[Academic achievement, engagement and burnout among first year medical students]. / Relación entre el bienestar y el rendimiento académico en alumnos de primer año de medicina.

BACKGROUND: Stress may affect the sense of wellbeing and academic achievement of university students. AIM: To assess the relationship of academic engagement and burnout with academic achievement among first year medical students. MATERIAL AND METHODS: The Utrecht Work Engagement Scale-Student and Maslach Burnout Inventory Student Survey (MBI-SS) were applied to 277 first year medical students of four universities. Their results were correlated with the grades obtained in the different courses. RESULTS: Moderately high engagement and low burnout levels were detected. There was a high level of satisfaction with studies and a moderate exhaustion level. Academic achievement was associated with the degree of engagement with studies but not with burnout. Conglomerate analysis detected a group of students with high levels of wellbeing, characterized by high levels of academic engagement and low burnout. Other group had moderate levels of engagement and lack of personal fulfilment. Other group, identified as extenuated, had high levels of personal exhaustion and depersonalization. Finally the disassociated group had a low academic engagement, low emotional exhaustion, high levels of depersonalization and lack of personal fulfillment. CONCLUSIONS: Academic achievement is associated with the level of engagement with studies but not with burnout.

[An assessment of the Dundee Ready Education Environment Measure (DREEM) in Chilean university students]. / Estructura factorial de la escala DREEM en estudiantes de medicina chilenos.

BACKGROUND: The entry to a University requires an adaptation process that not all students solve with the same kind of success. Even though students social adaptation and emotional skills are essential, the educational environmental that they perceive has a significant influence in their academic life. AIM: To describe the changes in the perception about academic environment that medical students experience during the first three years of undergraduate career. MATERIAL AND METHODS: The Dundee Ready Education Environment Measure (DREEM) scale was applied to 525 first to third year medical students and an exploratory factorial analysis was made. RESULTS: Four factors were identified: Academic Perception: academic quality that students attribute to the process in which they take part, as well as to the assessment that they do of their learning outcomes (coefficient ± = 0.85); Academic Experience: refers to positive emotions that students experience during the career such as confidence, pleasure and energy (coefficient ± = 0.76); Atmosphere Perception, comfort and calm that students experiment during their academic activities (coefficient ± = 0.79); Teachers Perception: the perception that students have of teachers about their interest and disposition towards students (coefficient ± = 0.50). CONCLUSIONS: The assessment of academic environment quality is inversely associated with the lapse that the students have spent in their undergraduate careers.

Relación entre el bienestar y el rendimiento académico en alumnos de primer año de medicina / Academic achievement, engagement and burnout among first year medical students

Background: Stress may affect the sense of wellbeing and academic achievement of university students. Aim: To assess the relationship of academic engagement and burnout with academic achievement among first year medical students. Material and Methods: The Utrecht Work Engagement Scale-Student and Maslach Burnout Inventory Student Survey (MBI-SS) were applied to 277 first year medical students of four universities. Their results were correlated with the grades obtained in the different courses. Results: Moderately high engagement and low burnout levels were detected. There was a high level of satisfaction with studies and a moderate exhaustion level. Academic achievement was associated with the degree of engagement with studies but not with burnout. Conglomerate analysis detected a group of students with high levels of wellbeing, characterized by high levels of academic engagement and low burnout. Other group had moderate levels of engagement and lack of personal fulfilment. Other group, identified as extenuated, had high levels of personal exhaustion and depersonalization. Finally the disassociated group had a low academic engagement, low emotional exhaustion, high levels of depersonalization and lack of personal fulfillment. Conclusions: Academic achievement is associated with the level of engagement with studies but not with burnout.

Estructura factorial de la escala DREEM en estudiantes de medicina chilenos

Background: The entry to a University requires an adaptation process that not all students solve with the same kind of success. Even though students social adaptation and emotional skills are essential, the educational environmental that they perceive has a significant influence in their academic life. Aim: To describe the changes in the perception about academic environment that medical students experience during the first three years of undergraduate career. Material and Methods: The Dundee Ready Education Environment Measure (DREEM) scale was applied to 525 first to third year medical students and an exploratory factorial analysis was made. Results: Four factors were identified: Academic Perception: academic quality that students attribute to the process in which they take part, as well as to the assessment that they do of their learning outcomes (coefficient ± = 0.85); Academic Experience: refers to positive emotions that students experience during the career such as confidence, pleasure and energy (coefficient ± = 0.76); Atmosphere Perception, comfort and calm that students experiment during their academic activities (coefficient ± = 0.79); Teachers Perception: the perception that students have of teachers about their interest and disposition towards students (coefficient ± = 0.50). Conclusions: The assessment of academic environment quality is inversely associated with the lapse that the students have spent in their undergraduate careers.

[Assessment of psychometric properties of the academic involvement questionnaire, expectations version]. / Propiedades psicométricas de un cuestionario para evaluar expectativas académicas en estudiantes de primer año de Medicina.

BACKGROUND: Academic Involvement Questionnaire, Expectations version (CIA-A), assesses the expectations of involvement in studies. It is a relevant predictor of student success. However, the evidence of its validity and reliability in Chile is low, and in the case of Medical students, there is no evidence at all. AIM: To evaluate the factorial structure and internal consistency of the CIA-A in Chilean Medical school freshmen. MATERIAL AND METHODS: The survey was applied to 340 Medicine freshmen, chosen by non-probability quota sampling. They answered a back-translated version of CIA-A from Portuguese to Spanish, plus a sociodemographic questionnaire. For psychometric analysis of the CIA-A, an exploratory factor analysis was carried on, the reliability of the factors was calculated, a descriptive analysis was conducted and their correlation was assessed. RESULTS: Five factors were identified: vocational, institutional and social involvement, use of resources and student participation. Their reliabilities ranged between Cronbach's alpha values of 0.71 to 0.87. Factors also showed statistically significant correlations between each other. CONCLUSIONS: Identified factor structure is theoretically consistent with the structure of original version. It just disagrees in one factor. In addition, the factors' internal consistency were adequate for using them in research. This supports the construct validity and reliability of the CIA-A to assess involvement expectations in medical school freshmen.

Comparación de valores de temperatura obtenidos con termómetro ótico digital y con termómetros axilar y rectal de mercurio en menores de 5 años / Comparison of body temperature measurements obtained with otic digital thermometer and mercury axillary and rectal thermometers in children under the age of five

Introducción: En los últimos años han aparecido nuevos métodos para medir la temperatura en niños, como el termómetro digital ótico. Siendo este un método más rápido para medir la temperatura y por lo tanto ideal para el servicio de urgencias, es necesario conocer su confiabilidad. Objetivo: Comparar los valores de temperatura corporal que entrega el termómetro ótico digital con los termómetros de mercurio axilar y rectal. Pacientes y Método: Se efectuó la medición de la temperatura en 50 pacientes menores de 5 años elegidos al azar, que consultaron en el Servicio de Urgencia del Hospital de Niños y Cunas de Viña del Mar. Se les midió la temperatura con un termómetro digital ótico al lado izquierdo y derecho, y las temperaturas axilar derecha y rectal con termómetros de mercurio. EL análisis de los resultados se efectuó en el grupo estudiado, separado en dos grupos, menores y mayores de 6 meses. Resultados: Los resultados entre ambos subgrupos fueron los mismos. La temperatura media rectal obtenida fue 0,414°C más alta que la media ótica derecha (p < 0,001) y 0,438°C más alta que la temperatura media ótica izquierda (p < 0,001). Conclusión: El termómetro ótico digital entrega una temperatura significativamente más baja que la que entregan los termómetros de mercurio axilar y rectal.

Background: In recent years, otic thermometers to measure body temperature in children have become increasingly popular as they reflect changes in body temperature sooner than other thermometers. The have become valuable assets in hospital emergency rooms; however, their accuracy and reliability need further studies. Objective: To compare corporal temperature readings between an otic thermometer and mercury axillary and rectal thermometers. Patients and Method: 50 patients under the age of 5, who were treated at the emergency room of our hospital, were randomly chosen to participate in this study. Temperature was measured on their right and left ears using an otic thermometer, and their rectal and right axillary temperature was taken using mercury thermometers. Patients were separated into 2 subgroups for comparison, children under and over 6 months old. Results: The results between the 2 subgroups were very similar. The average temperature obtained by rectal thermometers was 0.414°C higher than the average right-ear temperature (p < 0.001) and 0.438°c higher than the average left-ear temperature (p < 0.001). Conclusion: The otic thermometer's reading is significantly lower than the one obtained using mercury rectal and axillary thermometers.

Neuronal nicotinic receptors: insights gained from gene knockout and knockin mutant mice.

Neuronal nicotinic acetylcholine receptors are ligand-gated ion channels that subserve a range of functions in the brain and peripheral nervous system. They are pentamers variously composed of alpha (alpha2-alpha10) and beta subunits (beta2-beta4). Pharmacological and ligand-binding studies have shown that the different subunits vary in their distribution and channel properties, but precise delineation of the in vivo function of individual subunits has been hampered by lack of subunit-specific antagonists. The development of transgenic mice with targeted deletions of specific subunits (knockout mice) or mutations in critical receptor domains (knockin mice) has extended understanding of nicotinic receptors, revealing that some subunits are necessary for viability, whereas others mediate modulatory effects on learning and memory, locomotion, anxiety, nociception, dopaminergic neurotransmission, seizure threshold, development of the visual system and autonomic function. In some cases, studies of transgenic mice have confirmed expectations derived from pharmacological and expression studies, but in other cases, compensation by related subunits has revealed a degree of functional redundancy not predicted by previous approaches.

Electroencephalographic characterisation of pentylenetetrazole-induced seizures in mice lacking the alpha 4 subunit of the neuronal nicotinic receptor.

Autosomal Dominant Nocturnal Frontal Lobe Epilepsy (ADNFLE) is associated in some kindreds with mutations in the genes encoding the alpha 4 or beta 2 subunits of the neuronal nicotinic acetylcholine receptor (nAChR). Functional characterisation of the described ADNFLE mutations in oocyte preparations has produced conflicting results, with some studies suggesting hypofunction but others showing increased ligand sensitivity or delayed desensitisation. Knockout mice were studied to investigate extreme hypofunction of alpha 4 nAChRs in vivo. Mutant (Mt) and control mice underwent epidural electroencephalographic (EEG) recording for 2 h in the untreated state and for 1 h following administration of the gamma-amino butyric acid (GABA) antagonist, pentylenetetrazole (PTZ, 80 mg/kg). No spontaneous seizures occurred and no EEG differences were observed between the genotypes in drug naïve mice. Following PTZ, however, Mt mice showed markedly increased mortality compared to controls (85 vs 30%, P<0.001). Mts also had a greater number of generalised clonic seizures in the first 40 min following injection. In the same period, the EEGs of Mt mice showed an excess of spikes (P=0.033), multi-spike complexes (P=0.002) and continuous fast activity (P=0.017) compared to controls. These findings demonstrate that intact alpha 4 nAChR subunits provide significant in vivo protection against the proconvulsant effects of GABA antagonism.

beta1 Integrin-extracellular matrix protein interaction modulates the migratory response to chemokine stimulation.

It is well established that chemokines have a major role in the stimulation of cell movement on extracellular matrix (ECM) substrates. However, it is also clear that ECM substrates may influence the ability of cells to undergo migration. Using the migration chamber method, we assessed the migratory response of human embryonic kidney-293 (HEK) transfectant cells expressing the CC chemokine receptor 5 (CCR5) (HEK-CCR5) to stimulation by chemokines (macrophage inflamatory protein (MIP)-1alpha, MIP-1beta, and regulated on activation normal-T cell expressed and secreted (RANTES)) on ECM substrates (collagen type I and fibronectin). Using filters coated with collagen (20 microg/mL), results showed that the chemokines differed in their ability to elicit cell movement according to the order MIP-1beta > RANTES MIP-1alpha. In contrast, using filters coated with fibronectin (20 microg/mL), all three chemokines were similar in their ability to stimulate migration of HEK-CCR5 cells. In addition, the migratory response with respect to the concentrations of ECM substrates appeared biphasic: thus, chemokine-stimulated cell movement was inhibited at high ECM concentrations (100 microg/mL). To determine the involvement of beta1 integrins, results showed that the migratory response to chemokine stimulation on collagen was largely inhibited by monoclonal antibody (mAb) to alpha2beta1; however, complete inhibition required a combination of mAbs to alpha1beta1 and alpha2beta1. In comparison, migration on fibronectin was inhibited by mAb to alpha3beta1 and alpha5beta1. Our results suggest that the migratory response to CCR5 stimulation may vary quantitatively with both the CCR5 ligand (MIP-1alpha, MIP-1beta, and RANTES), as well as the nature and concentration of the ECM substrate involved.

Contrasting stress response of male arctic ground squirrels and red squirrels.

A hormonal-challenge protocol was used to compare the stress response of males of Arctic ground squirrels and red squirrels during the breeding season (May). These squirrels live in the same boreal forest of the Yukon, but have very different life histories and utilize the forest in markedly different ways. Red squirrels had levels of total cortisol, maximum corticosteroid-binding capacity, and free cortisol that were 5, 7, and 2 times, respectively, those of Arctic ground squirrels. Red squirrels were resistant to suppression by an artificial glucocorticoid, dexamethasone (DEX); Arctic ground squirrels were not. Cortisol levels in red squirrels responded slowly but continuously to the ACTH injection; Arctic ground squirrels responded rapidly and then stabilized. Testosterone levels in red squirrels were extremely sensitive to the challenge, being suppressed by both DEX and ACTH; levels in Arctic ground squirrels were resistant to the challenge, being modestly suppressed by DEX and stimulated by ACTH. Energy mobilization, as measured by glucose and free fatty acid responses, was not affected. Red squirrels had four times the levels of white blood cells and higher proportions of lymphocytes and lower proportions of eosinophils than Arctic ground squirrels, indicating that the latter were in worse condition immunologically. Our evidence suggests that the functions associated with the hypothalamic-pituitary-adrenal axis are compromised in breeding male Arctic ground squirrels, but not in red squirrels. We propose that in male red squirrels this axis has evolved in the context of a stable social system based on long-lived animals with individual territories which are needed to deal with unpredictable winter food supplies. In contrast, Arctic ground squirrels escape the rigors of winter by hibernation and this hormonal axis has evolved in short-lived males in the context of intense intra-sexual competition in a social system based on female kin groups and regular male dispersal to avoid inbreeding. J. Exp. Zool. 286:390-404, 2000.

El síndrome anoréctico en el hombre: otra psicopatología contemporánea / The anorectic syndrome in male: another contemporary psychopathology

La Anorexia Nerviosa (AN), trastorno del hábito del comer que afecta casi exclusivamente a la mujer, también ha sido descrita en el hombre, aunque su frecuencia representa sólo el 5% al 10% de todos los casos. Sin embargo, se ha podido apreciar que su incidencia, al igual que la de la mujer, ha experimentado un notorio aumento, especialmente desde las dos últimas décadas. En el presente artículo, se efectúa un análisis exhaustivo del desorden en ambos sexos, describiendo la historia de un joven anoréctico a modo de ilustración, sugiriéndose finalmente algunos factores que estarían plasmando el cuadro sindromático de la AN masculina, como otra psicopatología más de nuestro existir contemporáneo

Colesterol y triglicéridos sanguíneos en adolescentes durante el desarrollo sexual / Blood cholesterol and triglycerides in adolescents during sexual development

Se midieron las concentraciones séricas de colesterol y triglicéridos en 152 adolescentes (53 varones y 99 mujeres) que acudieron a control de salud al Consultorio Integral de Adolescentes Valparaíso. Las concentraciones de colesterol total fluctuaron entre 120 mg/dl (percentil 10) y 220 mg/dl (percentil 90) y 20,4%estaban sobre 200 mg/dl. Las de triglicéridos fluctuaron entre 57 mg/dl (percentil 10) y 161 mg/dl (percentil 90) siendo 11,9%mayores que 150 mg/dl. Sólo se encontró una tendencia a la asociación entre concentraciones de colesterol total y desarrollo mamario, en cambio se encontró asociación clara entre colesterol e índice de masa corporal (p < 0,01) y antecedente familiar de enfermedad coronaria (p < 0,02)

Prevalencia de bacteriuria en presscolares / Prevalence of bacteriuria in preschool children

En 320 preescolares divididos en dos grupos según edad (2 y 3 años, 4 y 5 años), se practicó - en dos muestras seriadas de orina - recuento total y de bacterias Gram negativas, como parte de un programa tendiente a medir la prevalencia de bacteriuria y la influencia de la edad, sexo y condición socioecocncómica sobre ella. En el grupo de 4 y 5 años, la prevalencia de bacteriuria fue similar a la encontrada en niñas de 6 a 15 años. Los recuentos bacterianos > ou = 10**5 fueron más frecuentes en el sexo femenino, no observándose influencia de la condición socioeconómica. Contrariamente, en las niñas de 2 y 3 años y de situación socioeconómica baja, se presentó mayor prevalencia de bacteriuria verdadera. Estos últimos resultados se contraponen con los obtenidos en estudios epidemiológicos anteriores