[The coverage gap for mental health disosrders in the primary healthcare level of the city of Cordoba, Argentina].

UNLABELLED: Many individuals with behavioral and mental health disorders do not receive care in specialized mental health services. These individuals could potentially be identified and managed in the primary healthcare level. OBJECTIVE: To analyze the coverage gap on mental health disorders in the primary healthcare level of Córdoba city, Argentina. METHODOLOGY: Stratified multistage random sample of individuals 19 to 69 years of age seeking care in primary healthcare centers of the public health system in Córdoba city. Presence of behavioral and mental health disorder and receiving healthcare through mental health services were assesed using CIDI 3.0. Data were analyzed using descriptive statistics. RESULTS: A total of 1,067 individuals were included in the present analysis. Overall, 20.15% of individuals included in the analysis had behavioral and mental health disorders during the last year, of whom 77.33% did not receive care through mental health services. DISCUSSION AND CONCLUSION: The proportion of individuals with behavioral and mental health disorders and of those who did not receive care through mental health services are similar to those observed in other Latin American countries, but higher than those reported in Europe. This communication gives preliminary results about the coverage gap on mental health disorders present in the primary healthcare level in Cordoba city. These individuals may benefit from interventions aimed to identify and manage those with mental health disorders in the primary healthcare level.

[Psychometric properties and reliability of the general health questionnaire(GHQ-12) for adult patients in primary care centers in Cordoba, Argentina].

INTRODUCTION: The General Health Questionnaire (GHQ-12) is a commonly used instrument to screen for psychiatric distress. However, the psychometric properties and reliability of the GHQ-12 in Argentina and, more specifically, in the city of Cordoba, have not previously been studied. OBJECTIVE: To assess the psychometric properties and reliability of GHQ-12 in adult consultants of primary care in Cordoba, Argentina. METHODS: Using probabilistic sampling in primary care centers in the city of Cordoba, a cross-sectional study was conducted. The Spanish version of the GHQ-12 was administered. The psychometric properties, including internal consistency and factor structure, for the Spanish version of the GHQ-12 were measured. RESULTS: 854 primary care consultants were included in the study. The questionnaire had high internal consistency, with a Cronbach's alpha of 0.80. An exploratory factor analysis suggested a two-factor model, similar to what has been reported for the original questionnaire. CONCLUSIONS: The GHQ-12 showed good psychometric properties and reliability in the studied population.

Relationship between academic performance, psychological well-being, and coping strategies in medical students.

INTRODUCTION: Academic performance is a product of the complex environment that surrounds the student, shaped by aspects such as intensity of study, motivation and context of relationships, which affect the academic achievement of individuals. There may be other psychological or emotional factors, such as anxiety, level of psychological well-being, and behavior strategies for effective adaptation to concrete environment demands and their associated emotional stress. OBJECTIVES: This research study aims at determining the level of psychological well-being and coping strategies in students of the Basic Common Cycle of studies leading to an MD degree in the School of Medicine of the National University of Córdoba, Argentina. METHODS AND MATERIALS: This is an observational study based on a "Questionnaire on determiners of academic performance", that was answered by 374 students. Data was processed using statistical bivariate analysis (p< 0.05) and multiple correspondence factorial analysis. RESULTS: Students with "VG/G (Very Good/Good) performance" show high levels of satisfaction and well-being use direct coping strategies which lead them to "cope with problematic situations" by means of "problem solving". Students with "R/I (Regular/Insufficient) academic performance" declare "dissatisfaction with most aspects of their personalities", feel unable to give a satisfactory response to environment demands, and assume "avoidance behaviors" as coping strategies. CONCLUSIONS: Student academic performance is associated with psychological well-being, feeling of satisfaction with achievements, and coping with stressful situations.

Introducción: El rendimiento académico es producto del complejo mundo que envuelve al estudiante, determinado por aspectos cotidianos (intensidad de estudio, motivación y medio relacional) que afectan el desempeño académico de los individuos. Otros factores pueden ser psicológicos o emocionales tales como la ansiedad, el grado de bienestar psicológico y las estrategias conductuales tendientes a lograr una adaptación efectiva a las demandas concretas del ambiente y al estrés emocional asociado. Objetivos: En esta investigación se propuso identificar el nivel de bienestar psicológico y las estrategias de afrontamiento en los estudiantes del Ciclo Básico de la Carrera de Medicina y analizar la relación entre bienestar, afrontamiento y rendimiento académico. Material y método: Es un estudio observacional el cual se trabajó a partir del "Cuestionario Determinantes relacionados con el rendimiento académico" implementado a 374 alumnos. El análisis de los datos se efectuó a través del procesamiento estadístico con análisis bivariado (p<0,05) y análisis factorial de correspondencia múltiple. Resultados: Los alumnos con "Rendimiento MB/B" presentan altos niveles de satisfacción y bienestar utilizando un afrontamiento directo que contribuye a "enfrentar las situaciones que preocupan" mediante la "solución de problemas". En tanto que los alumnos con "Rendimiento R/I" perciben "disgusto con la mayoría de los aspectos de su personalidad" sintiéndose impedidos para responder satisfactoriamente a las demandas del ambiente, asumiendo "comportamientos de evitación" como forma de afrontamiento. Conclusiones: El rendimiento académico de los estudiantes se asocia con la presencia de bienestar psicológico, satisfacción con respecto a los logros alcanzados y el afrontamiento de situaciones estresoras.

Consumo de sustancias y escuela: un estudio en adolescentes escolarizados de Córdoba / Substance use and school: a study in adolescent students in Cordoba

En esta investigación se propuso identificar el consumode sustancias psicoactivas según tipo de colegio y describir elconsumo según jornada de estudio, sexo, exigencia académicay disciplina escolar. Es un estudio es observacional y analítico.Se trabajó a partir de la Segunda Encuesta Nacional aEstudiantes de Enseñanza Media. El análisis descriptivo seefectuó a partir de las medidas de resumen, el exploratorioa través del procesamiento estadístico con análisis bivariado(p<0,05) y análisis factorial de correspondencia múltiple.Se identificó que fuman más cigarrillos los estudiantes queasisten a escuelas públicas que a escuelas privadas, quemayor es el riesgo de consumo de marihuana y cocaína en losalumnos que asisten a escuelas públicas que en privadas, quemenor es el consumo de sustancias en el turno matutino y que el consumo de alguna sustancia ilícita se asocia a problemas de comportamiento y repitencia escolar.

The objective of this study was to identify the use of psychoactive substances according to school type and describe consumption in relation to school shift, sex, school discipline and academic demand. Observational and analytical study based on the Second National Survey of High School Students. Descriptive analysis was based on summary measures, exploratory analysis lay on statistics processing with bivariate analysis (p<0,05) and multiple correspondence factor analysis. It was found out that students attending publicschools smoke cigarettes more than those at private schools, that the risk of marijuana and cocaine consumption is greater at public than at private schools, that there is lesssubstance consumption in the morning shift and, that consumption of illegal substances is associated with behavioral problems and school repetition.

Análisis y distribución espacial de la vulnerabilidad social en la prov. de Salta, Argentina / Analysis and spatial distribution of social vulnerability in the province of Salta, Argentina

A lo largo de su historia, la provincia de Salta ha sido afectada por distintos tipos de desastres, siendo aquellos de origen hidrometeorológico los más predominantes. Se acepta que para que se produzca una situación de desastre, una amenaza debe operar sobre una comunidad en situación de vulnerabilidad, esto es el grado de exposición de una familia o una comunidad, dada la probabilidad de ocurrencia de un peligro potencialmente dañino, y la insuficiencia o incapacidad de protegerse.Se realizó un análisis descriptivo de la base de datos correspondiente a los datos de la provincia de Salta del Censo Nacional de Población y Vivienda del año 2001, procesados a través de Redatam + SP Process. Se construyeron índices de acuerdo a la metodología empleada por Melina Con, a partir de las dimensiones: hacinamiento del hogar, calidad de los materiales de la vivienda, carga de dependencia sobre los perceptores de ingresos, las posibilidades de acceso al sistema de salud, y aspectos educativos del hogar. Los resultados obtenidos dan cuenta de que las zonas más alejadas a la región centro son las más postergadas y fundamentalmente los departamentos de la región este de la provincia de Salta. Se destaca la cantidad de hogares que acumulan 2 o más dimensiones de vulnerabilidad.

Throughout its history, Salta has been affected by several disasters, hydrometeorological ones have been the most prevalent. It is accepted that for a disaster situation to happen, a threat must operate on a vulnerable community; i.e., the degree of exposure of a family or a community in case of harmful hazards, and their failure or inability to protect themselves.We performed a descriptive analysis of the database corresponding to the information about the province of Salta gathered through the National Census of Population and Housing 2001, processed with Redatam + SP Process. Indexes were made according to the methodology employed by Melina Con, based on sizes: overcrowding, quality of building materials, dependency burden on income earners, access to health care, and learning aspects of the home. Results show that the furthest areas from the central region are the most neglected ones, mainly those in the eastern area of the province of Salta. An important number of households accumulate 2 or more dimensions of vulnerabilit.

Relationship between academic performance, psychological well-being, and coping strategies in medical students / Relationship between academic performance, psychological well-being, and coping strategies in medical students.

INTRODUCTION: Academic performance is a product of the complex environment that surrounds the student, shaped by aspects such as intensity of study, motivation and context of relationships, which affect the academic achievement of individuals. There may be other psychological or emotional factors, such as anxiety, level of psychological well-being, and behavior strategies for effective adaptation to concrete environment demands and their associated emotional stress. OBJECTIVES: This research study aims at determining the level of psychological well-being and coping strategies in students of the Basic Common Cycle of studies leading to an MD degree in the School of Medicine of the National University of Córdoba, Argentina. METHODS AND MATERIALS: This is an observational study based on a "Questionnaire on determiners of academic performance", that was answered by 374 students. Data was processed using statistical bivariate analysis (p< 0.05) and multiple correspondence factorial analysis. RESULTS: Students with "VG/G (Very Good/Good) performance" show high levels of satisfaction and well-being use direct coping strategies which lead them to "cope with problematic situations" by means of "problem solving". Students with "R/I (Regular/Insufficient) academic performance" declare "dissatisfaction with most aspects of their personalities", feel unable to give a satisfactory response to environment demands, and assume "avoidance behaviors" as coping strategies. CONCLUSIONS: Student academic performance is associated with psychological well-being, feeling of satisfaction with achievements, and coping with stressful situations.

Relationship between academic performance, psychological well-being, and coping strategies in medical students. / Relationship between academic performance, psychological well-being, and coping strategies in medical students.

INTRODUCTION: Academic performance is a product of the complex environment that surrounds the student, shaped by aspects such as intensity of study, motivation and context of relationships, which affect the academic achievement of individuals. There may be other psychological or emotional factors, such as anxiety, level of psychological well-being, and behavior strategies for effective adaptation to concrete environment demands and their associated emotional stress. OBJECTIVES: This research study aims at determining the level of psychological well-being and coping strategies in students of the Basic Common Cycle of studies leading to an MD degree in the School of Medicine of the National University of Córdoba, Argentina. METHODS AND MATERIALS: This is an observational study based on a "Questionnaire on determiners of academic performance", that was answered by 374 students. Data was processed using statistical bivariate analysis (p< 0.05) and multiple correspondence factorial analysis. RESULTS: Students with "VG/G (Very Good/Good) performance" show high levels of satisfaction and well-being use direct coping strategies which lead them to "cope with problematic situations" by means of "problem solving". Students with "R/I (Regular/Insufficient) academic performance" declare "dissatisfaction with most aspects of their personalities", feel unable to give a satisfactory response to environment demands, and assume "avoidance behaviors" as coping strategies. CONCLUSIONS: Student academic performance is associated with psychological well-being, feeling of satisfaction with achievements, and coping with stressful situations.

Consumo de sustancias y escuela: un estudio en adolescentes escolarizados de Córdoba / Substance use and school: a study in adolescent students in Cordoba

En esta investigación se propuso identificar el consumode sustancias psicoactivas según tipo de colegio y describir elconsumo según jornada de estudio, sexo, exigencia académicay disciplina escolar. Es un estudio es observacional y analítico.Se trabajó a partir de la Segunda Encuesta Nacional aEstudiantes de Enseñanza Media. El análisis descriptivo seefectuó a partir de las medidas de resumen, el exploratorioa través del procesamiento estadístico con análisis bivariado(p<0,05) y análisis factorial de correspondencia múltiple.Se identificó que fuman más cigarrillos los estudiantes queasisten a escuelas públicas que a escuelas privadas, quemayor es el riesgo de consumo de marihuana y cocaína en losalumnos que asisten a escuelas públicas que en privadas, quemenor es el consumo de sustancias en el turno matutino y que el consumo de alguna sustancia ilícita se asocia a problemas de comportamiento y repitencia escolar.(AU)

The objective of this study was to identify the use of psychoactive substances according to school type and describe consumption in relation to school shift, sex, school discipline and academic demand. Observational and analytical study based on the Second National Survey of High School Students. Descriptive analysis was based on summary measures, exploratory analysis lay on statistics processing with bivariate analysis (p<0,05) and multiple correspondence factor analysis. It was found out that students attending publicschools smoke cigarettes more than those at private schools, that the risk of marijuana and cocaine consumption is greater at public than at private schools, that there is lesssubstance consumption in the morning shift and, that consumption of illegal substances is associated with behavioral problems and school repetition.(AU)

Análisis y distribución espacial de la vulnerabilidad social en la prov. de Salta, Argentina / Analysis and spatial distribution of social vulnerability in the province of Salta, Argentina

A lo largo de su historia, la provincia de Salta ha sido afectada por distintos tipos de desastres, siendo aquellos de origen hidrometeorológico los más predominantes. Se acepta que para que se produzca una situación de desastre, una amenaza debe operar sobre una comunidad en situación de vulnerabilidad, esto es el grado de exposición de una familia o una comunidad, dada la probabilidad de ocurrencia de un peligro potencialmente dañino, y la insuficiencia o incapacidad de protegerse.Se realizó un análisis descriptivo de la base de datos correspondiente a los datos de la provincia de Salta del Censo Nacional de Población y Vivienda del año 2001, procesados a través de Redatam + SP Process. Se construyeron índices de acuerdo a la metodología empleada por Melina Con, a partir de las dimensiones: hacinamiento del hogar, calidad de los materiales de la vivienda, carga de dependencia sobre los perceptores de ingresos, las posibilidades de acceso al sistema de salud, y aspectos educativos del hogar. Los resultados obtenidos dan cuenta de que las zonas más alejadas a la región centro son las más postergadas y fundamentalmente los departamentos de la región este de la provincia de Salta. Se destaca la cantidad de hogares que acumulan 2 o más dimensiones de vulnerabilidad.(AU)

Throughout its history, Salta has been affected by several disasters, hydrometeorological ones have been the most prevalent. It is accepted that for a disaster situation to happen, a threat must operate on a vulnerable community; i.e., the degree of exposure of a family or a community in case of harmful hazards, and their failure or inability to protect themselves.We performed a descriptive analysis of the database corresponding to the information about the province of Salta gathered through the National Census of Population and Housing 2001, processed with Redatam + SP Process. Indexes were made according to the methodology employed by Melina Con, based on sizes: overcrowding, quality of building materials, dependency burden on income earners, access to health care, and learning aspects of the home. Results show that the furthest areas from the central region are the most neglected ones, mainly those in the eastern area of the province of Salta. An important number of households accumulate 2 or more dimensions of vulnerabilit.(AU)

El metodo de estudio de casos: una modalidad que genera practicas docentes diferentes en la enseñanza de la medicina / A method that creates different teaching practices in medical education

En el contexto de reforma curricular que la Facultad deCiencias Médicas lleva adelante y como una forma de mejorare innovar las prácticas docentes, la cátedra de Dermatologíadiseñó, para el año 2005, una propuesta pedagógica basada enel estudio de casos. Esta modalidad se implementó con 70alumnos de cuarto año de la carrera de Medicina.La decisión de este método se debe a la necesidad de plantearun eje diferente en las prácticas docentes, no se trata de exposiciónpor parte del docente y de un papel pasivo por parte del alumno,sino que se procura generar un pensamiento de orden superior,que según Sanjurjo (2003) implica juicio y razonamiento.

El metodo de estudio de casos: una modalidad que genera practicas docentes diferentes en la enseñanza de la medicina / A method that creates different teaching practices in medical education

En el contexto de reforma curricular que la Facultad deCiencias Médicas lleva adelante y como una forma de mejorare innovar las prácticas docentes, la cátedra de Dermatologíadiseñó, para el año 2005, una propuesta pedagógica basada enel estudio de casos. Esta modalidad se implementó con 70alumnos de cuarto año de la carrera de Medicina.La decisión de este método se debe a la necesidad de plantearun eje diferente en las prácticas docentes, no se trata de exposiciónpor parte del docente y de un papel pasivo por parte del alumno,sino que se procura generar un pensamiento de orden superior,que según Sanjurjo (2003) implica juicio y razonamiento.(AU)

Studies of membrane fluidity and heart contractile force in Trypanosoma cruzi infected mice

In Chagas disease serious cardiac dysfunction can appear. We specifically studied the cardiac function by evaluating: ventricle contractile force and norepinephrine response, affinity and density of beta-adrenergic receptors, dynamic properties of myocardial membranes, and electrocardiography. Albino swiss mice (n = 250) were infected with 55 trypomastigotes, Tulahuen strain and studied at 35, 75, and 180 days post-infection, that correspond to the acute, indeterminate, and chronic phase respectively. Cardiac beta-adrenergic receptors' affinity, myocardial contractility, and norepinephrine response progressively decreased from the acute to the chronic phase of the disease (p < 0.01). The density (expressed as fmol/mg.prot) of the receptors was similar to non-infected mice (71.96 ± 0.36) in both the acute (78.24 ± 1.67) and indeterminate phases (77.28 ± 0.91), but lower in the chronic disease (53.32 ± 0.71). Electrocardiographic abnormalities began in the acute phase and were found in 65 percent of the infected-mice during the indeterminate and chronic phases. Membrane contents of triglycerides, cholesterol, and anisotropy were similar in all groups. A quadratic correlation between the affinity to beta-adrenergic receptors and cardiac contractile force was obtained. In conclusion the changes in cardiac beta-adrenergic receptors suggests a correlation between the modified beta-adrenergic receptors affinity and the cardiac contractile force.

Studies of membrane fluidity and heart contractile force in Trypanosoma cruzi infected mice.

In Chagas disease serious cardiac dysfunction can appear. We specifically studied the cardiac function by evaluating: ventricle contractile force and norepinephrine response, affinity and density of beta-adrenergic receptors, dynamic properties of myocardial membranes, and electrocardiography. Albino swiss mice (n = 250) were infected with 55 trypomastigotes, Tulahuen strain and studied at 35, 75, and 180 days post-infection, that correspond to the acute, indeterminate, and chronic phase respectively. Cardiac beta-adrenergic receptors' affinity, myocardial contractility, and norepinephrine response progressively decreased from the acute to the chronic phase of the disease (p < 0.01). The density (expressed as fmol/mg.prot) of the receptors was similar to non-infected mice (71.96 +/- 0.36) in both the acute (78.24 +/- 1.67) and indeterminate phases (77.28 +/- 0.91), but lower in the chronic disease (53.32 +/- 0.71). Electrocardiographic abnormalities began in the acute phase and were found in 65% of the infected-mice during the indeterminate and chronic phases. Membrane contents of triglycerides, cholesterol, and anisotropy were similar in all groups. A quadratic correlation between the affinity to beta-adrenergic receptors and cardiac contractile force was obtained. In conclusion the changes in cardiac beta-adrenergic receptors suggests a correlation between the modified beta-adrenergic receptors affinity and the cardiac contractile force.

Trypanocidal effects of promethazine

Promethazine is currently used for its antipsychotic and ansiolytic effects. It is a phenothiazine with anticalmodulin action, not toxic for human beings at therapeutic dosis. The present results show that promethazine has trypanocidal effect on both epimastigote and trypomastigote stages of T. cruzi; two hundred muM inhibited epimastigote growth in culture medium and 2 muM immobilized and killed bloodstream trypomastigotes. When promethazine (55 mg/Kg/day) was used as treatment of T. cruzi infected mice, it proved effective in reducing parasitemia and it increased the survival of treated animals. Ultrastructural studies suggest that the lethal effect of this phenothiazine is related to a detergent effect that disrupts T. cruzi cell membrane.

Trypanocidal effects of promethazine

Promethazine is currently used for its antipsychotic and ansiolytic effects. It is a phenothiazine with anticalmodulin action, not toxic for human beings at therapeutic dosis. The present results show that promethazine has trypanocidal effect on both epimastigote and trypomastigote stages of T. cruzi; two hundred muM inhibited epimastigote growth in culture medium and 2 muM immobilized and killed bloodstream trypomastigotes. When promethazine (55 mg/Kg/day) was used as treatment of T. cruzi infected mice, it proved effective in reducing parasitemia and it increased the survival of treated animals. Ultrastructural studies suggest that the lethal effect of this phenothiazine is related to a detergent effect that disrupts T. cruzi cell membrane. (AU)

Cardiac beta receptors' density or affinity modified by different Trypanosoma cruzi amount

Chagas'disease presents complex physiopathogenic mechanism, many of them poorly understood, that in our country generally produce cardiac lesions. The acute phase related with the presence of the parasite is usually asymptomatic. This report studies if the amount of T. cruzi that induced acute infection could modify the myocardiopathy evolution. Previous works have shown that Albino Swiss mice inoculated with 45 tripomastigotes (AcL) presented alterations in the cardiac pharmacological response to adrenergic agonist and anatogonist studied at 30 days post-infection (p.i.). Mice inoculated with 7 x 10(4) parasites/animal showed similar behaviour at 7 days p.i. We studied the involvement of the affinity and density of cardiac beta receptors in both acute groups by binding with (3)H/DHA. The AcH group presented less cardiac beta receptors number (p<0.001), but their affinity was conserved. The AcL model presented significantly less affinity (p<0.01) but desinty, was not different from non infected animals. Beta receptors'affinity of both infected groups were similar, but AcH density was significantly diminished when compared with AcL. These studies demonstrates that the amount of T. cruzi received by the host determines and acelerates the evolution of the chagasic myocardiopathy.

Cardiac beta receptors density or affinity modified by different Trypanosoma cruzi amount

Chagasdisease presents complex physiopathogenic mechanism, many of them poorly understood, that in our country generally produce cardiac lesions. The acute phase related with the presence of the parasite is usually asymptomatic. This report studies if the amount of T. cruzi that induced acute infection could modify the myocardiopathy evolution. Previous works have shown that Albino Swiss mice inoculated with 45 tripomastigotes (AcL) presented alterations in the cardiac pharmacological response to adrenergic agonist and anatogonist studied at 30 days post-infection (p.i.). Mice inoculated with 7 x 10(4) parasites/animal showed similar behaviour at 7 days p.i. We studied the involvement of the affinity and density of cardiac beta receptors in both acute groups by binding with (3)H/DHA. The AcH group presented less cardiac beta receptors number (p<0.001), but their affinity was conserved. The AcL model presented significantly less affinity (p<0.01) but desinty, was not different from non infected animals. Beta receptorsaffinity of both infected groups were similar, but AcH density was significantly diminished when compared with AcL. These studies demonstrates that the amount of T. cruzi received by the host determines and acelerates the evolution of the chagasic myocardiopathy. (AU)