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Characterization of suicidal behavior in Coquimbo, Chile, between 2018 and 2020. 2018 年至 2020 年期间智利科金博自杀行为的特征。
IF 1.2 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-03-05 DOI: 10.5867/medwave.2024.02.2770
Patricia Paz-Soto, Larry Games-Díaz, Muriel Ramírez-Santana

Introduction: Suicidal behavior is a public health problem worldwide. The World Health Organization estimated 700 000 deaths for the year 2021.

Objective: This study aimed to estimate the prevalence of suicidal behavior and describe its related factors in the Coquimbo Region, Chile, between 2018 and 2020.

Methods: 2190 suicide attempt notifications from the regional epidemiological surveillance system were analyzed, corresponding to 1781 people, along with 217 reports from the Forensic Medical Service of people who died by suicide.

Results: The overall suicide rate for the region during that period was 9.79 deaths per 100 000 inhabitants. The 2018 rates were standardized according to available information, with direct methods for the regional rate (9.55 per 100 000 inhabitants) and indirect methods for the communes. Rural communes presented higher rates than urban ones. Women showed a higher risk of attempts (OR 1.28; 95% CI 1.23 to 1.33) and a lower risk of suicide compared to men (0.086; 0.06 to 0.13). Young people had a higher risk of suicide attempts and a lower risk of suicide compared to older people. The increased suicide rates in older people (70 to 79 years) during 2020 are noteworthy. Basic education level is a risk variable for suicide (2.21; from 1.15 to 4.23), compared to having higher education. Previous suicide attempts and psychiatric pathology are risk factors.

Conclusions: Suicide prevalence and related factors are similar to those reported in other studies and national reports, highlighting rurality and higher risk in older male adults. In contrast to suicides, attempts are more frequent in women and young people. A history of mental health problems, previous attempts, and family violence are risk factors for both outcomes. Knowing the patterns of suicidal behavior in the population is fundamental for its prevention.

简介自杀行为是一个全球性的公共卫生问题。据世界卫生组织估计,2021年将有70万人死亡:本研究旨在估算2018年至2020年期间智利科金博大区的自杀行为发生率,并描述其相关因素。方法:分析了大区流行病学监测系统中的2190份自杀未遂通知(对应1781人),以及法医部门的217份自杀死亡报告:在此期间,该地区的总体自杀率为每 10 万居民中有 9.79 人死亡。2018 年的自杀率根据现有信息进行了标准化,地区自杀率(每 10 万居民 9.55 例)采用直接方法,乡镇自杀率采用间接方法。农村市镇的比率高于城市市镇。与男性相比,女性自杀未遂的风险较高(OR 1.28;95% CI 1.23 至 1.33),自杀风险较低(0.086;0.06 至 0.13)。与老年人相比,年轻人自杀未遂的风险较高,自杀风险较低。值得注意的是,2020 年老年人(70 至 79 岁)的自杀率有所上升。与受过高等教育相比,基础教育水平是一个自杀风险变量(2.21;从 1.15 到 4.23)。曾经自杀未遂和精神疾病也是风险因素:自杀发生率和相关因素与其他研究和国家报告中报道的情况相似,突出了农村地区和老年男性的高风险。与自杀形成鲜明对比的是,自杀未遂在女性和年轻人中更为常见。精神健康问题史、自杀未遂和家庭暴力是导致这两种结果的风险因素。了解人群中自杀行为的模式对于预防自杀至关重要。
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引用次数: 0
Challenges in surveillance of all cancer cases: The Chilean National Cancer Registry. 监测所有癌症病例的挑战:智利国家癌症登记处。
IF 1.2 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-02-27 DOI: 10.5867/medwave.2024.01.2771
Carla Taramasco, Carla Rimassa, Johana Acevedo

Cancer causes millions of deaths worldwide, making its registration essential. There are clinical, hospital, and population-based registries in place. The latter is the gold standard for information on cancer incidence and survival in a defined region. Chile has five population-based registries located in specific areas of the country. The Chilean National Cancer Registry emerged with the challenge of creating a tool encompassing all three types of registries to identify the number of cancer cases by type. Its design involved a series of actions to achieve consensus among various actors regarding information, validation, and events to be registered. Four stages were identified in the care and registration process: suspected diagnosis, morphological confirmation (biopsy), clinical resolution (oncology committee, including treatment recommendations), treatment, and oncological follow-up. The platform's development (from 2018 to 2021) involved gathering information and agreements on the requirements for co-designing the registry, including a successful pilot program with over 20 public and private healthcare facilities that recorded nearly 7500 cancer cases. The deployment and use of the National Cancer Registry at a national level depends on the healthcare authority. It is an information system that continuously and systematically collects, stores, processes, and analyzes data on all cancer cases and types occurring in the country. This work presents the design and development of the tool, the challenges addressed, as well as its strengths and weaknesses.

癌症导致全球数百万人死亡,因此对癌症进行登记至关重要。目前已有临床、医院和人口登记处。后者是了解特定地区癌症发病率和存活率的黄金标准。智利在全国特定地区设立了五个人口登记处。智利国家癌症登记处面临的挑战是创建一个涵盖所有三类登记处的工具,以按类型确定癌症病例的数量。其设计涉及一系列行动,以在信息、验证和要登记的事件等方面在不同参与者之间达成共识。在护理和登记过程中确定了四个阶段:疑似诊断、形态学确认(活检)、临床解决(肿瘤委员会,包括治疗建议)、治疗和肿瘤随访。该平台的开发(从 2018 年到 2021 年)涉及收集信息和商定共同设计登记册的要求,包括与 20 多家公共和私营医疗机构成功开展试点项目,记录了近 7500 个癌症病例。国家癌症登记处在全国范围内的部署和使用取决于医疗机构。这是一个信息系统,可持续、系统地收集、存储、处理和分析全国所有癌症病例和类型的数据。这项工作介绍了该工具的设计和开发、应对的挑战及其优缺点。
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引用次数: 0
Urinary incontinence in health workers as a predisposing factor for presenteeism in Chile: A mixed-methods exploratory study. 在智利,医务工作者尿失禁是造成旷工的一个诱因:一项混合方法探索性研究。
IF 1.2 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-02-27 DOI: 10.5867/medwave.2024.01.2779
Julieta Aránguiz-Ramírez, Pedro Olivares-Tirado, Cecilia Baeza-Correa, Xavier Castells

Introduction: Urinary incontinence negatively impacts the quality of life and can harm work activities, causing presenteeism in health professionals and decreasing the quality of care and patient safety. The objective of this study is to explore the self-perception of health workers who suffer from urinary incontinence as a predisposing factor for presenteeism.

Methods: Mixed study of an exploratory-descriptive nature. The sample was selected in a non-probabilistic and intentional way by criterion and convenience with a size of 14 volunteers, considering the saturation of the information. Reliability criteria defined by Guba for the process and analysis of thematic data were considered.

Results: The sample had a mean age of 38.9 + 7.1 years and a mean SPS-6 score of 15.8 + 3.5 points, showing alteration in the dimension of avoiding deconcentration. The narratives in the case study provide relevant information on how urinary incontinence affects the work performance of health workers through the interruption in their day, decreases the quality of clinical care, and increases their anxiety regarding their environment.

Conclusions: Urinary incontinence and presenteeism are subjective, and multidimensional experiences affect work performance. Therefore, further studies are recommended to identify predictor variables and the economic losses associated with this condition to establish improvements in the work environment and the self-care of female employees seeking greater benefits and better levels of efficiency in the organization.

导言:尿失禁会对生活质量产生负面影响,并损害工作活动,导致医务人员旷工,降低护理质量和患者安全。本研究旨在探讨患有尿失禁的医务工作者对导致旷工的诱因的自我认知:方法:探索-描述性混合研究。考虑到信息的饱和度,通过标准和便利性以非概率和有意的方式选取了 14 名志愿者作为样本。考虑到了古巴为专题数据的处理和分析所定义的可靠性标准:样本的平均年龄为 38.9+7.1 岁,SPS-6 的平均得分为 15.8+3.5 分,显示出在避免非集中化方面的变化。案例研究中的叙述提供了相关信息,说明了尿失禁是如何通过打断医护人员的日常工作、降低临床护理质量和增加他们对环境的焦虑来影响其工作表现的:结论:尿失禁和旷工是主观的、多层面的体验,会影响工作表现。因此,建议开展进一步研究,以确定预测变量和与这种情况相关的经济损失,从而改善工作环境和女性员工的自我保健,为组织谋求更大的利益和更高的效率。
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引用次数: 0
New candidate SNPs for genetic association with Alzheimer's disease: a linkage disequilibrium analysis for the FCGRIIB and PILRA genes. 与阿尔茨海默病遗传相关的新候选 SNPs:FCGRIIB 和 PILRA 基因的连锁不平衡分析。
IF 1.2 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-02-26 DOI: 10.5867/medwave.2024.01.2754
Alejndro Levi-Monsalve, Sergio Vladimir Flores, Germán Manriquez, Ángel Roco-Videla

Background: Two new SNPs have been recently associated to Alzheimer's disease in African American populations: FCGRIIB rs1050501 C/T, and PILRA rs1859788 A/G. The risk of Alzheimer's disease in FCGRIIB C and PILRA A allele carriers is three times higher than in non-carriers. However, the association between these and other single nucleotide polymorphisms (SNPs) has not been assessed.

Methods: Linkage disequilibrium analysis, with r= 0.8 as a threshold value, was used to impute new candidate SNPs, on genomic data from both genes in 26 populations worldwide (n= 2504) from the 1000Genomes database.

Results: Four SNPs (rs13376485, rs3767640, rs3767639 and rs3767641) were linked to rs1050501 and one (rs2405442) to rs1859788 in the whole sample.

Conclusions: Five novel SNPs could be associated with Alzheimer's disease susceptibility and play a causal role, even if none of them are exon variants since their potential roles in the regulation of gene expression.

背景:最近在非裔美国人中发现了两个与阿尔茨海默病相关的新 SNPs:FCGRIIB rs1050501 C/T 和 PILRA rs1859788 A/G:FCGRIIB rs1050501 C/T 和 PILRA rs1859788 A/G。FCGRIIB C 和 PILRA A 等位基因携带者患阿尔茨海默病的风险是非携带者的三倍。然而,这些单核苷酸多态性(SNPs)与其他单核苷酸多态性之间的关联尚未得到评估:方法:以 r= 0.8 为临界值,对来自 1000Genomes 数据库的全球 26 个人群(n= 2504)的两个基因的基因组数据进行了连锁不平衡分析,以推算新的候选 SNPs:在整个样本中,四个 SNP(rs13376485、rs3767640、rs3767639 和 rs3767641)与 rs1050501 相关,一个 SNP(rs2405442)与 rs1859788 相关:结论:5 个新的 SNPs 可能与阿尔茨海默病的易感性有关并起着因果作用,即使它们都不是外显子变异,因为它们在基因表达调控中可能发挥作用。
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引用次数: 0
Training with a psychosocial health neurolearning approach in Peruvian professionals with health insurance: Experimental study. 秘鲁医疗保险专业人员的社会心理健康神经学习方法培训:实验研究。
IF 1.2 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-01-31 DOI: 10.5867/medwave.2024.01.2700
Luis Fidel Abregú Tueros, Cinthya Jannette Bravo-Esquivel, Franklin Dionisio Montalvo

Introduction: Psychosocial risk factors as determinants of health at work can affect both the physical and psychological well-being of the worker. Training systems that include cognitive-preventive content work best when knowledge construction is based on neurolearning. The purpose of this study was to compare the degree of content processing with the insertion of deterrent (group A) versus persuasive sentences (group B) as an effect of a training with a neurolearning approach to psychosocial health in the work of a group of professionals with health insurance in the Peruvian Amazon.

Methods: Experimental design with pre-/post-test, including two experimental groups plus a control group, n = 48 subjects in total and 16 per group, aged 22-36 years. The training took place between December 2018 and January 2019 with a duration of 18 hours spaced over six weeks. A register previously validated by five experts was used for data collection.

Results: The distribution of data in the groups was adequate in both pre-test and post-test, except in post-test in group "B" (p = 0.002). In the control group, the results of content processing in both pre-test and post-test remained similar (p = 0.667). The processing of psychosocial occupational health content in the post-test was significantly different between the intervention and control groups (p = 0.001), distinguishing the processing of content with the insertion of deterrent phrases.

Conclusions: The results indicate that training with a neurolearning approach can improve the processing of content with the insertion of deterrent phrases for compliance with regulations aimed at promoting psychosocial health at work.

简介作为工作健康决定因素的社会心理风险因素会影响工人的身心健康。当知识构建以神经学习为基础时,包含认知预防内容的培训系统效果最佳。本研究的目的是比较插入威慑性句子(A 组)和劝说性句子(B 组)的内容处理程度,以此作为在秘鲁亚马孙地区的一组医疗保险专业人员工作中采用神经学习法进行社会心理健康培训的效果:实验设计,前/后测试,包括两个实验组和一个对照组,共48名受试者,每组16名,年龄22-36岁。培训在 2018 年 12 月至 2019 年 1 月期间进行,为期 18 个小时,间隔六周。数据收集使用了一份事先经过五位专家验证的登记表:除 "B "组的后测(P = 0.002)外,各组在前测和后测中的数据分布均适当。在对照组中,前测和后测的内容处理结果仍然相似(p = 0.667)。干预组和对照组在后测中对社会心理职业健康内容的处理有显著差异(p = 0.001),这与插入威慑性短语的内容处理有区别:结果表明,采用神经学习方法进行培训可以提高对插入威慑性短语的内容的处理能力,从而遵守旨在促进工作中社会心理健康的规定。
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引用次数: 0
[Intersections between climate change and mental health: New challenges for the development of care services]. 气候变化与心理健康之间的交叉:护理服务发展的新挑战。
IF 1.2 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-01-30 DOI: 10.5867/medwave.2024.01.2809
Camila Solis Araya
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引用次数: 0
Validation of questionnaires for the measurement of health variables: Fundamental concepts. 健康变量测量问卷的验证:基本概念。
IF 1.2 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-01-23 DOI: 10.5867/medwave.2024.01.2746
Natalia Riva, Diego Grandi, Benjamín Cruzat, Ruben Alvarado

In clinical practice and population health, it is common to use questionnaires to assess conditions or variables that are not directly observable. However, the construction and validation of these instruments or questionnaires are often poorly understood. This narrative review aims to summarize in a general way the process of construction and validation of these questionnaires in order to have a better understanding of this process, the aspects that are evaluated, and the best way to use them. The validation of questionnaires corresponds to a process of analysis of the questionnaire, aiming to measure a latent variable and its dimensions, which cannot be observed directly. A latent variable can be inferred through a set of specific attributes that are part of it, such as the items of a questionnaire, which are observable. Through a narrative review, this article addresses the fundamental concepts of questionnaire or test validation, latent variables or constructs, reliability and validity studies, and the factors that theoretically affect the latter two characteristics. Examples of these concepts are presented in the text.

在临床实践和人口健康中,使用问卷来评估无法直接观察到的情况或变量是很常见的。然而,人们对这些工具或问卷的构建和验证往往知之甚少。这篇叙述性综述旨在对这些问卷的制作和验证过程进行概括总结,以便更好地了解这一过程、评估的方面以及使用问卷的最佳方式。问卷验证相当于对问卷进行分析的过程,旨在测量无法直接观察到的潜在变量及其维度。潜变量可以通过作为其一部分的一系列特定属性来推断,比如问卷中的项目,这些属性是可以观察到的。本文通过叙述性综述,阐述了问卷或测试验证、潜变量或建构、信度和效度研究的基本概念,以及理论上影响后两个特征的因素。文中举例说明了这些概念。
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引用次数: 0
[Climate change and malnutrition are a public health challenge]. 气候变化和营养不良是一项公共卫生挑战。
IF 1.2 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-01-22 DOI: 10.5867/medwave.2024.01.2806
Lorena Rodríguez-Osiac, Ignacio Silva-Santa Cruz
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引用次数: 0
[Climate change impacts childhood]. 气候变化影响童年。
IF 1.2 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-01-15 DOI: 10.5867/medwave.2024.01.2805
Karla Yohannessen
{"title":"[Climate change impacts childhood].","authors":"Karla Yohannessen","doi":"10.5867/medwave.2024.01.2805","DOIUrl":"10.5867/medwave.2024.01.2805","url":null,"abstract":"","PeriodicalId":18597,"journal":{"name":"Medwave","volume":"24 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2024-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139472724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Healthcare payment mechanism: Execution results of bundled payment program for bariatric surgery diagnosis in its first year of implementation in Chile. 医疗支付机制:在智利,减肥手术诊断捆绑支付计划在实施第一年的执行结果。
IF 1.2 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-01-03 DOI: 10.5867/medwave.2024.01.2762
Daniela Paredes Fernández, Rodrigo Muñoz Claro, Patricio Lamoza Kohan

Introduction: More than 600 thousand people in Chile live with morbid obesity. Effective, safe, cost-effective therapeutic interventions are critical for healthcare systems and insurance schemes. In 2022, two bundled payment codes for bariatric surgery (gastric bypass and gastric sleeve) were incorporated into the National Health Fund's free-choice modality fee scheme. The objective was to characterize the execution of this payment mechanism program associated with bariatric surgery diagnosis in its first year of implementation.More than six hundred thousand people in Chile are estimated to live with morbid obesity. Effective, safe, cost-effective therapeutic interventions are critical for health systems and insurance schemes. In 2022, FONASA incorporated two Bariatric Surgery codes into the Free Choice Modality: Gastric Bypass and Sleeve Gastrectomy. Our objective was to characterize the execution of the Bariatric Surgery Bundled Payment Program in its first year of implementation.

Methods: Descriptive and observational study of the pragmatic approach of the national execution of the payment associated with diagnosis in bariatric surgery. We examined sociodemographic variables (sex, age brackets, and National Health Fund tranches) and characterization of surgeries by code broken down by public or private provider, period of issue, unit cost, co-payment, and medical loans between March and December 2022.

Results: We recorded n = 13 118 surgeries (45.81% bypass versus 54.19% sleeve), of which n = 2424 (18.48%) used medical loans. A total of 85.01% (p = 0.01) of the procedures were in women, in people between 35 and 39 years of age (20.15%), and 45.12% in beneficiaries of tranche B. Private providers performed a total of 99.21% of the surgeries. Ten accounted for 50% of the activity (range n = 1200 to 426 surgeries per year; n = 4.8 to 1.7 surgeries per working day). Total program expenditure was $71 626 948 350 CLP, accounting for 5.04% of the total activity of the national Diagnosis Associated Payment Program.

Conclusions: The implementation of this bariatric surgery voucher benefited more than 13 thousand people living with obesity, mostly women of productive ages and with purchasing capacity. As an equity strategy, regardless of the access route through the voucher, it will be important to safeguard the activity in the public network.

引言智利有 60 多万人患有病态肥胖症。对于医疗系统和保险计划而言,有效、安全、具有成本效益的治疗干预措施至关重要。2022 年,减肥手术(胃旁路手术和胃袖状手术)的两个捆绑支付代码被纳入国家卫生基金的自由选择方式收费计划。这项研究的目的是对这一与减肥手术诊断相关的支付机制计划在实施第一年的执行情况进行分析。据估计,智利有超过 60 万人患有病态肥胖症。据估计,智利有 60 多万人患有病态肥胖症。有效、安全、具有成本效益的治疗干预措施对医疗系统和保险计划至关重要。2022 年,FONASA 将两个减肥手术代码纳入自由选择模式:胃旁路术和袖状胃切除术。我们的目标是描述减肥手术捆绑支付计划实施第一年的执行情况:对减肥手术诊断相关付款的国家执行情况进行描述性和观察性研究。我们研究了社会人口学变量(性别、年龄段和国家卫生基金分档)以及 2022 年 3 月至 12 月期间按公立或私立医疗机构、发放时间、单位成本、共同支付和医疗贷款细分的手术代码特征:我们记录了 n = 13 118 例手术(45.81% 为旁路手术,54.19% 为袖状手术),其中 n = 2424 例(18.48%)使用了医疗贷款。85.01%(P = 0.01)的手术是在女性、35 至 39 岁的人群(20.15%)和 45.12%的 B 级受益人中进行的。十家医疗机构的手术量占总手术量的 50%(每年手术量从 1200 例到 426 例不等;每个工作日手术量从 4.8 例到 1.7 例不等)。项目总支出为 71 626 948 350 美元,占全国诊断相关付费项目总活动的 5.04%:减肥手术代金券的实施使 1.3 万多名肥胖症患者受益,其中大部分是有生育能力的妇女。作为一项公平战略,无论通过何种途径获得优惠券,都必须保障公共网络中的活动。
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引用次数: 0
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Medwave
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