reestenosis, que fue predicha por un Score de Wilkins > 8 (p = 0,03). Cinco pacientes fallecieron (2,04 por ciento), 22 (8,9 por ciento) requirieron reemplazo de la válvula mitral y 11 (4,5 por ciento) una segunda VMP. No encontramos variables clínicas o ecocardiográficas capaces de predecir estos eventos. Conclusiones La VMP tuvo una tasa aceptable de complicaciones atribuibles al procedimiento. Las características ecocardiográficas de la válvula mitral se correlacionaron con la reestenosis. La incidencia de eventos tardíos es baja.

Objective: To evalúate the long-term results of percutaneous mitral valvuloplasty (PMV), and analyze the factors associated with restenosis and late events. Methods and results: Of 252 PMV performed between December 1987 and December 2006, 245 patients with a minimum of 6 months follow-up and echocardiographic evaluation before and after the procedure, were selected for long-term follow-up (97 percent). The mean age was 46.3 +/- 11.37 years old, 83.6 percent women. The mean follow-up was 35.25 +/- 28.84 months, range 6-132. Cardiovascular death, and mitral valve replacement or second PMV, were considered as markers of worst outcome. The mitral valve area increased from 1.0+/-0.17cm2 to 1.71 +/- 0.31 cm2 (p <0.0001) after the first procedure. During follow up, 53 patients (21.6 percent) developed restenosis, which was predicted by a Wilkins score > 8 (p = 0.03). Five (2.04 percent) patients died. Twenty-two (8.9 percent) required mitral valve replacement and 11(4.5 percent) a second PMV. We found that no clinical or echocardiographic variables were able to predict these events. Conclusions: PMV had an acceptable rate of complications attributable to the procedure. The echocardiographic characteristics of the mitral valve correlated with restenosis. The incidence of late events is low.

Aplicación de un sistema de análisis de peligros y control de puntos críticos en la nutrición enteral administrada en la unidad de cuidados intensivos / Application of a hazard analysis control of critical points on the enteral feeding administered at the intensive care unit

Se aplicó un sistema de Análisis de Peligros y Control de Puntos Críticos (HACCP) en la administración de la nutrición enteral (NE) en la Unidad de Cuidados Intensivos (UCI) de un Hospital de alta complejidad, con la colaboración del personal que trabaja en la UCI, para garantizar la seguridad de la calidad en la preparación, almacenamiento y entrega de la nutrición enteral a pacientes hospitalizados. Se estudiaron los métodos de rutina de preparación de la nutrición enteral, su almacenamiento y entrega a pacientes y se realizó un diagrama de flujo del proceso de administración de la fórmula de NE, luego, se identificaron los peligros y se evaluó su gravedad. Se determinaron los Puntos Críticos de Control (PCC) y se establecieron los criterios de control. La abertura del envase de la Fórmula Enteral (FE) y la introducción del equipo de infusión a la FE constituyen los únicos PCC cuando se manipula una FE lista para colgar. Se monitorearon y se aplicaron límites críticos y medidas correctivas para cada uno de los PCC del proceso. Además, se tomaron muestras para realizar un análisis para medir la calidad microbiológica del producto en cada PCC del proceso y se controló su temperatura ambiental. El análisis estadístico del recuento bacteriano de Aerobios Mesófilos (RAM) y Coliformes totales (CT) al tiempo 0 y 48 horas señala que no existen diferencias estadísticamente significativas en el nivel RAM y CT (p<0,05) en esos tiempos de estudio. La aplicación del sistema HACCP en la manipulación de la FE listas para usar en pacientes hospitalizados en la UCI, demuestra que es un sistema eficaz que permite garantizar en forma efectiva y segura el empleo de NE en pacientes hospitalizados.

A Hazard Analysis and Control of Critical Points (HACCP) was applied to enteral nutrition (EN) at the Intensive Care Unit (ICU) in a highly complex Hospital, with the collaboration of personnel working at the ICU to guarantee the certainty of the quality in the preparation, storage and delivery of enteral feeding solutions to hospitalized patients. Routine methods of food preparation, storage and delivery to patients were studied and a flux diagram of the process of the administration of the EN formula was draw; later, hazards were identified and their seriousness was evaluated. Critical Controls Points (CCP) were determined, and control criteria were established. The opening of the EN container and the introduction of infusion equipment are the only Critical Control Points (CCP) when a ready-to-hang EN preparation is manipulated. Critical limits and correction measures were monitored and applied for each of the CCP of the process. Moreover, samples were taken to analyze and measure the microbiologic quality of the product at each CCP of the process and room temperature was controlled. The statistical analysis of bacteria recount on enteral food shows that there are no statistically significant differences at RMA and TC levels (p<0.05).

[Effects of TeenSTAR, an abstinence only sexual education program, on adolescent sexual behavior]. / TeenSTAR: una opción de madurez y libertad: programa de educación integral de la sexualidad, orientado a adolescentes.

BACKGROUND: Urgent measures are required to stop the increase in the frequency of pregnancies and sexually transmitted diseases among teenagers. A means of facing this problem is promoting sexual abstinence among youngsters. There are studies that confirm the efficacy of this approach. AIM: To show the results of the application of a holistic sexuality program (TeenSTAR) among Chilean teenagers. SUBJECTS AND METHODS: Students attending basic or high school were divided into a control or study group. The control group (342 students) received the usual education on sexuality given by their schools and the study group (398 students) participated in twelve TeenSTAR sessions lasting 1.5 hours each, given by a trained professor. Assessment of achievements was made using an anonymous questionnaire answered at the start and end of the program. RESULTS: The rates of sexual initiation among control and study groups were 15 and 6.5%, respectively. Among sexually active students, 20% of those in the study group and 9% of those in the control group discontinued sexual activity. CONCLUSIONS: A higher proportion of students in the TeenSTAR program retarded their sexual initiation or discontinued sexual activity and found more reasons to maintain sexual abstinence than control students.

TeenSTAR: una opción de madurez y libertad. Programa de educación integral de la sexualidad, orientado a adolescentes / Effects of Teenstar, an abstinence only sexual education program, on adolescent sexual behavior

Background: Urgent measures are required to stop the increase in the frequency of pregnancies and sexually transmitted diseases among teenagers. A means of facing this problem is promoting sexual abstinence among youngsters. There are studies that confirm the efficacy of this approach. Aim: To show the results of the application of a holistic sexuality program (TeenSTAR) among Chilean teenagers. Subjects and Methods: Students attending basic or high school were divided into a control or study group. The control group (342 students) received the usual education on sexuality given by their schools and the study group (398 students) participated in twelve TeenSTAR sessions lasting 1.5 hours each, given by a trained professor. Assessment of achievements was made using an anonymous questionnaire answered at the start and end of the program. Results: The rates of sexual initiation among control and study groups were 15 and 6.5%, respectively. Among sexually active students, 20% of those in the study group and 9% of those in the control group discontinued sexual activity. Conclusions: A higher proportion of students in the TeenSTAR program retarded their sexual initiation or discontinued sexual activity and found more reasons to maintain sexual abstinence than control students.

Adolescent pregnancy prevention: An abstinence-centered randomized controlled intervention in a Chilean public high school.

PURPOSE: To evaluate the efficacy of an abstinence-centered sex education program in adolescent pregnancy prevention, the TeenSTAR Program was applied in a high school in Santiago, Chile. METHODS: A total of 1259 girls from a Santiago high school were divided into three cohorts depending on the year they started high school: the 1996 cohort of 425 students, which received no intervention; the 1997 cohort, in which 210 students received an intervention and 213 (control group) did not; and the 1998 cohort, in which 328 students received an intervention and 83 (control group) did not. Students were randomly assigned to control and intervention groups in these cohorts, before starting with the program. We conducted a prospective, randomized study using the application of the TeenSTAR sex education program during the first year of high school to the intervention groups in the 1997 and 1998 cohorts. All cohorts were followed up for 4 years; pregnancy rates were recorded and subsequently contrasted in the intervention and control groups. Pregnancy rates were measured and Risk Ratio with 95% confidence interval were calculated for intervention and control groups in each cohort. RESULTS: Pregnancy rates for the intervention and control groups in the 1997 cohort were 3.3% and 18.9%, respectively (RR: 0.176, CI: 0.076-0.408). Pregnancy rates for the intervention and control groups in the 1998 cohort were 4.4% and 22.6%, respectively (RR 0.195, CI: 0.099-0.384). CONCLUSIONS: The abstinence-centered TeenSTAR sex education intervention was effective in the prevention of unintended adolescent pregnancy.

Alterations of rat liver mitochondrial oxidative phosphorylation and calcium uptake by benzo[a]pyrene.

We report that oxidative phosphorylation and Ca2+ uptake processes are enhanced in liver mitochondria isolated from benzo[a]pyrene (B[a]P)-treated rats. The carcinogen did not affect either the respiratory control index or the Ca2+ control ratio. B[a]P treatment increased the oxidation rate of several substrates that donate electrons at the level of all three coupling sites, either the ADP- or Ca2+-stimulated rates or those observed after ADP or Ca2+ exhaustion. However, the efficiency of energy coupling was maintained because both ADP/O and Ca2+/site ratios remained unchanged. The electron flow through NADH-oxidase, NADH-duroquinone reductase, NADH-juglone reductase, NADH-cytochrome c reductase, succinate-cytochrome c reductase, and cytochrome c oxidase was enhanced by B[a]P; however, succinate dehydrogenase activity was not affected. All these effects depended on the time post B[a]P administration, with a greater increase close to 48 h after administration of the carcinogen. The contents of cytochromes b, c1, and a + a3 from liver mitochondria, especially those isolated 48 h after B[a]P, were also significantly increased, although cytochrome c levels was just lightly increased 24 h after B[a]P treatment. These results suggest that B[a]P treatment stimulates mitochondrial respiration by increasing the level of several components of the mitochondrial respiratory chain. This may reflect mitochondrial adaptation to the cellular energy requirements of cell division in the neoplastic transformation process.

[The effect of psychosocial variables during pregnancy and in birth weight and gestational age of the newborn]. / El efecto de variables psicosociales durante el embrazo, en el peso y la edad gestacional del recién nacido.

BACKGROUND: Psychosocial events experienced by pregnant women could have an effect on the newborn. AIM: To study the effects of psychosocial events during pregnancy on the birth weight and gestational age of the newborn. MATERIAL AND METHODS: One hundred ninety two pregnant women, coming from urban and rural areas, were interviewed at about 35 weeks of gestation. Information from the obstetrical chart was obtained and different inquiries were applied, about personal history, socioeconomic level, emotional state, vital events, family and social support. RESULTS: Fifty six percent of interviewed women did not plan their pregnancy, 32% considered their pregnancy as a negative event in their life, 62% had symptoms of emotional distress and 81% were unsatisfied with the social support that were receiving. When psychosocial factors were included in the multiple regression analyses, their predictive power for birth weight and gestational age improved. Including these variables, the R2 for birth weight was 0.22 and for gestational age, 0.18. CONCLUSIONS: Psychosocial factors during pregnancy are important predictors of birth weight and gestational age of the newborn. Measures should be taken to reduce the impact of these factors on the product of pregnancy.

Morbilidad consultada por adolescentes en atención primaria / Consulted morbidity by adolescents in primary care

Se analiza la estructura de los grupos de diagnósticos y dianósticos específicos, en las consultas realizadas por una población de 15 a 19 años, durante un año, en 5 consultorios del Servicio de Salud Metropolitana Occidente. Estas anteciones de salud corresponden a 6,1% del total otorgado en el programa del adulto con un rango de 10% a 2,8%. Las consultas disminuyen de los 15 a los 19 años de 20% a 16%. Los adolescentes consultan principalmente por enfermedades infecciosas y parasitarias, respiratorias, y mentales, osteomusculares, digestivas. No se observan diferencias importantes en cada edad. Las causas específicas más frecuentes corresponden a neurosis, virosis respiratorias, bronquitis, discopatías y colon irritable. En este análisis conviene tener presente que el enfoque anamnéstico, diagnóstico y terapéutico es diferente si la atención del adolescente la realiza un médico de adultos o un pediatra, y ello debe influir en la estructura de las consultas por causas