ABSTRACT Obesity is a risk factor for chronic non-communicable diseases. This condition mainly affects women of low socioeconomic status. Nutritional literacy, understood as knowledge of food and nutrition, could determine the quality of the diet, which in turn could cause the development of obesity. The aims were 1) To describe the nutritional literacy, nutritional status, and food quality, and 2) To explore the relationship between these three variables, in a group of women from communes with multidimensional poverty in the Metropolitan Region. We conducted a cross-sectional, non-probabilistic study in which 122 women participated. The nutritional status was evaluated by calculating the Body Mass Index using weight and height measurements. The diet quality was evaluated using a survey of food consumption trends and the Healthy Eating Index. Nutritional literacy was evaluated with the Nutritional Literacy questionnaire in Spanish adapted for the Chilean population. The prevalence of obesity was 47.5%, and 88.5% of the women presented the need for changes in their diet. 66.4% of women had low nutritional literacy, with more overweight women in this category. The nutrition labeling domain was the one with the worst results. We concluded that women’s food and nutritional condition suggests a challenge for health professionals and those who make decisions about food and nutrition.

RESUMEN La obesidad es factor de riesgo para las enfermedades crónicas no transmisibles. Esta condición afecta principalmente a mujeres de bajo nivel socioeconómico. La alfabetización nutricional, referida al conocimiento en alimentación y nutrición, podría estar determinando la calidad de la dieta, la que a su vez podría favorecer el desarrollo de la obesidad. Los objetivos del estudio fueron 1) Describir la alfabetización nutricional, el estado nutricional y la calidad de la alimentación, y 2) Explorar la relación entre estas tres variables, en un grupo de mujeres de comunas con pobreza multidimensional de la Región Metropolitana. Se diseñó un estudio transversal, no probabilístico, en donde participaron 122 mujeres. Se evalúo el estado nutricional mediante el cálculo del Índice de Masa Corporal, midiendo peso y talla. La calidad de la alimentación se evaluó utilizando una encuesta de tendencia de consumo alimentaria y el Índice de Alimentación Saludable, y la alfabetización nutricional, con el cuestionario Nutritional Literacy en español (NLit-S), adaptado a la población chilena. La prevalencia de obesidad fue 47,5% y el 88,5% de las mujeres presentó necesidad de cambios en su alimentación. Un 66,4% presentó una alfabetización nutricional deficiente, con más mujeres con exceso de peso en esta categoría. Dominio de etiquetado nutricional fue el que obtuvo peores resultados. Se concluye que la condición alimentaria nutricional de las mujeres de nuestro estudio sugiere un desafío para el trabajo por parte de profesionales de la salud, así como para quienes toman decisiones en alimentación y nutrición.

Background: Lack of compliance with medication prescription is common among older adults and hamper an adequate management of chronic conditions. Aim: To study the association between health literacy and medication adherence in older adults with chronic diseases in Temuco, Chile. Material and Methods: The Health Literacy survey for Spanish-speaking Adults, MiniMental examination and the Morisky-Green test to assess compliance with medication prescription were applied to 119 older adults aged 60 to 88 years. Results: All participants had an adequate global cognitive performance; 24% had inadequate literacy, and 42% did not comply with medication prescription. There was a significant correlation between health literacy and medication adherence. Conclusions: Health literacy influences medication adherence in Chilean older adults.

Introduction: Maxillofacial trauma (MFT) is a relevant problem in highly complex hospital centers. Aim: To show and update the epidemiology of the maxillofacial trauma of surgical resolution under general anesthesia, in a major operating room, treated in the Emergency Hospital Public Assistance during the period from December 2014 to December 2017 and to compare it with the epidemiological reality of other high complexity hospital centers in Chile and abroad. Materials and Method: A retrospective study was carried out and the surgical protocols of the patients operated for maxillofacial trauma, in a major operating room, under general anesthesia, in a period of 37 months, were analyzed. The variables considered were diagnosis, age, gender, facial third and affected anatomic area. Results: 127 surgical procedures were performed, for the resolution of 259 fractures. The average age of the operated patients was 33 years, with predominance of the male gender (85.8%), the lower third was the most affected (77.2%), specifically in the parasymphysis area (22.4%). Discussion: The exposed results agree with studies carried out internationally, but it has discordance in relation to the most affected anatomical area at national level comparing it with the other hospitals that analyzed its epidemiology. Conclusion: It is necessary to continue the epidemiological investigation of these pathologies and to unify diagnostic and treatment criteria in order to establish efficient prevention and treatment policies in relation to each service and jointly at the level of public health.

Resumen Introducción: El trauma maxilofacial (TMF) constituye un problema de relevancia en los centros hospitalarios de alta complejidad. Objetivo: Evidenciar y actualizar la epidemiología del trauma maxilofacial de resolución quirúrgica bajo anestesia general, en pabellón central tratado en el Hospital de Urgencia Asistencia Pública durante el período comprendido entre diciembre de 2014 a diciembre de 2017 y compararla con la realidad epidemiológica de otros centros hospitalarios de alta complejidad en Chile y en el extranjero. Materiales y Método: Se realizó un estudio retrospectivo en el que se analizaron los protocolos operatorios de los pacientes intervenidos quirúrgicamente por trauma maxilofacial, en pabellón central, bajo anestesia general, en un período de 37 meses. Las variables analizadas fueron diagnóstico, edad, género, tercio facial y zona anatómica afectada. Resultados: Se realizaron 127 procedimientos quirúrgicos, para resolver 259 fracturas. La edad promedio de los pacientes intervenidos fue de 33 años, con predominio del género masculino (85,8%); el tercio inferior fue el más afectado (77,2%), específicamente en la zona parasinfisiaria mandibular (22,4%). Discusión: Los resultados expuestos concuerdan con estudios realizados internacionalmente, pero tiene discordancia en relación a la zona anatómica más afectada al comparalo con los otros centros que analizaron su epidemiología. Conclusión: Resulta necesario continuar la investigación epidemiológica de estas patologías y unificar criterios de diagnóstico y tratamiento para poder establecer políticas de prevención y tratamiento eficientes en relación a cada servicio y en conjunto a nivel de salud pública.

ABSTRACT: Molecular techniques that provide valuable information about the epidemiology of oral strains. The purpose of this study was to determine the genetic relatedness of 83 Enterococcus faecalis strains isolated from treated root canals. These strains were obtained from patients who were treated for persistent endodontic infections. E. faecalis isolates were molecular typed by Pulsed Field Gel Electrophoresis using Smal. Ten clonal groups and 13 pulse types with 38.7 % similarity for the less related strains were identified. Genetic heterogeneity among strains from different patients and a high level of genetic homogeneity among intrapatient strains were observed. Therefore, restriction endonuclease fingerprinting of genomic DNA from E. faecalis strains confirmed the polyclonality of the isolates obtained from the root canals of patients diagnosed with persistent endodontic infections, compared with other reports. These results provide additional data for a better understanding of the epidemiological aspects of root canal infections by E. faecalis.

RESUMEN: Las técnicas moleculares proporcionan información valiosa sobre la epidemiología de aislados orales. El propósito de este estudio fue determinar la relación genética de 83 cepas de Enterococcus faecalis aisladas de conductos radiculares tratados. Estas cepas se obtuvieron de pacientes que fueron tratados por infecciones endodónticas persistentes. Los aislados de E. faecalis se tipificaron molecularmente por electroforesis en gel de campo pulsado usando Smal. Se identificaron diez grupos clonales y 13 pulsotipos con un 38,7 % de similitud para las cepas menos relacionadas. Se observó heterogeneidad genética entre las cepas de diferentes pacientes y un alto nivel de homogeneidad genética entre las cepas intrapacientes. Por lo tanto, la toma de huellas dactilares a traves de restricción de ADN genómico de cepas de E. faecalis confirmó la policlonalidad de los aislados obtenidos de los conductos radiculares de pacientes diagnosticados con infecciones endodónticas persistentes, en comparación con otros informes. Estos resultados proporcionan datos adicionales para una mejor comprensión de los aspectos epidemiológicos de las infecciones del conducto radicular por E. faecalis.

ABSTRACT INTRODUCTION Health systems are one determinant of health; their role is to facilitate timely and equitable access to quality services. The way in which a health system is organized can profoundly affect achievement of its objectives. The main feature of the Chilean health system is the coexistence of a public health insurance program (based on a social insurance model) with several market-based private health insurance companies. This hybrid structure provides an interesting framework for analyzing and evaluating the system’s effects on health inequalities. OBJECTIVE Assess Chilean public and private health insurance schemes’ performance and its effects on health inequalities. METHODS Public health insurance was compared with private insurance using indicators from 2013 (or the closest year) in the following domains: inputs, outputs (provider visits, discharges), outcomes (coverage) and impact (on health, quality of life, finances and patient satisfaction) as well as demographic and social determinant indicators. A conceptual framework for measuring health system performance was used. Data were obtained from administrative records and population-based surveys. RESULTS The publicly insured population had greater health care needs, was older (aging index 83.4 vs. 36.5) and poorer (17.2% vs. 1.5% below the poverty line) than the population covered by private insurers. The public insurer received average monthly funding of US$50.94 per beneficiary and spent US$51.43, while private insurers on average collected US$94.79 monthly per beneficiary, and spent US$69.63 on health services (excluding medical leave benefits). Private health insurance beneficiaries were more likely than their publicly insured counterparts to access specialized medical services (18.3% vs. 9.3%) and dentists (11.2% vs. 5.9%), have laboratory tests (18.1% vs. 4.8%), and undergo surgery (7.8% vs. 5.9%). Risk factor and disease prevalence was lower among private insurance beneficiaries for 16 of 18 tracer conditions, although age-adjusted differences were not significant. Finally, incidence of catastrophic spending was slightly lower among private insurance beneficiaries (3.7% vs. 4.2%), and a greater proportion of them were satisfied or very satisfied with the health system (37% vs. 17%). CONCLUSIONS The relative youth and better financial status of beneficiaries of private insurers is compatible with selection for lower risk. While private plans offer greater financial protection and receive higher user satisfaction ratings than the public plan, differences in financing between the two types of insurance affect availability and utilization of services. This constitutes a structural problem for the Chilean health system. There is an urgent need to move toward an integrated health system, in which incentives are aligned with social insurance objectives.

The early break in maternal bonding and social isolation are variables involved with social and emotional behaviors and also with increased anxiety, especially in stressful situations. However, there is no research to explain the morphological changes of the adrenal gland (GSR). Therefore, our objective was to experimentally study through alteration model of social ties and early mother-cub bond alteration belated social isolation, the effect on the morphometric and stereological characteristics of the GSR in rats of the Sprague Dawley subjected to intermittent chronic stress in adulthood. We used 35 newborn female rats, divided into groups of 7 under lactating and standardized feeding conditions. The experimental groups were exposed to adverse experiences early (E1), late (E2), and early/late (E3) and subsequently, subject to intermittent chronic stress in adulthood. Left GSR was isolated from each animal determining morphometric characteristics and stereological parameters. The absolute weight was higher in control group C2 and the experimental group E1. In the group E3 number of cells per mm3, the percentage of glandular tissue and density of the surface in the fascicular area of the GSR was lower. Stereological characteristics of the GRS in rats, not only can be affected by exposure to stress in adulthood, but also early and / or late adverse experiences play an important role in the changes of quantitative morphological parameters observed in this gland.

La ruptura temprana del vínculo materno y el aislamiento social son variables que están involucradas con los comportamientos social y emocional y también con el aumento de la ansiedad, especialmente en situaciones estresantes. Sin embargo, no se dispone de investigaciones que expliquen los cambios morfológicos de la glándula suprarrenal (GSR). Por lo anterior, el objetivo de este trabajo fue conocer experimentalmente, a través del modelo de alteración del vínculo social temprano madre-cría y alteración del vínculo social tardío por aislamiento, el efecto sobre las características morfométricas y estereológicas de la GSR, en ratas de la cepa Sprague Dawley sometidas a estrés crónico intermitente en la vida adulta. Utilizamos 35 ratas hembras recién nacidas, distribuidas en grupos de 7, en condiciones de lactancia y alimentación estandarizadas. Los grupos experimentales fueron expuestos a experiencias adversas temprana (E1), tardía (E2), temprana-tardía (E3) y posteriormente, sometidas a estrés crónico intermitente en la adultez. Se aisló la GSR izquierda de cada animal determinando características morfométricas y parámetros estereológicos. El peso absoluto fue mayor en los grupos control C2 y grupo experimental (E1). El número de células por mm3, el porcentaje de tejido glandular y la densidad de superficie en la zona fascicular de la GSR fue menor en el grupo E3. Las características estereológicas de la GRS en ratas, no sólo pueden ser afectadas por la exposición al estrés en la adultez, sino que también las experiencias adversas temprana y/o tardía juegan un rol importante en los cambios de los parámetros morfológicos cuantitativos observados en esta glándula.

O estudo tem por objetivos apresentar a validação de um instrumento formulado racionalmente para avaliar, mediante auto-relato, o comportamento social de adolescentes chilenos (CACSA) e descrever o comportamento social de dois grupos: adolescentes escolarizados (N=1914) e adolescentes infratores da lei (N=264). O questionário consiste de 56 itens que exploram três dimensões gerais: a) Comportamento Pró-social (CPRO), b) Anti-Social (CAT) c) Vítimas de Abuso de Poder (VAP). CAT contém seis dimensões específicas: Delitos (D), Transgressões de Ofensa à Propriedade (TPRO), Transgressões Contra as Pessoas (TPER), Comportamentos Abusivos entre Pares (CAP), Consumo do Álcool e Drogas (OHD) e Transgressões Sociais Leves (TSL). O estudo incluiu também uma escala de desejabilidade social e outra atitudinal. Os resultados revelam que o instrumento mostra excelentes qualidades psicométricas e capacidade de discriminação entre os adolescentes escolarizados e os infratores da lei. Discute-se a importância de reconhecer a prevalência de comportamentos anti-sociais por meio de auto-relato e a relação entre condutas pró-sociais e anti-sociais em adolescentes chilenos.

This paper reports the validation of a rationally built self-report instrument to assess social behavior in Chilean adolescents (CACSA) and presents the findings on social behavior from two samples: school attending adolescents (N=1914) and juvenile offenders (N=264). The questionnaire consists of 56 items, which explore three general behavioral dimensions: Prosocial (CPRO) and Antisocial (CAT) behavior, and Victims of Abuse of Power (VAP); CAT contains six specific dimensions: Crimes (D), Transgressions Against Property (TPRO), Transgressions Against Persons (TPER); Abusive Behavior with Peers (CAP), Substance Abuse (OHD); and Minor Social Transgressions (TSL). The study also includes a social desirability scale and an attitudinal scale. Results revealed the questionnaire has important psychometric strengths, as well as discriminative properties between the school attending adolescents and the juvenile offenders. The importance and reliability of self-report data for building indices of antisocial behavior is discussed, as well as the relationship between prosocial and antisocial behavior among Chilean adolescents.

El estudio tiene por objetivo presentar la validación de un instrumento formulado racionalmente para evaluar, mediante auto-reporte, el comportamiento social en adolescentes chilenos (CACSA) y describir el comportamiento social de dos grupos: adolescentes escolarizados (N=1914) y adolescentes infractores de ley (N=264). El cuestionario posee 56 ítemes que exploran tres dimensiones generales, a) Comportamiento Prosocial (CPRO), b) Comportamiento Antisocial Total (CAT); y c) Víctima de Abuso de Poder (VAP); CAT contiene seis dimensiones específicas: Delitos (D), Transgresiones Contra la Propiedad (TPRO), Transgresiones Contra las Personas (TPER), Comportamiento Abusivo con Pares (CAP), Consumo de Alcohol y Drogas (OHD); y Transgresiones Sociales Leves (TSL). El estudio incluye también una escala de deseabilidad social y otra actitudinal. Los resultados revelan importantes fortalezas psicométricas del instrumento y capacidad de discriminación entre adolescentes escolarizados e infractores de ley. Se discute la importancia de reconocer por auto-reporte la prevalencia de comportamientos antisociales y la relación entre conductas prosociales y antisociales en adolescentes chilenos.