Gambetta-Tessini, K; Mariño, R; Ghanim, A; Calache, H; Manton, D J
Molar-Incisor Hypomineralisation (MIH) is a prevalent developmental defect of tooth enamel associated with a high burden of disease. The present study aimed to survey Australian and Chilean oral health care practitioners (OHCPs) working in public dental facilities and to compare their knowledge, clinical experience and perceptions about MIH. Findings would give insights about how current knowledge has penetrated into OHCPs working into the public systems. A mixed-mode survey regarding MIH was carried out amongst Australian and Chilean OHCPs from the public sector. The survey required responses to questions regarding sociodemographics, clinical experience, perceptions, clinical management and preferences for further training. The level of knowledge regarding MIH was determined by Delphi methods for consensus. Data analysis utilised Chi-square, linear and logistic regression models using SPSS Ver. 22.0. The majority of respondents had observed MIH in their patients (88.6 %) and the level of knowledge regarding MIH was high in Australian participants (p = 0.03). Australian respondents felt more confident when diagnosing (OR 8.80, 95 % CI 2.49-31.16) and treating MIH-affected children (OR 4.56, 95 % CI 2.16-9.76) compared to Chilean respondents. Oral health therapists reported higher levels of confidence than Australian general dental practitioners when providing treatment to children with MIH (OR 7.53; 95 % CI 1.95-29.07). Continuing to update clinical guidelines may help practitioners increase their understanding when diagnosing and treating MIH-affected children. Dissemination of information and awareness regarding MIH is necessary in public clinics, and in particular Chilean general dental practitioners should be alerted to these factors.
Marcella M S Kwan
Full Text Available Rural medical workforce shortage contributes to health disadvantage experienced by rural communities worldwide. This study aimed to determine the regional results of an Australian Government sponsored national program to enhance the Australian rural medical workforce by recruiting rural background students and establishing rural clinical schools (RCS. In particular, we wished to determine predictors of graduates' longer-term rural practice and whether the predictors differ between general practitioners (GPs and specialists.A cross-sectional cohort study, conducted in 2012, of 729 medical graduates of The University of Queensland 2002-2011. The outcome of interest was primary place of graduates' practice categorised as rural for at least 50% of time since graduation ('Longer-term Rural Practice', LTRP among GPs and medical specialists. The main exposures were rural background (RB or metropolitan background (MB, and attendance at a metropolitan clinical school (MCS or the Rural Clinical School for one year (RCS-1 or two years (RCS-2.Independent predictors of LTRP (odds ratio [95% confidence interval] were RB (2.10 [1.37-3.20], RCS-1 (2.85 [1.77-4.58], RCS-2 (5.38 [3.15-9.20], GP (3.40 [2.13-5.43], and bonded scholarship (2.11 [1.19-3.76]. Compared to being single, having a metropolitan background partner was a negative predictor (0.34 [0.21-0.57]. The effects of RB and RCS were additive-compared to MB and MCS (Reference group: RB and RCS-1 (6.58[3.32-13.04], RB and RCS-2 (10.36[4.89-21.93]. Although specialists were less likely than GPs to be in LTRP, the pattern of the effects of rural exposures was similar, although some significant differences in the effects of the duration of RCS attendance, bonded scholarships and partner's background were apparent.Among both specialists and GPs, rural background and rural clinical school attendance are independent, duration-dependent, and additive, predictors of longer-term rural practice. Metropolitan
Nelson, Scott C; Hooker, Roderick S
One role of physician assistants (PAs) and nurse practitioners (NPs) is to meet the growing demand for access to rural health care. Critical Access Hospitals, those with less than 25 beds, are usually located in rural communities, often providing continuity of care that clinics cannot deliver. Because little is known about staffing in these small hospital emergency departments, an exploratory study was undertaken using a mixed-methods approach. In Washington State, 18 of the 39 Critical Access Hospitals staff their emergency departments with PAs and NPs. Utilization data were collected through structured interviews by phone or in person on site. Most PAs and NPs lived within the community and staffing tended to be either 24 hours in-house or short notice if they lived or worked nearby. Emergency department visits ranged from 200 to 25,000 per year. All sites were designated level V or IV trauma centers and often managed cardiac events, significant injuries and, in some larger settings, obstetrics. In most instances, PAs were the sole providers in the emergency departments, albeit with physician backup and emergency medical technician support if a surge of emergency cases arose. Two-thirds of the PAs had graduated within the last 5 years. Most preferred the autonomy of the emergency department role and all expressed job satisfaction. Geographically, the more remote a Washington State Critical Access Hospital is, the more likely it will be staffed by PAs/NPs. The diverse utilization of semiautonomous PAs and NPs and their rise in rural hospital employment is a new workforce observation that requires broader investigation.
Pit, S W; Hansen, V
The Australian general practice workforce is ageing. This and a trend towards higher exit intentions and earlier retirement make it increasingly important to identify those work and personal factors affecting intention to leave, which are amenable to change. To assess the various work, occupational and individual health factors associated with early retirement intentions among Australian rural general practitioners (GPs) that may be amenable to intervention. A cross-sectional study of GPs practising in rural Australia. Odds ratios of early retirement intentions across work, occupational and individual health factors were calculated. There were 92 participants (response rate 56%), and 47% of responders intended to retire before 65. GPs with medium to high burnout levels had higher odds of intending to retire. Increased job satisfaction and work ability scores were associated with decreased retirement intentions, whereas increased physical and mental work ability demands were associated with an increase in retirement intentions. Absenteeism was not related to retirement intentions but presenteeism was. GPs reporting any work-related sleep problems were found to have a 3-fold increase in the odds of early retirement intentions. The odds of early retirement intentions also increased with higher psychological distress, worsening general health and longer working hours. From a health policy reform perspective, the greatest impact on reducing early retirement intentions among ageing GPs could potentially be made by intervening in areas of working hours, burnout and work-related sleep issues, followed by job satisfaction, psychological distress, health, general workability and mental and physical work ability. © The Author 2014. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: firstname.lastname@example.org.
Yang, Xiu-Mu; Qi, Yu-Long; Shne, Zheng-Fu; Han, Bu-Xin; Meng, Bei
To perform theory construction and empirical study of the competency model of rural general practitioners. Through literature study, job analysis, interviews, and expert team discussion, the questionnaire of rural general practitioners competency was constructed. A total of 1458 rural general practitioners were surveyed by the questionnaire in 6 central provinces. The common factors were constructed using the principal component method of exploratory factor analysis and confirmatory factor analysis. The influence of the competency characteristics on the working performance was analyzed using regression equation analysis. The Cronbach 's alpha coefficient of the questionnaire was 0.974. The model consisted of 9 dimensions and 59 items. The 9 competency dimensions included basic public health service ability, basic clinical skills, system analysis capability, information management capability, communication and cooperation ability, occupational moral ability, non-medical professional knowledge, personal traits and psychological adaptability. The rate of explained cumulative total variance was 76.855%. The model fitting index were Χ(2)/df 1.88, GFI=0.94, NFI=0.96, NNFI=0.98, PNFI=0.91, RMSEA=0.068, CFI=0.97, IFI=0.97, RFI=0.96, suggesting good model fitting. Regression analysis showed that the competency characteristics had a significant effect on job performance. The rural general practitioners competency model provides reference for rural doctor training, rural order directional cultivation of medical students, and competency performance management of the rural general practitioners.
This open-access article is distributed under. Creative ... procedures performed in rural hospitals in Africa; and Framework for CPD ..... quality surgical care in rural areas is a challenge faced by the present .... Mullan F. The metrics of the physician brain drain. N Engl J Med ... Dare AJ, NgKamstra JS, Patra J, et al. Deaths ...
Hunting, Robert P.; Mousley, Judith A.; Perry, Bob
The project Mathematical Thinking of Preschool Children in Rural and Regional Australia: Research and Practice aimed to investigate views of preschool practitioners about young children's mathematical thinking and development. Structured individual interviews were conducted with 64 preschool practitioners from rural areas of three Australian states. The questions focused on five broad themes: children's mathematics learning, support for mathematics teaching, technology and computers, attitudes and feelings, and assessment and record keeping. We review results from the interview data for each of these themes, discuss their importance, and outline recommendations related to teacher education as well as resource development and research.
Barth, R. E.; van der Meer, J. T. M.; Hoepelman, A. I. M.; Schrooders, P. A.; van de Vijver, D. A.; Geelen, S. P. M.; Tempelman, H. A.
The purpose of this study was to assess the one-year efficacy of highly active antiretroviral therapy (HAART) administered by general practitioners in a primary care community clinic in rural South Africa. We performed an observational cohort study of 675 treatment-naive human immunodeficiency virus
Kverno, Karan; Kozeniewski, Kate
Workforce shortages in mental health care are especially relevant to rural communities. People often turn to their primary care providers for mental healthcare services, yet primary care providers indicate that more education is needed to fill this role. Rural primary care nurse practitioners (NPs) are ideal candidates for educational enhancement. Online programs allow NPs to continue living and working in their communities while developing the competencies to provide comprehensive and integrated mental healthcare services. This article presents a review of current online postgraduate psychiatric mental health NP (PMHNP) options. Website descriptions of online PMHNP programs were located using keywords: PMHNP or psychiatric nurse practitioner, postgraduate or post-master's, and distance or online. Across the United States, 15 online postgraduate certificate programs were located that are designed for primary care NPs seeking additional PMHNP specialization. For rural primary care NPs who are ready, willing, and able, a postgraduate PMHNP specialty certificate can be obtained online in as few as three to four semesters. The expected outcome is a cadre of dually credentialed NPs capable of functioning in an integrated role and of increasing rural access to comprehensive mental healthcare services. ©2016 American Association of Nurse Practitioners.
Barnett, Tony; Hoang, Ha; Stuart, Jackie; Crocombe, Len
Rural residents have poorer oral health and more limited access to dental services than their city counterparts. In rural communities, health care professionals often work in an extended capacity due to the needs of the community and health workforce shortages in these areas. Improved links and greater collaboration between resident rural primary care and dental practitioners could help improve oral health service provision such that interventions are both timely, effective and lead to appropriate follow-up and referral. This study examined the impact oral health problems had on primary health care providers; how primary care networks could be more effectively utilised to improve the provision of oral health services to rural communities; and identified strategies that could be implemented to improve oral health. Case studies of 14 rural communities across three Australian states. Between 2013 and 2016, 105 primary and 12 dental care providers were recruited and interviewed. Qualitative data were analysed in Nvivo 10 using thematic analysis. Quantitative data were subject to descriptive analysis using SPSSv20. Rural residents presented to primary care providers with a range of oral health problems from "everyday" to "10 per month". Management by primary care providers commonly included short-term pain relief, antibiotics, and advice that the patient see a dentist. The communication between non-dental primary care providers and visiting or regional dental practitioners was limited. Participants described a range of strategies that could contribute to better oral health and oral health oral services in their communities. Rural oral health could be improved by building oral health capacity of non-dental care providers; investing in oral health promotion and prevention activities; introducing more flexible service delivery practices to meet the dental needs of both public and private patients; and establishing more effective communication and referral pathways between
Roots, Alison; MacDonald, Marjorie
The formalized nurse practitioner (NP) role in British Columbia is relatively new with most roles implemented in primary care. The majority of primary care is delivered by physicians using the fee-for-service model. There is a shortage of general practitioners associated with the difficulties of recruitment and retention, particularly in rural and remote locations. The uptake of the primary care NP role has been slow due to challenges in understanding the extent of its contributions. This study aims to identify the outcomes associated with the NP role in collaborative primary care practice. Three case studies where NPs were embedded into rural fee-for-service practices were undertaken to determine the outcomes at the practitioner, practice, community, and health services levels. Interviews, documents, and before and after data, were analyzed to identify changes in practise, access, and acute care service utilization. The results showed that NPs affected how care was delivered, particularly through the additional time afforded each patient visit, development of a team approach with interprofessional collaboration, and a change in style of practise from solo to group practise, which resulted in improved physician job satisfaction. Patient access to the practice improved with increased availability of appointments and practice staff experienced improved workplace relationships and satisfaction. At the community level, access to primary care improved for harder-to-serve populations and new linkages developed between the practice and their community. Acute care services experienced a statistically significant decrease in emergency use and admissions to hospital (P = 0.000). The presence of the NP improved their physician colleagues' desire to remain in their current work environment. This study identified the diversity of needs that can be addressed by the NP role. Namely, the importance of time to enhance patient care and its associated benefits, especially in the fee
Overton, John; Murray, Warwick E.
Globalization and industrial restructuring transform rural places in complex and often contradictory ways. These involve both quantitative changes, increasing the size and scope of operation to achieve economies of scale, and qualitative shifts, sometimes leading to a shift up the quality/price scale, towards finer spatial resolution and…
María T. Muñoz Q
Full Text Available Objective: to evaluate the presence of organophosphate metabolites (OP in the urine of rural schoolchildren and estimate its association with their cognitive performance. Methodology: a cross-sectional exploratory study in which a total of 25 children were assessed. Cognitive functioning was measured using the WISC-III intelligence test. Additionally, the concentration of OP metabolites in their urine was tested. Results: 56% of the children had concentration levels above the detection limit for dimethylphosphate (DMP and dimethyltiophosphate (DMTP. Moreover, 92% of them had the metabolite diethylphosphate (DEP values on this limit. Regarding the WISC-III, the intelligence quotient (IQ values below the average (IQ ˃ 90 correspond to: Total IQ = 60% performance IQ = 64%, verbal IQ = 52%, perceptual organization IQ = 60%, processing speed IQ = 95%, and freedom from distractibility IQ = 64%. An inverse association was found between the processing speed factor and DMTP (rs = -0.44, p = 0.014. Conclusions: results indicate that the rural schoolchildren whose urine was measured with OP metabolite biomarkers had been exposed to OP pesticides. A relationship was observed between the presence of OP metabolites and the cognitive performance factor of the WISC-III test. We believe it is appropriate to evaluate the effects of the presence of OP metabolites on cognitive functioning in a larger sample, while considering other exposure variables.
Ingham, Gerard; Fry, Jennifer; O'Meara, Peter; Tourle, Vianne
In medical education, a learner-centred approach is recommended. There is also a trend towards workplace-based learning outside of the hospital setting. In Australia, this has resulted in an increased need for General Practitioner (GP) supervisors who are receptive to using adult learning principles in their teaching. Little is known about what motivates Australian GP supervisors and how they currently teach. A qualitative study involving semi-structured interviews with 20 rural GP supervisors who work within one Regional Training Provider region in Australia explored their reasons for being a supervisor and how they performed their role. Data was analysed using a thematic analysis approach. GP supervisors identified both personal and professional benefits in being a supervisor, as well as some benefits for their practice. Supervision fulfilled a perceived broader responsibility to the profession and community, though they felt it had little impact on rural retention of doctors. While financial issues did not provide significant motivation to teach, the increasing financial inequity compared with providing direct patient care might impact negatively on the decision to be or to remain a supervisor in the future. The principal challenge for supervisors was finding time for teaching. Despite this, there was little evidence of supervisors adopting strategies to reduce teaching load. Teaching methods were reported in the majority to be case-based with styles extending from didactic to coach/facilitator. The two-way collegiate relationship with a registrar was valued, with supervisors taking an interest in the registrars beyond their development as a clinician. Supervisors report positively on their teaching and mentoring roles. Recruitment strategies that highlight the personal and professional benefits that supervision offers are needed. Practices need assistance to adopt models of supervision and teaching that will help supervisors productively manage the increasing
McCarty, Dennis; Rieckmann, Traci; Green, Carla; Gallon, Steve; Knudsen, Jeff
The Opiate Medication Initiative for Rural Oregon Residents trained physicians and counselors in Central and Southwestern Oregon to use buprenorphine and develop service models that supported patient participation in drug abuse counseling. The Change Book from Addiction Technology Transfer Centers was used to structure the change process. Fifty-one individuals (17 physicians, 4 pharmacists, 2 nurse practitioners, and 28 drug abuse counselors and administrators) from seven counties completed the training and contributed to the development of community treatment protocols. A pre-post measure of attitudes and beliefs toward the use of buprenorphine suggested significant improvements in attitude after training, especially among counselors. Eight months after training, 10 of 17 physicians trained had received waivers to use buprenorphine and 29 patients were in treatment with six of the physicians. The Change Book facilitated development of county change teams and structured the planning efforts. The initiative also demonstrated the potential to concurrently train physicians, pharmacists, and counselors on the use of buprenorphine.
Nahar, Papreen; Kannuri, Nanda Kishore; Mikkilineni, Sitamma; Murthy, G V S; Phillimore, Peter
This analysis challenges a tendency in public health and the social sciences to associate India's medical pluralism with a distinction between biomedicine, as a homogeneous entity, and its non-biomedical 'others'. We argue that this overdrawn dichotomy obscures the important part played by 'informal' biomedical practice, an issue with salience well beyond India. Based on a qualitative study in rural Andhra Pradesh, South India, we focus on a figure little discussed in the academic literature - the Registered Medical Practitioner (RMP) - who occupies a niche in the medical market-place as an informal exponent of biomedical treatment. We explore the significance of these practitioners by tracking diagnosis and treatment of one increasingly prominent medical 'condition', namely diabetes. The RMP, who despite the title is rarely registered, sheds light on the supposed formal-informal sector divide in India's healthcare system, and its permeability in practice. We develop our analysis by contrasting two distinctive conceptualisations of 'informality' in relation to the state in India - one Sarah Pinto's, the other Ananya Roy's. © 2016 The Authors. Sociology of Health & Illness published by John Wiley & Sons Ltd on behalf of Foundation for SHIL.
Waddimba, Anthony C; Scribani, Melissa; Krupa, Nicole; May, John J; Jenkins, Paul
Widespread dissatisfaction among United States (U.S.) clinicians could endanger ongoing reforms. Practitioners in rural/underserved areas withstand stressors that are unique to or accentuated in those settings. Medical professionals employed by integrating delivery systems are often distressed by the cacophony of organizational change(s) that such consolidation portends. We investigated the factors associated with dis/satisfaction with rural practice among doctors/non-physician practitioners employed by an integrated healthcare delivery network serving 9 counties of upstate New York, during a time of organizational transition. We linked administrative data about practice units with cross-sectional data from a self-administered multi-dimensional questionnaire that contained practitioner demographics plus valid scales assessing autonomy/relatedness needs, risk aversion, tolerance for uncertainty/ambiguity, meaningfulness of patient care, and workload. We targeted medical professionals on the institutional payroll for inclusion. We excluded those who retired, resigned or were fired during the study launch, plus members of the advisory board and research team. Fixed-effects beta regressions were performed to test univariate associations between each factor and the percent of time a provider was dis/satisfied. Factors that manifested significant fixed effects were entered into multivariate, inflated beta regression models of the proportion of time that practitioners were dis/satisfied, incorporating clustering by practice unit as a random effect. Of the 473 eligible participants. 308 (65.1 %) completed the questionnaire. 59.1 % of respondents were doctoral-level; 40.9 % mid-level practitioners. Practitioners with heavier workloads and/or greater uncertainty intolerance were less likely to enjoy top-quintile satisfaction; those deriving greater meaning from practice were more likely. Higher meaningfulness and gratified relational needs increased one's likelihood of
Ollerenshaw, Alison; Wong Shee, Anna; Yates, Mark
To explore the awareness and usage of an online dementia pathways tool (including decision tree and region-specific dementia services) for primary health practitioners (GPs and nurses) in regional Victoria. Quantitative pilot study using surveys and Google Analytics. A large regional area (48 000 square kilometres, population 220 000) in Victoria. Two hundred and sixty-three GPs and 160 practice nurses were invited to participate, with 42 respondents (GPs, n = 21; practice nurses, n = 21). Primary care practitioners' awareness and usage of the dementia pathways tool. Survey respondents that had used the tool (n = 14) reported accessing information about diagnosis, management and referral. Practitioners reported improvements in knowledge, skills and confidence about core dementia topics. There were 9683 page views between August 2013 and February 2015 (monthly average: 509 page views). The average time spent on page was 2.03 min, with many visitors (68%) spending more than 4 min at the site. This research demonstrates that the tool has been well received by practitioners and has been consistently used since its launch. Health practitioners' valued the content and the availability of local resources. Primary health practitioners reported that the dementia pathways tool provided access to region-specific referral and management resources for all stages of dementia. Such tools have broad transferability in other health areas with further research needed to determine their contribution to learning in the practice setting and over time. © 2017 National Rural Health Alliance Inc.
Alam, Nazmul; Mridha, Malay K; Kristensen, Sibylle; Vermund, Sten H
Sexually transmitted infection (STI) management is considered rudimentary among rural medical practitioners (RMPs) in Bangladesh. We sought to understand the level of knowledge and skills in STI management and to assess the impact of a two-day training orientation among RMPs in Tangail district. Data were collected through a baseline survey of 225 practicing RMPs in the study area and a three-month follow-up survey of 99 RMPs who participated in a two-day STI/HIV orientation training. The level of formal training among RMPs ranged from none (22.7%), to paramedical training (14.7%) and local medical assistant training (62.6%). The baseline survey revealed a low level of STI/HIV knowledge and misconceptions about the transmission of STI/HIV among RMPs. RMPs mostly prescribed first line antibiotics for treatment of common reproductive tract infections (RTIs) including STIs, but they rarely prescribed the correct dosages according to the national RTI/STI management guidelines. Only 3% of RMPs were able to correctly answer all four HIV transmission (unprotected sexual intercourse, blood transfusion, needle sharing and mother to child transmission) questions at baseline, while 94.9% of RMPs answered all four correctly at three months following the training (p=0.001). Only 10% of RMPs reported suggesting the recommended drug (azithromycin) and only 2% mentioned about the recommended dosage (2gm single dose) for the treatment of urethritis/cervicitis; compared to 49.5% suggested azithromycin at follow-up with 39.4% mentioned the recommended 2gm single dose (p=0.001). Our study found low level of knowledge and poor practices related RTI/STI management among RMPs. Short orientation training and education intervention shown promise to increase knowledge and management skills for RTIs/STIs.
Full Text Available Abstract: We studied the relationship between happiness and individual socio-demographic context and health and dietary variables by interviewing 389 elderly individuals (age 60-90 years living in rural areas in the Maule Region of Central Chile. The Lyubomirsky & Lepper (1999 subjective happiness scale was used. Ordinal logistic regression models were estimated. The discrete dependent variable was level of happiness. The following variables were significantly associated with happiness: (1 individual socio-demographic variables like age and satisfaction with the economic situation; (2 health variables like independence in activities of daily living, common activities, and self-rated health; and (3 dietary variables such as life satisfaction related to food and the frequency with which the elders shared dinner with others. The study results suggest more efficient efforts at healthy eating for the elderly in rural areas.
Byrd, Pippa; Ward, Olga; Hamdorf, Jeffrey
Objective To investigate the effect of a short surgical skills course on general practitioners' confidence levels to perform procedural skills. Design Prospective observational study. Setting The Clinical Evaluation and Training Centre, a practical skills-based educational facility, at The University of Western Australia. Participants Medical practitioners who participated in these courses. Nurses, physiotherapists, and medical students were excluded. The response rate was 61% with 61 participants providing 788 responses for pre- and postcourse confidence levels regarding various surgical skills. Intervention One- to two-day surgical skills courses consisting of presentations, demonstrations, and practical stations, facilitated by specialists. Main Outcome Measures A two-page precourse and postcourse questionnaire was administered to medical practitioners on the day. Participants rated their confidence levels to perform skills addressed during the course on a 4-point Likert scale. Results Of the 788 responses regarding confidence levels, 621 were rated as improved postcourse, 163 were rated as no change, and 4 were rated as lower postcourse. Seven of the courses showed a 25% median increase in confidence levels, and one course demonstrated a 50% median increase. All courses showed statistically significant results ( p skills course resulted in a statistically significant improvement in the confidence levels of rural general practitioners to perform these skills.
Wardle, J; Adams, J; Sibbritt, D
Homeopathy has attracted considerable recent attention from the Australian conventional medical community. However, despite such increased attention there has been little exploration of the interface between homeopathy and Australian conventional medical practice. This article addresses this research gap by exploring homeopathic practice and referral by rural and regional Australian general practitioners (GPs). A 27-item questionnaire was sent to all 1486 GPs currently practising in rural and regional New South Wales, Australia (response rate 40.7%). Few GPs in this study utilised homeopathy in their personal practice, with only 0.5% of GPs prescribing homeopathy in the past 12 months, and 8.5% referring patients for homeopathic treatment at least a few times over the past 12 months. Nearly two-thirds of GPs (63.9%) reported that they would not refer for homeopathy under any circumstances. Being in a remote location, receiving patient requests for homeopathy, observing positive responses from homeopathy previously, using complementary and alternative medicine (CAM) practitioners as information sources, higher levels of knowledge of homeopathy, and being interested in increasing CAM knowledge were all independently predictive of increased referral to homeopathy amongst GPs in this study. GPs in this study were less likely to refer to homeopathy if they used peer-reviewed literature as the major source of their information on CAM. Homeopathy is not integrated significantly in rural general practice either via GP utilisation or referral. There is significant opposition to homeopathy referral amongst rural and regional GPs, though some level of interaction with homeopathic providers exists. Copyright © 2013 The Faculty of Homeopathy. Published by Elsevier Ltd. All rights reserved.
Choo, Wai K; McGeary, Katie; Farman, Colin; Greyling, Andre; Cross, Stephen J; Leslie, Stephen J
This study aimed to examine whether general practitioner (GP) practice locations in remote and rural areas affected the pattern of direct access echocardiography referral and to assess any variations in echocardiographic findings. All referrals made by all GP practices in the Scottish Highlands over a 36-month period were analysed. Referral patterns were examined according to distance and rurality based on the Scottish Government's Urban-Rural Classification. Reasons for referral and cardiac abnormality detection rates were also examined. In total, 1188 referrals were made from 49 different GP practices; range of referral rates was 0.3-20.1 per 1000 population with a mean of 6.5 referrals per 1000 population. Referral rates were not significantly different between urban and rural practices after correction for population size. There was no correlation between the referral rates and the distance from the centre (r2=0.004, p=0.65). The most common reason for referral was the presence of new murmur (46%). The most common presenting symptom was breathlessness (44%). Overall, 28% of studies had significant abnormal findings requiring direct input from a cardiologist. There was no clear relationship between referral rates and cardiac abnormality detection rates (r2=0.07, p=0.37). The average cardiac abnormality detection rate was 56%, (range 52-60%), with no variation based on rurality (p=0.891). In this cohort, rurality and distance were not barriers to an equitable direct access echocardiography service. Cardiac abnormality detection rates are consistent with that of other studies.
Day, Susan E; Alford, Katrina; Dunt, David; Peacock, Stuart; Gurrin, Lyle; Voaklander, Don
Background Recent increases in the bulk-billing rate have been taken as an indication that the Federal government's Strengthening Medicare initiative, and particularly the bulk-billing incentives, are 'working'. Given the enduring geographic differences in the supply of general practitioners (GPs) it is timely to reconsider the impact that this increase in the provision of 'free care' will have on access to Medicare-funded GP services in rural and urban areas of Australia. Utilisation has been modelled as two different stochastic processes: the decision to consult and the frequency of consultation. Results In the decision to consult model the supply of FFS GPs is a more important predictor of utilisation than the bulk-billing rate. Paradoxically the modelling predicts that ceteris paribus increases in either GP supply or the bulk-billing rate appear to have perverse effects in some areas by decreasing utilisation. In the frequency of consultation model, GP density is not a predictor and increasing the bulk-billing rate will unambiguously increase the frequency of consultation across all areas. In both models, the positive impacts associated with changes in supply and cost are constrained outside the inner metropolitan area by reduced geographic accessibility to Medicare-funded GP services. The modelling also shows that people are more likely to consult a GP in areas of high socioeconomic disadvantage, although socioeconomic status is not a predictor of frequency of consultation. Conclusion Bulk-billing rates and the supply of FFS GPs are important features of the Australian health care system that are, potentially, amenable to policy manipulation. The implications of this research are that government policies designed to achieve similarity in these characteristics across geographic areas will not result in equity of access because they fail to address problems caused by geographic inaccessibility in rural and remote areas. Attempting to increase bulk-billing rates
Edwards, Michael B; Theriault, Daniel S; Shores, Kindal A; Melton, Karen M
Research on youth physical activity has focused on urban areas. Rural adolescents are more likely to be physically inactive than urban youth, contributing to higher risk of obesity and chronic diseases. Study objectives were to: (1) identify perceived opportunities and barriers to youth physical activity within a rural area and (2) identify rural community characteristics that facilitate or inhibit efforts to promote youth physical activity. Thirty in-depth interviews were conducted with expert informants in 2 rural southern US counties. Interviewees were recruited from diverse positions across multiple sectors based on their expert knowledge of community policies and programs for youth physical activity. Informants saw ball fields, natural amenities, and school sports as primary resources for youth physical activity, but they were divided on whether opportunities were abundant or scarce. Physical distance, social isolation, lack of community offerings, and transportation were identified as key barriers. Local social networks facilitated political action and volunteer recruitment to support programs. However, communities often lacked human capital to sustain initiatives. Racial divisions influenced perceptions of opportunities. Despite divisions, there were also examples of pooling resources to create and sustain physical activity opportunities. Developing partnerships and leveraging local resources may be essential to overcoming barriers for physical activity promotion in rural areas. Involvement of church leaders, school officials, health care workers, and cooperative extension is likely needed to establish and sustain youth rural physical activity programs. Allocating resources to existing community personnel and volunteers for continuing education may be valuable. © 2014 National Rural Health Association.
Ahmed, M.; Fatmi, Z.; Ali, S.; Ahmed, S.; Ara, N.
Tuberculosis is prevailing in both urban and rural areas of Pakistan. Knowledge, attitude and practice (KAP) of private practitioners (PPs) regarding tuberculosis management have been reported only in urban areas of Pakistan. This survey was conducted for the first time in a rural area of Sindh, Pakistan. This survey was conducted in January 2007 at Thatta, a rural district of Sindh, Pakistan. Study subjects were twenty-two allopathic qualified (MBBS) doctors of district Thatta, who were practicing in private setups for at least last one year. Before TB-DOTS training PPs had filled the KAP questionnaire regarding tuberculosis (TB) diagnosis and management through DOTS. Survey data was analysed through SPSS version 11.05 software. On average, five TB suspects per month were seen by each PP. Only 14% of PPs advised sputum microscopy solely for pulmonary TB diagnosis, while 86% of PPs used different combination of tests (chest x-ray/sputum microscopy/ESR/tuberculin test) for TB diagnosis. Over 40% PPs did not prescribe TB treatment regimen according to TB-DOTS category. Majority PPs (85%) did not follow the treatment through sputum microscopy and instead relied on clinical improvement and x-ray clearance. Nearly 60% of TB patients at PPs clinic did not show compliance to the TB treatment and none of PPs were following the retrieval of default cases. A gross lack of PPs knowledge and right practice regarding TB diagnosis and management through DOTS was identified and needed to be addressed through providing DOTS training. (author)
Adams, Ryan D F; Cole, Elaine; Brundage, Susan I; Morrison, Zoe; Jansen, Jan O
An understanding of stakeholders' views is key to the successful development and operation of a rural trauma system. Scotland, which has large remote and rural areas, is currently implementing a national trauma system. The aim of this study was to identify key barriers and enablers to the development of an effective trauma system from the perspective of rural healthcare professionals. This is a qualitative study, which was conducted in rural general hospitals (RGH) in Scotland, from April to June 2017. We used an opportunistic sampling strategy to include hospital providers of rural trauma care across the region. Semi-structured interviews were conducted, recorded, and transcribed. Thematic analysis was used to identify and group participant perspectives on key barriers and enablers to the development of the new trauma system. We conducted 15 interviews with 18 participants in six RGHs. Study participants described barriers and enablers across three themes: 1) quality of care, 2) interfaces within the system and 3) interfaces with the wider healthcare system. For quality of care, enablers included confidence in basic trauma management, whilst a perceived lack of change from current management was seen as a barrier. The theme of interfaces within the system identified good interaction with other services and a single point of contact for referral as enablers. Perceived barriers included challenges in referring to tertiary care. The final theme of interfaces with the wider healthcare system included an improved transport system, increased audit resource and coordinated clinical training as enablers. Perceived barriers included a rural staffing crisis and problematic patient transfer to further care. This study provides insight into rural professionals' perceptions regarding the implementation of a trauma system in rural Scotland. Barriers included practical issues, such as retrieval, transfer and referral processes. Importantly, there is a degree of uncertainty
Full Text Available This paper reports the results of a study on whether government use of information technology potentially compromises access to law and justice by Queensland regional and rural (RR legal practitioners. The paper describes current approaches to the use of information technology by state and federal governments, and provides an insight into the challenges and opportunities identified by individual RR legal practitioners, policy-makers and the judiciary on the use of such technology. The paper makes recommendations to promote increased access to law and justice for RR legal practitioners when using government information technology.
Hemphill, Elizabeth; Dunn, Steve; Barich, Hayley; Infante, Rebecca
This paper repositions the challenge of attracting and retaining rural GPs in a marketing context as a new focus for future research and policy development. Case study with mixed design of surveys of GPs and medical students and depth interviews with GPs, medical students, regional-division administrators and GP recruitment agents. GP recruitment and retention in the Limestone Coast region of South Australia. Twenty-seven Limestone Coast (LC) GPs; random sample of medical students from Adelaide University, Adelaide University Rural Health Society and Flinders University; snowball sampling two adjacent rural regions (20 GPs); and administrators from LC and adjacent regions and GP recruitment agencies in Adelaide. Drawing from marketing theory, creative suggestion of 'promotion of the practice and not the region' offers a means of GP recruitment and retention for structured succession planning for rural general practices. Structural attempts to broaden the GP market with overseas recruitment have done little for improving full-time equivalent GP levels. Market segmentation and market orientation offer a new emphasis on value exchange between the corporation (the practice), customer (GPs) and competition (all practices) to influence future mobility. A marketing orientation to the GP challenge emphasises individual's perceptions of value, GP expectations and practice offerings. Failure to acknowledge benefits of this marketing approach means that solutions such as those developed in the Limestone Coast region are unlikely. Research is now required to define GP satisfaction and value for long-term viability of general practices.
Hasbrouck, Melinda A; Waddimba, Anthony C
Escalating demands on practitioners, stagnating/dwindling resources, and diminishing autonomy have heightened patient-care work-related stress. Using qualitative content/thematic analysis of responses to open-ended survey questions, plus spontaneous comments, we sought to identify rural clinicians' subjective perceptions of their workplace stressors and typical adaptive/coping strategies. Within a hybrid inductive-deductive approach, we framed empirical themes (derived by consensus, corroborated with text segments, and extant literature) into theory-based coding templates by which we analyzed the data. Of 308 (65.1% of) recipients completing questionnaires, 290 (94%) answered open-ended questions and/or provided comments. Categorizing stressors by socio-ecology, they cited four themes: Organizational, practitioner/staff-related, patient-related, and third party-induced stressors. Organizational stressors were referenced most conspicuously. How respondents described their coping fitted the Stress, Appraisal and Coping. [Lazarus and Folkman (1984): New York, NY: Springer Publishing Company, Inc] model. Emotion-focused were referenced more than problem-focused approaches. Themes scarcely differed by demographics, except for marital status. Findings highlight needs for resilience coaching, rekindling work meaningfulness, mentorship in work-home balance/limit-setting, supportive peer networks, and deeper teamwork. © 2017 Wiley Periodicals, Inc.
Paul, Christine L; Piterman, Leon; Shaw, Jonathan E; Kirby, Catherine; Forshaw, Kristy L; Robinson, Jennifer; Thepwongsa, Isaraporn; Sanson-Fisher, Robert W
In Australia, rural and remote communities have high rates of diabetes-related death and hospitalisation. General practitioners (GPs) play a major role in diabetes detection and management. Education of GPs could optimise diabetes management and improve patient outcomes at a population level. The study aimed to describe the uptake of a continuing medical education intervention for rural GPs and its impact on the viability of a cluster randomised controlled trial of the effects of continuing medical education on whole-town diabetes monitoring and control. Trial design: the cluster randomised controlled trial involved towns as the unit of allocation and analysis with outcomes assessed by de-identified pathology data (not reported here). The intervention programme consisted of an online active learning module, direct electronic access to specialist advice and performance feedback. Multiple rounds of invitation were used to engage GPs with the online intervention content. Evidence-based strategies (e.g. pre-notification, rewards, incentives) were incorporated into the invitations to enrol in the programme. Recruitment to the programme was electronically monitored through the hosting software package during the study intervention period. Eleven matched pairs of towns were included in the study. There were 146 GPs in the 11 intervention towns, of whom 34 (23.3%) enrolled in the programme, and 8 (5.5%) completed the online learning module. No town had more than 10% of the resident GPs complete the learning module. There were no contacts made by GPs regarding requests for specialist advice. Consequently, the trial was discontinued. There is an ongoing need to engage primary care physicians in improving diabetes monitoring and management in rural areas. Online training options, while notionally attractive and accessible, are not likely to have high levels of uptake, even when evidence-based recruitment strategies are implemented. Australian New Zealand Clinical Trials
Supervision, support and mentoring interventions for health practitioners in rural and remote contexts: an integrative review and thematic synthesis of the literature to identify mechanisms for successful outcomes.
Moran, Anna M; Coyle, Julia; Pope, Rod; Boxall, Dianne; Nancarrow, Susan A; Young, Jennifer
To identify mechanisms for the successful implementation of support strategies for health-care practitioners in rural and remote contexts. This is an integrative review and thematic synthesis of the empirical literature that examines support interventions for health-care practitioners in rural and remote contexts. This review includes 43 papers that evaluated support strategies for the rural and remote health workforce. Interventions were predominantly training and education programmes with limited evaluations of supervision and mentoring interventions. The mechanisms associated with successful outcomes included: access to appropriate and adequate training, skills and knowledge for the support intervention; accessible and adequate resources; active involvement of stakeholders in programme design, implementation and evaluation; a needs analysis prior to the intervention; external support, organisation, facilitation and/or coordination of the programme; marketing of the programme; organisational commitment; appropriate mode of delivery; leadership; and regular feedback and evaluation of the programme. Through a synthesis of the literature, this research has identified a number of mechanisms that are associated with successful support interventions for health-care practitioners in rural and remote contexts. This research utilised a methodology developed for studying complex interventions in response to the perceived limitations of traditional systematic reviews. This synthesis of the evidence will provide decision-makers at all levels with a collection of mechanisms that can assist the development and implementation of support strategies for staff in rural and remote contexts.
Supervision, support and mentoring interventions for health practitioners in rural and remote contexts: an integrative review and thematic synthesis of the literature to identify mechanisms for successful outcomes
Objective To identify mechanisms for the successful implementation of support strategies for health-care practitioners in rural and remote contexts. Design This is an integrative review and thematic synthesis of the empirical literature that examines support interventions for health-care practitioners in rural and remote contexts. Results This review includes 43 papers that evaluated support strategies for the rural and remote health workforce. Interventions were predominantly training and education programmes with limited evaluations of supervision and mentoring interventions. The mechanisms associated with successful outcomes included: access to appropriate and adequate training, skills and knowledge for the support intervention; accessible and adequate resources; active involvement of stakeholders in programme design, implementation and evaluation; a needs analysis prior to the intervention; external support, organisation, facilitation and/or coordination of the programme; marketing of the programme; organisational commitment; appropriate mode of delivery; leadership; and regular feedback and evaluation of the programme. Conclusion Through a synthesis of the literature, this research has identified a number of mechanisms that are associated with successful support interventions for health-care practitioners in rural and remote contexts. This research utilised a methodology developed for studying complex interventions in response to the perceived limitations of traditional systematic reviews. This synthesis of the evidence will provide decision-makers at all levels with a collection of mechanisms that can assist the development and implementation of support strategies for staff in rural and remote contexts. PMID:24521004
Vyas, Rashmi; Zachariah, Anand; Swamidasan, Isobel; Doris, Priya; Harris, Ilene
Christian Medical College Vellore (CMC) aspired through its Fellowship in Secondary Hospital Medicine (FSHM), a 1-year distance-learning program, to integrate academic learning and service development through guided projects for junior doctors working in small rural hospitals. The purpose of this article is to report the evaluation of the effectiveness of the project work in the FSHM program. Mixed method evaluation was done using focus group discussion with students, written surveys for students and faculty, and telephone interviews with students and medical superintendents. Evidence for validity was gathered for the written survey. Criteria for trustworthiness were applied for the qualitative data analysis. The major strengths of the project work identified were that students became aware of local health problems and how to deal with them, learned to work as a team, and had a sense of doing something useful. Recommendations for improvement were to have more interactions between guides and students. The benefits of projects to the hospital were providing improved clinical care, improved health systems, cost effective care management and benefits to the community. Service learning through guided project work should be incorporated into distance-learning educational programs for junior doctors working in rural hospitals.
Roche, Tina E; Gardner, Glenn; Jack, Leanne
Health reforms in service improvement have included the use of nurse practitioners. In rural emergency departments, nurse practitioners work to the full scope of their expanded role across all patient acuities including those presenting with undifferentiated chest pain. Currently, there is a paucity of evidence regarding the effectiveness of emergency nurse practitioner service in rural emergency departments. Inquiry into the safety and quality of the service, particularly regarding the management of complex conditions is a priority to ensure that this service improvement model meets health care needs of rural communities. This study used a prospective, longitudinal nested cohort study of rural emergency departments in Queensland, Australia. Sixty-one consecutive adult patients with chest pain who presented between November 2014 and February 2016 were recruited into the study cohort. A nested cohort of 41 participants with suspected or confirmed acute coronary syndrome were identified. The primary outcome was adherence to guidelines and diagnostic accuracy of electrocardiograph interpretation for the nested cohort. Secondary outcomes included service indicators of waiting times, diagnostic accuracy as measured by unplanned representation rates, satisfaction with care, quality-of-life, and functional status. Data were examined and compared for differences for participants managed by emergency nurse practitioners and those managed in the standard model of care. The median waiting time was 8.0 min (IQR 20) and length-of-stay was 100.0 min (IQR 64). Participants were 2.4 times more likely to have an unplanned representation if managed by the standard service model. The majority of participants (91.5%) were highly satisfied with the care that they received, which was maintained at 30-day follow-up measurement. In the evaluation of quality of life and functional status, summary scores for the SF-12 were comparable with previous studies. No differences were
Zuma, Thembelihle; Wight, Daniel; Rochat, Tamsen; Moshabela, Mosa
Traditional health practitioners (THPs) play a vital role in the health care of the majority of the South African population and elsewhere on the African continent. However, many studies have challenged the role of THPs in health care. Concerns raised in the literature include the rationale, safety and effectiveness of traditional health practices and methods, as well as what informs them. This paper explores the processes followed in becoming a traditional healer and how these processes are related to THP roles. A qualitative research design was adopted, using four repeat group discussions with nine THPs, as part of a larger qualitative study conducted within the HIV Treatment as Prevention trial in rural South Africa. THPs were sampled through the local THP association and snowballing techniques. Data collection approaches included photo-voice and community walks. The role identity theory and content analysis were used to explore the data following transcription and translation. In the context of rural Northern KwaZulu-Natal, three types of THPs were identified: 1) Isangoma (diviner); 2) Inyanga (one who focuses on traditional medical remedies) and 3) Umthandazi (faith healer). Findings revealed that THPs are called by ancestors to become healers and/or go through an intensive process of learning about traditional medicines including plant, animal or mineral substances to provide health care. Some THPs identified themselves primarily as one type of healer, while most occupied multiple healing categories, that is, they practiced across different healing types. Our study also demonstrates that THPs fulfil roles that are not specific to the type of healer they are, these include services that go beyond the uses of herbs for physical illnesses or divination. THPs serve roles which include, but are not limited to, being custodians of traditional African religion and customs, educators about culture, counsellors, mediators and spiritual protectors. THPs' mode specific
Dowell, J; Norbury, M; Steven, K; Guthrie, B
Widening access to medicine in the UK is a recalcitrant problem of increasing political importance, with associated strong social justice arguments but without clear evidence of impact on service delivery. Evidence from the United States suggests that widening access may enhance care to underserved communities. Additionally, rural origin has been demonstrated to be the factor most strongly associated with rural practice. However the evidence regarding socio-economic and rural background and subsequent practice locations in the UK has not been explored. The aim of this study was to investigate the association between general practitioners' (GPs) socio-economic and rural background at application to medical school and demographic characteristics of their current practice. The study design was a cross-sectional email survey of general practitioners practising in Scotland. Socio-economic status of GPs at application to medical school was assessed using the self-coded National Statistics Socio-Economic Classification. UK postcode at application was used to define urban-rural location. Current practice deprivation and remoteness was measured using NHS Scotland defined measures based on registered patients' postcodes. A survey was sent to 2050 Scottish GPs with a valid accessible email address, with 801 (41.5 %) responding. GPs whose parents had semi-routine or routine occupations had 4.3 times the odds of working in a deprived practice compared to those with parents from managerial and professional occupations (95 % CI 1.8-10.2, p = 0.001). GPs from remote and rural Scottish backgrounds were more likely to work in remote Scottish practices, as were GPs originating from other UK countries. This study showed that childhood background is associated with the population GPs subsequently serve, implying that widening access may positively affect service delivery in addition to any social justice rationale. Longitudinal research is needed to explore this association and the
Caroline Lydia Hart
Since 2007 the Legal Profession Act 2007 (Qld) has offered legal practitioners a wider choice of business structure other than sole practitioner or partnership, to include incorporated legal practice ('ILP') or multidisciplinary partnership. In particular the use of ILPs offers legal practitioners a range of benefits in terms of operating a law firm consistent with business management practices. The status of ILP however comes at a cost of putting in place 'appropriate management systems'. ...
Wardle, Jon L; Sibbritt, David W; Adams, Jon
Massage therapists are an important part of the health care setting in rural and regional Australia and are the largest complementary and alternative medicine (CAM) profession based on both practitioner numbers and use. The purpose of this study was to survey medical general practitioners (GPs) in rural and regional New South Wales, Australia, to identify their knowledge, attitudes, relationships, and patterns of referral to massage therapy in primary health care. A 27-item questionnaire was sent to all 1486 GPs currently practicing in rural and regional Divisions of General Practice in New South Wales, Australia. The survey had 5 general areas: the GP's personal use and knowledge of massage, the GP's professional relationships with massage practice and massage practitioners, the GP's specific opinions on massage, the GP's information-seeking behavior in relation to massage, and the GP's assumptions on massage use by patients in their local areas. A total of 585 questionnaires were returned completed, with 49 survey questionnaires returned as "no longer at this address" (response rate of 40.7%). More than three-quarters of GPs (76.6%) referred to massage therapy at least a few times per year, with 12.5% of GPs referring at least once per week. The GP being in a nonremote location (odds ratio [OR], 14.28; 95% confidence interval [CI], 3.7-50.0), graduating from an Australian medical school (OR, 2.03; 95% CI, 1.09-3.70), perceiving a lack of other treatment options (OR, 2.64; 95% CI, 1.15-6.01), perceiving good patient access to a wide variety of medical specialists (OR, 11.1; 95% CI, 1.7-50.0), believing in the efficacy of massage therapy (OR, 2.75; 95% CI, 1.58-4.78), experiencing positive results from patients using massage therapy previously (OR, 13.95; 95% CI, 5.96-32.64), or having prescribed any CAM previously (OR, 1.83; 95% CI, 1.03-3.27) were all independently predictive of increased referral to massage therapy among the GPs in this study. There appears to
Keane, Sheila; Lincoln, Michelle; Rolfe, Margaret; Smith, Tony
Policy initiatives to improve retention of the rural health workforce have relied primarily on evidence for rural doctors, most of whom practice under a private business model. Much of the literature for rural allied health (AH) workforce focuses on the public sector. The AH professions are diverse, with mixed public, private or combined practice settings. This study explores sector differences in factors affecting retention of rural AH professionals. This study compared respondents from the 2008 Rural Allied Health Workforce (RAHW) survey recruiting all AH professionals in rural New South Wales. Comparisons between public (n = 833) and private (n = 756) groups were undertaken using Chi square analysis to measure association for demographics, job satisfaction and intention to leave. The final section of the RAHW survey comprised 33 questions relating to retention. A factor analysis was conducted for each cohort. Factor reliability was assessed and retained factors were included in a binary logistic regression analysis for each cohort predicting intention to leave. Six factors were identified: professional isolation, participation in community, clinical demand, taking time away from work, resources and 'specialist generalist' work. Factors differed slightly between groups. A seventh factor (management) was present only in the public cohort. Gender was not a significant predictor of intention to leave. Age group was the strongest predictor of intention to leave with younger and older groups being significantly more likely to leave than middle aged.In univariate logistic analysis (after adjusting for age group), the ability to get away from work did not predict intention to leave in either group. In multivariate analysis, high clinical demand predicted intention to leave in both the public (OR = 1.40, 95% CI = 1.08, 1.83) and private (OR = 1.61, 95% CI = 1.15, 2.25) cohorts. Professional isolation (OR = 1.39. 95% CI = 1.11, 1.75) and Participation in community (OR = 1
Tynan, Anna; Deeth, Lisa; McKenzie, Debra; Bourke, Carolyn; Stenhouse, Shayne; Pitt, Jacinta; Linneman, Helen
Residents of residential aged care facilities are at very high risk of developing complex oral diseases and dental problems. Key barriers exist in delivering oral health services to residential aged care facilities, particularly in regional and rural areas. A quality improvement study incorporating pre- and post chart audits and pre- and post consultation with key stakeholders, including staff and residents, expert opinion on cost estimates and field notes were used. One regional and three rural residential aged care facilities situated in a non-metropolitan hospital and health service in Queensland. Number of appointments avoided at an oral health facility Feedback on program experience by staff and residents Compliance with oral health care plan implementation Observations of costs involved to deliver new service. The model developed incorporated a visit by an oral health therapist for screening, education, simple intervention and referral for a teledentistry session if required. Results showed an improvement in implementation of oral health care plans and a minimisation of need for residents to attend an oral health care facility. Potential financial and social cost savings for residents and the facilities were also noted. Screening via the oral health therapist and teledentistry appointment minimises the need for a visit to an oral health facility and subsequent disruption to residents in residential aged care facilities. © 2018 National Rural Health Alliance Ltd.
Berndt, Angela; Murray, Carolyn M; Kennedy, Kate; Stanley, Mandy J; Gilbert-Hunt, Susan
Allied health professionals working in rural areas face unique challenges, often with limited access to resources. Accessing continuing professional development is one of those challenges and is related to retention of workforce. Effectiveness of distance learning strategies for continuing professional development in rural allied healthcare workers has not been evaluated. We searched 17 databases and the grey literature up to September 2016 following the PRISMA guidelines. Any primary studies were included that focussed on allied health and distance delivery regardless of education topic or study design. Two independent reviewers extracted data and critically appraised the selected studies. The search returned 5257 results. With removal of duplicate references, we reviewed 3964 article titles and abstracts; n = 206 appeared potentially eligible and were scrutinised via full text screening; n = 14 were included. Studies were published between 1997 and 2016, were of varied methodological quality and were predominantly from Australia, USA and Canada with a focus on satisfaction of learners with the delivery method or on measures of educational outcomes. Technologies used to deliver distance education included video conference, teleconference, web based platforms and virtual reality. Early papers tended to focus more on the technology characteristics than educational outcomes. Some studies compared technology based delivery to face to face modes and found satisfaction and learning outcomes to be on par. Only three studies reported on practice change following the educational intervention and, despite a suggestion there is a link between the constructs, none measured the relationship between access to continuing professional development and workforce retention. Technology based options of delivery have a high utility, however the complex inter-relatedness of time, use, travel, location, costs, interactivity, learning outcomes and educational design suggest a need
Massengo, Serge A; Cisse, M; Guiziou, C; Leray, E; Rajabally, Yusuf A; Edan, G
Management of transient ischemic attacks (TIAs) is of vital importance in an attempt to prevent stroke. However, suboptimal management still raise concern among general practitioners (GPs) and emergency department (ED) physicians-the first medical contact of most TIA patients. This may relate to their poorly updated knowledge about TIA. The study was designed to assess knowledge of TIA among these non-neurologists. The study was a post-mailed questionnaire survey among GPs and ED physicians. The questionnaire related to selective clinical aspects on TIA. There were a total of 85 respondents for analysis, mostly GPs (n=64; 75.3%), out of 177 mailed physicians. Response rate was 52.7%. Many of these respondents were unaware of the newly proposed TIA definition (59%), unfamiliar with TIA mimics and predictors of post-TIA early stroke recurrence and therefore with the rationales underlying the need of emergency management of TIA. More than one third (39%) were unaware of the relevant national guidelines. Guidelines-aware respondents performed better in most part of the mailed questionnaire. Our results show that poorly updated knowledge about TIA among non-neurologists represents a potential contributing factor to the persisting sub-optimal management of the disorder. Although further studies are needed to confirm this, improved continuous medical education of this group of health care professionals appears warranted. Copyright © 2013 Elsevier B.V. All rights reserved.
Prasad, Sadhana; Dunn, Wendy; Hillier, Loretta M; McAiney, Carrie A; Warren, Rex; Rutherford, Paul
This article describes the implementation of the Care for Seniors model of care, an innovative approach to improving care coordination and integration, and provides preliminary evidence of effective use of specialist resources and acute care services. Retrospective. Primary care; cross-sector. Older adults living in a rural area in southwestern Ontario, Canada. Number of new geriatrician referrals and follow-up visits before and after the launch of the Care for Seniors program, number of Nurse Practitioner visits in a primary care setting, in-home, retirement home and hospital, number of discharges home from hospital and length of hospital stay between. In the 2 years before the launch of the program, the total number of visits to the geriatrician for individuals from this FHT was relatively low, 21 and 15, respectively for 2005-06 and 2006-07, increasing to 73 for the 2011-12 year. Although the absolute number of individuals supported by the NP-Geri has remained relatively the same, the numbers seen in the primary care office or in the senior's clinic has declined over time, and the number of home visits has increased, as have visits in the retirement homes. The percentage of individuals discharged home increased from 19% in 2008-09 to 31% in 2009-10 and 26% in 2011-12 and the average length of stay decreased over time. This model of care represents a promising collaboration between primary care and specialist care for improving care to frail older adults living in rural communities, potentially improving timely access to health care and crisis intervention. © 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.
Moshabela, Mosa; Zuma, Thembelihle; Orne-Gliemann, Joanna; Iwuji, Collins; Larmarange, Joseph; McGrath, Nuala
The ANRS 12249 Treatment-as-Prevention (TasP) cluster-randomized trial in rural South Africa uses a "test and treat" approach. Home-based testing services and antiretroviral treatment initiation satellite clinics were implemented in every cluster as part of the trial. A social science research agenda was nested within TasP with the aim of understanding the social, economic and contextual factors that affect individuals, households, communities and health systems with respect to TasP. Considering the rural nature of the trial setting, we sought to understand community perceptions and experiences of the TasP Trial interventions as seen through the eyes of traditional health practitioners (THPs). A qualitative study design was adopted using four repeat focus group discussions conducted with nine THPs, combined with community walks and photo-voice techniques, over a period of 18 months. A descriptive, interpretive and explanatory approach to analysis was adopted. Findings indicate that THPs engaged with the home-based testing services and HIV clinics established for TasP. Specifically, home-based testing services were perceived as relatively successful in increasing access to HIV testing. A major gap observed by THPs was linkage to HIV clinics. Most of their clients, and some of the THPs themselves, found it difficult to use HIV clinics due to fear of labelling, stigma and discrimination, and the ensuing personal implications of unsolicited disclosure. On the one hand, a growing number of patients diagnosed with HIV have found sanctuary with THPs as alternatives to clinics. On the other hand, THPs in turn have been struggling to channel patients suspected of HIV into clinics through referrals. Therefore, acceptability of the TasP test and treat approach by THPs is a major boost to the intervention, but further success can be achieved through strengthened ties with communities to combat stigma and effectively link patients into HIV care, including partnerships with THPs
Jones, Martin; Ferguson, Monika; Walsh, Sandra; Martinez, Lee; Marsh, Michael; Cronin, Kathryn; Procter, Nicolas
There are well-established training programmes available to support health and human services professionals working with people vulnerable to suicide. However, little is known about involving people with lived experience in the delivery of suicide prevention training with communities with increased rates of suicide. The aim of this paper was to report on a formative dialogical evaluation that explored the views of health and human services workers with regard to a suicide prevention training programme in regional (including rural and remote areas) South Australia which included meaningful involvement of a person with lived experience in the development and delivery of the training. In 2015, eight suicide prevention training workshops were conducted with health and human services workers. All 248 participants lived and worked in South Australian regional communities. We interviewed a subsample of 24 participants across eight sites. A thematic analysis of the interviews identified five themes: Coproduction is key, It is okay to ask the question, Caring for my community, I can make a difference and Learning for future training. The overall meta-theme was "Involvement of a person with lived experience in suicide prevention training supports regional communities to look out for people at risk of suicide." This paper highlights the need for suicide prevention training and other workforce development programmes to include lived experience participation as a core component in development and delivery. © 2018 John Wiley & Sons Ltd.
Full Text Available In low- and middle-income countries (LMICs, where the rates of maternal mortality continue to be inappropriately high, there has been recognition of the importance of training traditional birth attendants (TBAs to help improve outcomes during pregnancy and childbirth. In Guatemala, there is no national comprehensive training program in place despite the fact that the majority of women rely on TBAs during pregnancy and childbirth. This community case study presents a unique education program led by TBAs for TBAs in rural Guatemala. Discussion of this training program focuses on programming implementation, curriculum development, sustainable methodology, and how an educational partnership with the current national health-care system can increase access to health care for women in LMICs. Recent modifications to this training model are also discussed including how a change in the clinical curriculum is further integrating TBAs into the national health infrastructure. The training program has demonstrated that Guatemalan TBAs are able to improve their basic obstetrical knowledge, are capable of identifying and referring early complications of pregnancy and labor, and can deliver basic prenatal care that would otherwise not be provided. This training model is helping transform the role of the TBA from a sole cultural practitioner to a validated health-care provider within the health-care infrastructure of Guatemala and has the potential to do the same in other LMICs.
Hernandez, Sasha; Oliveira, Jessica Bastos; Shirazian, Taraneh
In low- and middle-income countries (LMICs), where the rates of maternal mortality continue to be inappropriately high, there has been recognition of the importance of training traditional birth attendants (TBAs) to help improve outcomes during pregnancy and childbirth. In Guatemala, there is no national comprehensive training program in place despite the fact that the majority of women rely on TBAs during pregnancy and childbirth. This community case study presents a unique education program led by TBAs for TBAs in rural Guatemala. Discussion of this training program focuses on programming implementation, curriculum development, sustainable methodology, and how an educational partnership with the current national health-care system can increase access to health care for women in LMICs. Recent modifications to this training model are also discussed including how a change in the clinical curriculum is further integrating TBAs into the national health infrastructure. The training program has demonstrated that Guatemalan TBAs are able to improve their basic obstetrical knowledge, are capable of identifying and referring early complications of pregnancy and labor, and can deliver basic prenatal care that would otherwise not be provided. This training model is helping transform the role of the TBA from a sole cultural practitioner to a validated health-care provider within the health-care infrastructure of Guatemala and has the potential to do the same in other LMICs.
Full Text Available Introduction: Sport is one of the most popular social events worldwide. It becomes interesting to characterize its practitioners, even more in some poorly studied groups such as Paralympic athletes. The main objective of this study is to determine the anthropometric profile of Chilean Elite Paralympic Athletes (CEPA through body composition and somatotype. Material and Methods: A cross-sectional study was conducted with 41 subjects (93% of the classified to the Para-Panamerican Games Toronto 2015, who practiced table tennis (n=6, football 5 (n=11, swimming (n=8, rugby (n=7, powerlifting (n=6 and wheelchair tennis (n=3. The body composition and somatotype were assessed through the protocol described by the International Society for the Advancement of Kinanthropometry (ISAK. Results: The CEPA reach an average for that classifies somatotype mostly as meso-endomorphic (5.3 - 7.8 - 0.5, a BMI of 27.4 kg/m2, and body composition for fat mass reaches 29.8% in women and 25.7% in men, while muscle mass gain 42.6% (women and 44.5% (men. Conclusions: The CEPA have a somatotype profile that classifies mostly as meso-endomorphic, body composition has a predominance muscle mass and high fat mass, although is similar to other Paralympics athletes.
Vergara M, Cristian; Barthel M, Elizabeth; Labarca M, Eduardo; Neira O, Patricia; Espinoza E, Roberto
Tungiasis is a cutaneous ectoparasitosis caused by the female sand flea Tunga penetrans whose higher prevalence occurs in Sub-Saharan Africa, South América and the Caribbean. We report a case of a 23 year old chilean male who presented dermal lesions suggestive of tungiasis on his return from Brazil. The diagnosis was confirmed by biopsy, identifying the arthropod and an egg from one of the lesions. The natural history, co-morbidities and treatment options were reviewed.
José Miguel Palacios; Catalina Donoso Pinto
This article approaches the trauma of the Chilean dictatorship through the intersection between childhood and exile. It analyzes the role of childhood in Chilean exile cinema, focusing on documentaries produced throughout the 1970s and 80s. We will study the presence of childhood as a symbol in the political imaginary of exile, discuss the ways in which cinema recognizes and authorizes children’s testimony, and cover the dilemmas of desexilio and counter-nostalgia in films devoted to the them...
Valdivia, Mario; Silva, Daniel; Sanhueza, Félix; Cova, Félix; Melipillán, Roberto
Suicide mortality rates are increasing among teenagers. To study the prevalence and predictive factors of suicide attempts among Chilean adolescents. A random sample of 195 teenagers aged 16 ± 1 years (53% males) answered an anonymous survey about their demographic features, substance abuse, the Osaka suicidal ideation questionnaire, Smilksten familial Apgar. Beck hopelessness scale, Beck depression scale and Coppersmith self-esteem inventory. Twenty five percent of respondents had attempted suicide at least in one occasion during their lives. These attempts were significantly associated with female gender, absent parents, family dysfunction, drug abuse, smoking, low self-esteem, hopelessness, depression and recent suicidal ideation. A logistic regression analysis accepted female gender, smoking and recent suicidal ideation as significant independent predictors of suicide attempt. Suicide attempted is common among teenagers and its predictors are female sex, smoking and previous suicidal ideation.
Sharp, Dayle B; Monsivais, Diane
To describe difficulties associated with the business-related aspects of practice in role transition of rural nurse practitioners (NPs), and to give practice implications. This focused ethnographic study derived data from semi-structured interviews. Participants provided information about rural NP practice ownership and barriers. The sample consisted of 24 rural NPs living throughout the United States. The majority were 51-60 years of age (45%) and females (93%) who had been in rural practice for 1 to over 20 years. NP social entrepreneurs experience difficulties related to scope of practice, business skills, and role conflict. To decrease barriers for NP clinic ownership and management, NPs need to receive education related to financing a rural practice, legal/regulatory practices, strategic planning, leadership, and clinic management. ©2014 American Association of Nurse Practitioners.
Olafsson, G; Sigurdsson, J A
To examine the access, workload, duties, commitments and quality standards of primary care physicians (GPs) resulting from out-of-hours service. All GPs (n = 96) in rural Iceland. Answers to a postal survey. The participation rate was 80%. The GPs estimated that in 97% of the cases they could be contacted within 5 minutes in an emergency. Under usual circumstances (weather conditions) and within a distance of 10 km, 70% of them could reach the patient within 30 minutes of receiving the call. In severe weather conditions, 50% of the GPs in smaller districts (650-6000 inhabitants) estimated that it could take up to 5 hours or more to reach the patient (which could happen once a year). In the least populated districts, 84% of the GPs had to be on call 14 days or more per month. Serious emergencies (involving special training such as cardiac resuscitation or tracheal intubation) were relatively rare, and GPs expressed the necessity for regular refresher courses in such fields. Modern telecommunication networks guarantee good access to out-of-hours service. The workload and on-call duties are great and do not comply with European Union (EU) recommendations regarding minimal rest time. If GPs in rural areas are to be expected to provide frontline health care, including in severe emergency situations, regular training courses are needed.
Carlos A Celis-Morales
Full Text Available BACKGROUND: Effects of urbanisation on diabetes risk appear to be greater in indigenous populations worldwide than in populations of European origin, but the reasons are unclear. This cross-sectional study aimed to determine whether the effects of environment (Rural vs. Urban, adiposity, fitness and lifestyle variables on insulin resistance differed between individuals of indigenous Mapuche origin compared to those of European origin in Chile. METHODOLOGY/PRINCIPAL FINDINGS: 123 Rural Mapuche, 124 Urban Mapuche, 91 Rural European and 134 Urban European Chilean adults had blood taken for determination of HOMA-estimated insulin resistance (HOMA(IR and underwent assessment of physical activity/sedentary behaviour (using accelerometry, cardiorespiratory fitness, dietary intake and body composition. General linear models were used to determine interactions with ethnicity for key variables. There was a significant "ethnicity x environment" interaction for HOMA(IR (Mean±SD; Rural Mapuche: 1.65±2.03, Urban Mapuche: 4.90±3.05, Rural European: 0.82±0.61, Urban European: 1.55±1.34, p((interaction = 0.0003, such that the effect of urbanisation on HOMA(IR was greater in Mapuches than Europeans. In addition, there were significant interactions (all p<0.004 with ethnicity for effects of adiposity, sedentary time and physical activity on HOMA(IR, with greater effects seen in Mapuches compared to Europeans, an observation that persisted after adjustment for potential confounders. CONCLUSIONS/SIGNIFICANCE: Urbanisation, adiposity, physical activity and sedentary behaviour influence insulin resistance to a greater extent in Chilean Mapuches than Chileans of European descent. These findings have implications for the design and implementation of lifestyle strategies to reduce metabolic risk in different ethnic groups, and for understanding of the mechanisms underpinning human insulin resistance.
Celis-Morales, Carlos A; Perez-Bravo, Francisco; Ibañes, Luis; Sanzana, Ruth; Hormazabal, Edison; Ulloa, Natalia; Calvo, Carlos; Bailey, Mark E S; Gill, Jason M R
Effects of urbanisation on diabetes risk appear to be greater in indigenous populations worldwide than in populations of European origin, but the reasons are unclear. This cross-sectional study aimed to determine whether the effects of environment (Rural vs. Urban), adiposity, fitness and lifestyle variables on insulin resistance differed between individuals of indigenous Mapuche origin compared to those of European origin in Chile. 123 Rural Mapuche, 124 Urban Mapuche, 91 Rural European and 134 Urban European Chilean adults had blood taken for determination of HOMA-estimated insulin resistance (HOMA(IR)) and underwent assessment of physical activity/sedentary behaviour (using accelerometry), cardiorespiratory fitness, dietary intake and body composition. General linear models were used to determine interactions with ethnicity for key variables. There was a significant "ethnicity x environment" interaction for HOMA(IR) (Mean±SD; Rural Mapuche: 1.65±2.03, Urban Mapuche: 4.90±3.05, Rural European: 0.82±0.61, Urban European: 1.55±1.34, p((interaction)) = 0.0003), such that the effect of urbanisation on HOMA(IR) was greater in Mapuches than Europeans. In addition, there were significant interactions (all pMapuches compared to Europeans, an observation that persisted after adjustment for potential confounders. Urbanisation, adiposity, physical activity and sedentary behaviour influence insulin resistance to a greater extent in Chilean Mapuches than Chileans of European descent. These findings have implications for the design and implementation of lifestyle strategies to reduce metabolic risk in different ethnic groups, and for understanding of the mechanisms underpinning human insulin resistance.
Pérez, F; Santos, J L; Albala, C; Calvillán, M; Carrasco, E
Although there is a clear relationship between body mass index and leptin levels, few authors have addressed the possible influence of ethnic factors on these levels. To measure serum leptin in three different Chilean aboriginal populations. Fasting serum leptin and insulin levels were measured by radioimmunoassay in 345 rural mapuche individuals, 247 rural aymara subjects and 162 urban mapuche subjects. A body mass index of 27.5 kg/m2 was used as cutoff point to classify study subjects. Among the three ethnic groups, women had serum leptin levels three times higher than men. In all three ethnic groups, there was a significant association between leptin levels, body mass index and gender (r2 = 0.32 and 0.5 p mapuche, r2 = 0.32 and 0.5 p mapuche populations). No differences in leptin levels were observed for the interaction between age and insulin. The increments per quartile in leptin levels were lower among mapuche than aymara individuals. Rural mapuche individuals have a high frequency of obesity. However their leptin levels are lower than those of aymara or urban mapuche populations. The higher leptin levels observed in urban mapuche subjects could be due to environmental influences.
Pantoja, Silvio; Luis Iriarte, José; Daneri, Giovanni
Chilean Patagonia is one of the most extended fjord regions in the world that covers nearly 240,000 km 2 with an extremely complex coastline and topography in one of the least densely populated areas of the country (1-8 inhabitants every 10 km 2). In recent years, the area has been undergoing somewhat intense pressure since several commercial projects in hydroelectricity, tourism, and commercial salmon and mytilid cultures have been developed, or are in progress. Concomitantly, several large research programs have been devised to study the physical, chemical, and biological environment of Patagonia, such as the CIMAR FIORDO, and recently COPAS Sur-Austral based at Universidad de Concepcion, that attempts to close the bridge between oceanographic knowledge and its use by society. In this introductory article we summarize the collection of papers comprising this Special Issue of Continental Shelf Research. These papers deal with aspects of regional oceanography and geology, inorganic and organic geochemistry, ecology of pelagic and benthic organisms, and past changes in productivity.
Carla Marchant Santiago
Full Text Available Academic production about the main Chilean cities exceeds the existing documentation on intermediate cities, though they have shown interesting trends patterns in recent years which have changed the urban system in Chile. This paper aims to analyze the urban growth processes in Chilean intermediate cities using Temuco as a case study. It begins with an historical look at the city and then mentions that in the last decades this kind of cities have undergone new forms of segregation associated to real estate activities such as private communities, rural residential properties and new localization of services which have resulted in a fragmentation of urban space, a phenomenon reinforced by the consolidation of some satellite cities. At the same time, many urban problems associated to poverty, like a standstill of the regional economy and environmental pollution have appeared, jeopardizing the sustainability of these spaces, questioning current development parameters. The article ends considering the future challenges in Temucos urban development.
José Miguel Palacios
Full Text Available This article approaches the trauma of the Chilean dictatorship through the intersection between childhood and exile. It analyzes the role of childhood in Chilean exile cinema, focusing on documentaries produced throughout the 1970s and 80s. We will study the presence of childhood as a symbol in the political imaginary of exile, discuss the ways in which cinema recognizes and authorizes children’s testimony, and cover the dilemmas of desexilio and counter-nostalgia in films devoted to the theme of return. The article argues that Chilean exile cinema turns to childhood as a key experience to understand the cultural phenomenon of uprootment, its psychological and social repercussions, and its role in the formation of an exilic subjectivity.
Baeza, J.; Contreras, H.; Chavez, J.; Klein, J.; Mansilla, R.; Marin, J.; Medina, R.
Due to HEU-LEU core conversion necessity for the Chilean MTR reactors, the Fuel Elements Plant is being implemented to LEU nuclear fuel elements fabrication. A glove box line for powder-compact processing designed at CCHEN, which supposed to operate under an automatic control system, is at present under initial tests. Results of first natural uranium fuel plates manufacturing runs are shown
Hamuy, M.; Pignata, G.; Maza, J.
The CHilean Automatic Supernova sEarch (CHASE) project began in 2007 with the goal to discover young, nearby southern supernovae in order to (1) better understand the physics of exploding stars and their progenitors, and (2) refine the methods to derive extragalactic distances. During the first...
Bishop, Kelley; Michnowicz, Jim
The present investigation examines possible social and linguistic factors that influence forms of address used in Chilean Spanish with various interlocutors. A characteristic of the Spanish of Chile is the use of a variety of forms of address for the second person singular, "tu", "vos", and "usted", with corresponding…
Full Text Available Chilean newborn screening program began in 1984 through of a covenant between the National Ministry of Health and the Chilean University through its Institute of Nutrition and Food Technology (INTA with the aim of implementing a pilot study for neonatal detection of phenylketonuria (PKU in Santiago’s central area. In 1989 a program for neonatal diagnosis of PKU and congenital hypothyroidism (HC was initiated by INTA along with Santiago´s occidental health ministry rural area, which covered 20% of newborn population. PKU and HC had an incidence of 1:14,640 and 1:2000 living newborns respectively. These findings allowed the establishment of a favorable cost/benefit ratio which validated the implementation of a program with National character. In 1992 the Chilean Ministry of Health ruled the initiation of PKU and HC newborn screening program and by 1998 the coverage across the country was achieved. INTA is the National Reference Center for confirmation and long term treatment for PKU and HC patients. A follow-up program consists of medical, nutritional, neurological and psychological outcome evaluations as well as periodic biochemical testing in order to guarantee normal patient growth and development. To date 184 children have been diagnosed with classic or moderate PKU, all of them follow a strict monitoring program.
Goic, Alejandro; Armas, Rodolfo
In Chile there has been a close interaction between medical teaching and health care. In 1943, the University of Chile School of Medicine (founded in 1833) created Chairs in several public hospitals. The University of Chile School of Public Health (founded in 1943) played a key role in the creation in 1952 of a centralized National Health Service (NHS). The NHS had outpatient clinics and hospitals all over the country and was responsible for health care and for the promotion of health and disease prevention programs. In 1954, the NHS and the School of Medicine set up Residencies and General Practitioners programs aimed at improving the distribution of specialists and general practitioners throughout the country. In 1979, the NHS was replaced with 27 autonomous Health Services headed by the Ministry of Health, while the administration of primary care outpatient clinics was transferred to the municipal government. However, sanitary programs were still managed at the central level. Higher education also expanded and was decentralized. There are currently 60 universities and 17 medical schools, compared to eight and six, respectively, in 1981. The number of students in higher education has increased by 370% in 20 years. At the present time, the Chilean health case system is a predominantly public system with a strong and sizeable private system. Sixty two percent of the population is covered by public health insurance, while 27% is covered by private insurance. New and well equipped private clinics have multiplied. Private non profit institutions manage the prevention and treatment of work related injuries and diseases. Chile's outstanding health indicators (fertility rate: 17.2 x 1,000; mortality: 5.4 x 1,000; maternal mortality: 2.3 x 10,000; neonatal mortality: 4.5 x 1,000; life expectancy: 76 years) are a direct consequence of the improved social, cultural and economic condition of the general populations as well as of the sanitary programs sustained over the past
Full Text Available The article reports an exploratory research on the uses given in Chile to the Anglicism bullying. In order to do so, its evolution is reviewed from the early studies in the Nordic countries, to the treatment of the topic in the Chilean context. The focus of this work is based on socioconstructionism and in turn promotes the consideration of the characteristics of the socio-cultural and historical context of knowledge production with a postcolonial intention. To review the constructions on the subject, we selected Chilean videos at the YouTube virtual platform, using as methodology discourse analysis and dense description. In results can be observed two meanings of bullying: (i to refer to any kind of aggression and (ii as a homologous of abuse among schoolchildren. In response, it is realized the discrepancy with the proposed definitions from general academia and those used in the local environment in investigations, interventions, public policy and mass media in Chile.
Rivera Aedo, Edinson; Lakner, Sebastian; Brümmer, Bernhard
The reform-process towards a higher world-market orientation has a long tradition in Chile, with all its strengths and weaknesses. The food processing industry is highly competitive on the worldmarket. The following paper investigates the technical efficiency of the Chilean food processing industry between 2001 and 2007. We used a data-set from the 5,941 of firms in food processing industry. The observations are taken of the 'Annual National Industrial Survey'. The method of stochastic fronti...
This report provides a comprehensive survey, in depth assessment of the activities overview of ENDESA, Chilean Electricity Company, highlighting economical information and including historical and technical aspects. Economics is its focal point, but other relevant data are shown, like technical data on hydroelectric and thermoelectric power plants. Main activities developed by ENDESA are described, such in Chile as in the foreign. Data on power generation, transmission and transport are also presented and an economical balance of each colligated company are done and analysed
Camilla Dutra Vieira-Machado
Full Text Available Abstract The presence of Native Americans, Europeans, and Africans has led to the development of a multi-ethnic, admixed population in Chile. This study aimed to contribute to the characterization of the uniparental genetic structure of three Chilean regions. Newborns from seven hospitals in Independencia, Providencia, Santiago, Curicó, Cauquenes, Valdívia, and Puerto Montt communes, belonging to the Chilean regions of Santiago, Maule, and Los Lagos, were studied. The presence of Native American mitochondrial DNA (mtDNA haplogroups and two markers present in the non-recombinant region of the Y chromosome, DYS199 and DYS287, indicative of Native American and African ancestry, respectively, was determined. A high Native American matrilineal contribution and a low Native American and African patrilineal contributions were found in all three studied regions. As previously found in Chilean admixed populations, the Native American matrilineal contribution was lower in Santiago than in the other studied regions. However, there was an unexpectedly higher contribution of Native American ancestry in one of the studied communes in Santiago, probably due to the high rate of immigration from other regions of the country. The population genetic sub-structure we detected in Santiago using few uniparental markers requires further confirmation, owing to possible stratification for autosomal and X-chromosome markers.
Cabieses, Baltica; Pickett, Kate E.; Tunstall, Helena
This study explored a range of sociodemographic factors associated with disability among international immigrants in Chile, and compared them to the Chilean-born. Secondary data analysis of the Chilean population-based survey CASEN-2006 was conducted (268,873 participants). Main health outcomes: any disability and six different types of disability: visual, hearing, learning, physical, psychiatric and speaking (binary outcomes). Sociodemographic variables: Demographic factors (age, sex, marital status, urban/rural, ethnicity), socioeconomic status (SES: income, education, employment status, and an integrated indicator combining the SES measures through cluster analysis for the immigrant population), material factors (overcrowding, sanitation, housing quality) and migration related (country of origin and length of stay). Immigrants reported a significantly lower prevalence of any disability (3.55%), visual (1.00%) and physical disability (0.38%). Factors associated with any disability among immigrants were age, low SES or over 20 years duration of residence in Chile; while a range of sociodemographic factors were associated with disability in the Chilean-born. Conditional regression models by age group varied between populations, but SES remained significantly associated with disability across immigrants and the Chilean-born. However, there are no similar patterns of factors associated to different types of disability between the populations under study. Factors associated with disability varied between populations under study, but SES showed a consistent association with any disability in immigrants and the Chilean-born. Types of disability showed different patterns of factors associated to them between populations, which suggest the great complexity of underlying mechanisms related to disability in Chile. PMID:23211607
Cabieses, Baltica; Pickett, Kate E; Tunstall, Helena
This study explored a range of sociodemographic factors associated with disability among international immigrants in Chile, and compared them to the Chilean-born. Secondary data analysis of the Chilean population-based survey CASEN-2006 was conducted (268,873 participants). Main health outcomes: any disability and six different types of disability: visual, hearing, learning, physical, psychiatric and speaking (binary outcomes). Sociodemographic variables: Demographic factors (age, sex, marital status, urban/rural, ethnicity), socioeconomic status (SES: income, education, employment status, and an integrated indicator combining the SES measures through cluster analysis for the immigrant population), material factors (overcrowding, sanitation, housing quality) and migration related (country of origin and length of stay). Immigrants reported a significantly lower prevalence of any disability (3.55%), visual (1.00%) and physical disability (0.38%). Factors associated with any disability among immigrants were age, low SES or over 20 years duration of residence in Chile; while a range of sociodemographic factors were associated with disability in the Chilean-born. Conditional regression models by age group varied between populations, but SES remained significantly associated with disability across immigrants and the Chilean-born. However, there are no similar patterns of factors associated to different types of disability between the populations under study. Factors associated with disability varied between populations under study, but SES showed a consistent association with any disability in immigrants and the Chilean-born. Types of disability showed different patterns of factors associated to them between populations, which suggest the great complexity of underlying mechanisms related to disability in Chile.
Full Text Available This study explored a range of sociodemographic factors associated with disability among international immigrants in Chile, and compared them to the Chilean-born. Secondary data analysis of the Chilean population-based survey CASEN-2006 was conducted (268,873 participants. Main health outcomes: any disability and six different types of disability: visual, hearing, learning, physical, psychiatric and speaking (binary outcomes. Sociodemographic variables: Demographic factors (age, sex, marital status, urban/rural, ethnicity, socioeconomic status (SES: income, education, employment status, and an integrated indicator combining the SES measures through cluster analysis for the immigrant population, material factors (overcrowding, sanitation, housing quality and migration related (country of origin and length of stay. Immigrants reported a significantly lower prevalence of any disability (3.55%, visual (1.00% and physical disability (0.38%. Factors associated with any disability among immigrants were age, low SES or over 20 years duration of residence in Chile; while a range of sociodemographic factors were associated with disability in the Chilean-born. Conditional regression models by age group varied between populations, but SES remained significantly associated with disability across immigrants and the Chilean-born. However, there are no similar patterns of factors associated to different types of disability between the populations under study. Factors associated with disability varied between populations under study, but SES showed a consistent association with any disability in immigrants and the Chilean-born. Types of disability showed different patterns of factors associated to them between populations, which suggest the great complexity of underlying mechanisms related to disability in Chile.
Rengifo, Francisca; Ruz, Gonzalo A; Mascareño, Aldo
In the first decades of the 20th century, political actors diagnosed the incubation of a crisis in the Chilean schooling process. Low rates of enrollment, literacy, and attendance, inefficiency in the use of resources, poverty, and a reduced number of schools were the main factors explaining the crisis. As a response, the Law on Compulsory Primary Education, considering mandatory for children between 6 and 14 years old to attend any school for at least four years, was passed in 1920. Using data from Censuses of the Republic of Chile from 1920 and 1930, reports of the Ministry of Justice, the Ministry of Education, and the Statistical Yearbooks between 1895 and 1930, we apply machine learning techniques (clustering and decision trees) to assess the impact of this law on the Chilean schooling process between 1920 and 1930. We conclude that the law had a positive impact on the schooling indicators in this period. Even though it did not overcome the differences between urban and rural zones, it brought about a general improvement of the schooling process and a more efficient use of resources and infrastructure in both big urban centers and small-urban and rural zones, thereby managing the so-called crisis of the Republic.
Cheng, Chen-Hsiu; Chen, Shih-Chien
Nurse practitioner development affirms the social value of nursing staff and promotes the professional image of nursing. As the medical environment and doctor-patient relations change, how should a nurse practitioner carry out clinical care? Apart from having foundations in medical knowledge and high-quality nursing techniques, nurse practitioners must have other clinical skills, in order to break out of their former difficult position, promote nursing competitiveness, provide a multi -dimensional service, win the people's acclamation and develop international links.
The purpose of my visit to Chilean Antarctic Stations was to assess the present status of geophysical observations and research, as the South Shetland Island, West Antarctica, where the stations are located, are one of the most active tectonic regions on the Antarctic plate. The Instituto Antartico Chileno (INACH) kindly gave me a chance to stay in Frei/Escudero Bases as an exchange scientist under the Antarctic Treaty for two weeks in January 2000. I stayed in Frei Base as a member of a geol...
disaster response strategies and operations of Chilean agencies, including perceived or actual failures in disaster preparation that impacted the medical disaster response; post-disaster health and medical interventions to save lives and limit suffering; and the lessons learned by public health and medical personnel as a result of their experiences. Despite devastating damage to the health care and civic infrastructure, the health care response to the Chilean earthquake appeared highly successful due to several factors. Like other first responders, the medical community had the ability and resourcefulness to respond without centralized control in the early response phase. The health care community maintained patient care under austere conditions, despite many obstacles that could have prevented such care. National and international resources were rapidly mobilized to support the medical response. The Emergency Services Team sought to collect information on all phases of emergency management (preparedness, mitigation, response, and recovery) and determine what worked well and what could be improved upon. The Chileans reported being surprised that they were not as ready for this event as they thought they were. The use of mass care sheltering was limited, given the scope of the disaster, because of the resiliency of the population. The impacts of the earthquake and the tsunami were quite different, as were the needs of urban and rural dwellers, necessitating different response activities. The Volunteer Services Team examined the challenges faced in mobilizing a large number of volunteers to assist in the aftermath of a disaster of this scale. One of the greatest challenges expressed was difficulty in communication; the need for redundancy in communication mechanisms was cited. The flexibility and ability to work autonomously by the frontline volunteers was a significant factor in effective response. It was also important for volunteer leadership to know the emergency plans
To identify the impact of family life on the ways women practice rural medicine and the changes needed to attract women to rural practice. Census of women rural doctors in Victoria in 2000, using a self-completed postal survey. General and specialist practice. Two hundred and seventy-one female general practitioners and 31 female specialists practising in Rural, Remote and Metropolitan Area Classifications 3-7. General practitioners are those doctors with a primary medical degree and without additional specialist qualifications. Interaction of hours and type of work with family responsibilities. Generalist and specialist women rural doctors carry the main responsibility for family care. This is reflected in the number of hours they work in clinical and non-clinical professional practice, availability for on-call and hospital work, and preference for the responsibilities of practice partnership or the flexibility of salaried positions. Most of the doctors had established a satisfactory balance between work and family responsibilities, although a substantial number were overworked in order to provide an income for their families or meet the needs of their communities. Thirty-six percent of female rural general practitioners and 56% of female rural specialists preferred to work fewer hours. Female general practitioners with responsibility for children were more than twice as likely as female general practitioners without children to be in a salaried position and less likely to be a practice partner. The changes needed to attract and retain women in rural practice include a place for everyone in the doctor's family, flexible practice structures, mentoring by women doctors and financial and personal recognition. Women make up less than a quarter of the rural general practice workforce and an even smaller percentage of the specialist rural medical workforce. As a result their experiences are not well articulated in research on rural medical practice and their needs are
Nagarajan, P.; Jiji, G. Wiselin
This paper is intended as a gender issue to the rural finance practitioners. It highlights the questions that need to be asked and addressed to the gender mainstream. It will also be useful to gender experts to wish to increase their understanding on specific gender issues in rural finance through mobile services. It focuses on rural microfinance…
Cortes, Sandra; Fortt, Antonia
The intake of fish products is a major public health concern due to possible methyl mercury exposure, which is especially toxic to the human nervous system. This pilot study (n = 46) was designed to determine mercury concentrations in fish products for national consumption (Chilean jack mackerel, hake, Chilean mussel, tuna) and for export (salmon, Patagonian toothfish, swordfish, southern hake), and to estimate the exposure of the general population. The fish products were collected from markets in Talcahuano, Puerto Montt and Santiago. Samples were analyzed at the National Environmental Center by cold vapor atomic absorption spectrophotometry. Mercury levels in swordfish and one canned tuna sample exceeded levels prescribed by national and international standards. The remaining two export products (Patagonian toothfish, also known as Chilean sea bass, and salmon) complied with international limits, which are more demanding than Chilean regulations. Theoretical estimates of mercury intake varied from 0.08 to 3.8 microg kg(-1) bw day(-1) for high fish consumers, exceeding the provisional tolerable intake for tuna, Chilean seabass, Chilean jack mackerel and swordfish. This group appears to be at the greatest risk from mercury contamination among the Chilean population.
Author Guidelines. The Nigerian Medical Practitioner, a monthly Journal publishes clinical and research articles in medicine and related fields which are of interest to a large proportion of medical and allied health practitioners. It also publishes miscellaneous articles-hospital administration, business practice, accounting, ...
Bahamonde, Jorge; Bollen, Johan; Elejalde, Erick; Ferres, Leo; Poblete, Barbara
Even democracies endowed with the most active free press struggle to maintain diversity of news coverage. Consolidation and market forces may cause only a few dominant players to control the news cycle. Editorial policies may be biased by corporate ownership relations, narrowing news coverage and focus. To an increasing degree this problem also applies to social media news distribution, since it is subject to the same socio-economic drivers. To study the effects of consolidation and ownership on news diversity, we model the diversity of Chilean coverage on the basis of ownership records and social media data. We create similarity networks of news outlets on the basis of their ownership and the topics they cover. We then examine the relationships between the topology of ownership networks and content similarity to characterize how ownership affects news coverage. A network analysis reveals that Chilean media is highly concentrated both in terms of ownership as well as in terms of topics covered. Our method can be used to determine which groups of outlets and ownership exert the greatest influence on news coverage.
Gabriela Alejandra Vásquez Leyton
Full Text Available The military coup of september 11th in 1973 was the beggining of a hard dictatorship that placed Pinochet for 17 years in the chilean executive power. This fact, gave origin to many research that, from different visions, positions and ideas, intend to create an “historical conscience” among the citizens who lived in dictatorship and live in democracy today. Related to this, from the educational world, this research has a real importance as, knowing ideas about dictatorship will allow to see the visión of this “sons of democracy” who perceive the effects of this histórical process. For chilean secondary students, the process of dictatorship was caracterised by violence because of the hard repression during the military regime to demonstrations and protest, enphasising that for them, Dictatorship and Transition are parts of the same historical period, as they relate the transition with facts and situations that happened in the military regime.
Full Text Available Food intake in Chile has changed markedly in the last decades, showing an increase in fat consumption and presently a small fruit and vegetables intake. A parallel is made between the Chilean and Mediterranean diet (mainly the one from Spain, Italy, and Greece, both currently and from 50 years ago. The main differences and similarities are based on food availability. Although Chilean diet seems to be approaching the traditional Mediterranean diet of the 60's, there is concern about changes that are moving away from Chilean traditional diet and towards a western one. A new food pyramid for Chile is proposed based on the traditional Mediterranean-type diet
Huneeus, Andrea; Deardorff, Julianna; Lahiff, Maureen; Guendelman, Sylvia
Although condom use in adolescence is related to higher lifetime educational attainment, the association between primary education (from kindergarten to eighth grade) and adolescent sexual behavior is not well understood. This study examined the association between type of school in which primary education was completed-public, charter, or private-and condom use at sexual debut among Chilean adolescents. Drawing on the 2009 Chilean National Youth Survey, a population-based sample of general community youth aged 15 to 29 years, we conducted a study of the 4217 participants who reported onset of sexual activity during adolescence. Bivariate and multple logistic regression was used to examine the relationship between type of primary school attended (60.1% public, 30.3% charter, and 9.6% private) and condom use at sexual debut while controlling for sociodemographic characteristics and sexual behavior. Compared with students who completed their primary education in private or charter schools, students who completed their primary education in public schools had 1.85 (95% confidence interval, 1.12-3.04) and 1.67 (95% confidence interval, 1.26-2.23) higher odds, respectively, of not using condoms at sexual debut. Odds were similar for students living in urban settings, whereas there were too few students attending private schools in rural areas to allow meaningful estimates. Independent of household income, primary schooling is associated with sexual health behaviors among Chilean adolescents living in urban areas and can serve as a target for public health interventions designed to prevent sexually transmitted infections in adolescence.
JAIME ROZOWSKI; ÓSCAR CASTILLO
Food intake in Chile has changed markedly in the last decades, showing an increase in fat consumption and presently a small fruit and vegetables intake. A parallel is made between the Chilean and Mediterranean diet (mainly the one from Spain, Italy, and Greece), both currently and from 50 years ago. The main differences and similarities are based on food availability. Although Chilean diet seems to be approaching the traditional Mediterranean diet of the 60's, there is concern about changes t...
Wine tourism has become a thriving niche in global tourism industry with successful cases like Napa Valley in the USA with 19 million visitors per year. However, there are important disparities among wine regions. The paper analyses the case of the Chilean wine tourism, which is one of the regions with less wine tourists although it is very important in global wine industry, and its reasons for its low level of development. Chilean wine industry has been developing its infrastructure in wine ...
, construct their identities in the light of inclusive education, and how they negotiate the tensions and contradictions emerging from the processof becoming inclusive practitioners. Central to this discussion is the understanding that teachers' ...
Lobos, G.; Schnettler, B.; Grunert, Klaus G
Objective: The main objective of this study is to show why perceived resources are a strong predictor of satisfaction with food-related life in Chilean older adults. Design, sampling and participants: A survey was conducted in rural and urban areas in 30 communes of the Maule Region with 785...... participants over 60 years of age who live in their own homes. The Satisfaction with Food-related Life (SWFL) scale was used. Generalized linear models (GLM) were used for the regression analysis. Results: The results led to different considerations: First, older adults’ perceived levels of resources...... are a good reflection of their actual levels of resources. Second, the individuals rated the sum of the perceived resources as ‘highly important’ to explain older adults’ satisfaction with food-related life. Third, SWFL was predicted by satisfaction with economic situation, family importance, quantity...
Cariola Sanz, L
This paper discusses the employment situation of Chilean migrant workers, their impact on labor markets in Patagonia, Argentina, and the government's past and projected responses to this phenomenon. In 1980, Chilean inhabitants of patagonia comprised 11% of the area's population. Chilean migration to patagonia was closely linked to economic activities that began to flourish in the 20th century, such as livestock raising, fruit and vegetable cultivation, and mining for coal and petroleum. No Chilean migrants work in a wide range of sectors. In Patagonia's southern provinces availability and ability to withstand rigorous climate conditions are the main factors which account for the prevalence of Chilean manpower. Chilean migrants do not in general displace local manpower. Legislation and the permeability of the border ensure that most workers enter the country as tourists. Clandestine migration is not an issue. Illegal migrants have provoked negative reactions for several reasons: 1) they comprise a marginal population without formal citizenship; 2) being employed as clandestine workers, they pay no social security, nor do their employers; 3) being illegal, they are obliged to accept lower wages and inferior working conditions which creates unfair competition within labor markets; and 4) as a result of these conditions, xenophobic and endophobic attitudes in relations with Argentine nationalists are reinforced. The government has attempted to solve these problems through various measures. Beginning in 1934, most foreigners entered Argentina with a tourist visa, becoming illegal when they stayed beyond authorized limits. Several measures over the years provided amnesty to illegal migrants. Currently, the law promotes immigration, monitors the admission of foreigners to the country and stipulates their rights and obligations. The law lists 115 articles on immigration promotion and on regulation of the movements of foreigners. Because of the present economic crisis in
Full Text Available Understanding ecosystem processes is vital for developing dynamic adaptive management of human-dominated landscapes. We focus on conservation and management of the central Chilean silvopastoral savanna habitat called “espinal”, which often occurs near matorral, a shrub habitat. Although matorral, espinal and native sclerophyllous forest are linked successionally, they are not jointly managed and conserved. Management goals in “espinal” include increasing woody cover, particularly of the dominant tree Acacia caven, improving herbaceous forage quality, and increasing soil fertility. We asked whether adjacent matorral areas contribute to espinal ecosystem processes related to the three main espinal management goals. We examined input and outcome ecosystem processes related to these goals in matorral and espinal with and without shrub understory. We found that matorral had the largest sets of inputs to ecosystem processes, and espinal with shrub understory had the largest sets of outcomes. Moreover, we found that these outcomes were broadly in the directions preferred by management goals. This supports our prediction that matorral acts as an ecosystem process bank for espinal. We recommend that management plans for landscape resilience consider espinal and matorral as a single landscape cover class that should be maintained as a dynamic mosaic. Joint management of espinal and matorral could create new management and policy opportunities.
Guerrero Vallejos, Patricia Andrea
This thesis discusses the nuclear radiation that people who work with radioactive material is exposed to and its control by the Chilean Nuclear Energy Commission. A full analysis of the System is presented with information about the Commission and the Department of Nuclear and Radiological Safety which runs the System. Ana analysis of the System is presented in order to obtain requirements. Management flow diagrams, the processes involved and current problems experienced by the users are described. A design logic is modeled producing Data Flow Diagrams (DFD). based on this physical design, or, Model of Physical Data, is prepared including tables, attributes, types of data, primary and foreign keys. A description is presented of how the System is implemented, the tools that are used and how the testing phase is carried out. The Dosimetry System meets the criteria for a Software Engineering project, where the basic cycle was used as a working methodology. The System developed supports the dosimetric control of people exposed to radioactive material. (author)
Hidalgo, Hector; Chipulu, Maxwell; Ojiako, Udechukwu
The objective of this study is to identify how risk and social variables are likely to be impacted by an increase in private sector participation in health insurance provision. The study focuses on the Chilean health insurance industry, traditionally dominated by the public sector. Predictive risk modelling is conducted using a database containing over 250,000 health insurance policy records provided by the Superintendence of Health of Chile. Although perceived with suspicion in some circles, risk segmentation serves as a rational approach to risk management from a resource perspective. The variables that have considerable impact on insurance claims include the number of dependents, gender, wages and the duration a claimant has been a customer. As shown in the case study, to ensure that social benefits are realised, increased private sector participation in health insurance must be augmented by regulatory oversight and vigilance. As it is clear that a "community-rated" health insurance provision philosophy impacts on insurance firm's ability to charge "market" prices for insurance provision, the authors explore whether risk segmentation is a feasible means of predicting insurance claim behaviour in Chile's private health insurance industry.
I have been delivering the flexible family work approaches outlined in this supplement at Aquarius for the past 8 years. Aquarius is an English Midlands-based addictions charity working with people who have problems with alcohol, drugs, or gambling and supporting their family members/concerned others. I have been a practitioner participating in…
Høst, Jeppe Engset
In this article I will review the historical, cultural and social formation of rural development policies in Denmark and situate these in a Scandinavian context. The review is based on a reading of commission reports, law documents and texts produced by the planners and scholars involved...... paradigm” (OECD 2006) and its implications for ethnological scholars and practitioners of today. In the “new rural paradigm”, bottom-up processes, “place-bound” cultural and historical values are highlighted as essential to local development. This of course empowers the ethnologists, but also put us...
Full Text Available The purpose of my visit to Chilean Antarctic Stations was to assess the present status of geophysical observations and research, as the South Shetland Island, West Antarctica, where the stations are located, are one of the most active tectonic regions on the Antarctic plate. The Instituto Antartico Chileno (INACH kindly gave me a chance to stay in Frei/Escudero Bases as an exchange scientist under the Antarctic Treaty for two weeks in January 2000. I stayed in Frei Base as a member of a geological survey group named "Tectonic Evolution of the Antarctic Peninsula" which was organized by Prof. F. Herve, University of Chile, from January 05 to 19,2000. All my activity in the Antarctic was organized by INACH. During my stay in Frei Base, I also visited Bellingshausen (Russian, Great Wall (China and Artigas (Uruguay stations. All these stations are located within walking distance of Frei Base. King Sejong Station (Korea, located 10km east from Frei Base, and Jubany Base (Argentine, another 6km south-east from King Sejong Station, were also visited with the aid of a zodiac boat that was kindly operated for us by King Sejong Station. All stations except Escudero Base carry out meteorological observations. The seismological observations in Frei Base are operated by Washington State University of the U. S. monitoring of earthquake activity and three-component geomagnetic observations are done at King Sejong and Great Wall stations. Earth tide is monitored at Artigas Base. Continuous monitoring of GPS and gravity change are planned at King Sejong Station in the near future. Scientific research activities of each country in the area in the 1999/2000 Antarctic summer season were studied and the logistic ability of all stations was also assessed for our future international cooperation.
an alternative understanding of collaborative design practice as participatory inquiry. The paper suggests that participatory inquiry, as it more fully takes into account the learning driven and relational nature of design practice, could help inform alternative design educational strategies.......There is an inherent dilemma that some research indicates ways and means of doing design practice, in particular how practitioners bring what this paper identifies as informal resources into play, that are seldom reflected in how and what design students are taught or learn. The question is posed...... as to whether today’s design students are in fact equipped to be tomorrow’s practitioners. This paper introduces a range of literature and empirical observations that describe a number of different appreciations of process and practice, from both design and non-design perspectives. This in order to draw up...
Herrera, Juan Carlos; Lira, Mariana; Kain, Juliana
Although obesity is related to socioeconomic level, studies are inconclusive. To determine obesity risk according to socioeconomic vulnerability among Chilean children (1st grade) in 2009 and 2013 and assess its change during that period, by sex and geographical area. Cross-sectional study (N = 175,462 in 2009) and (N = 189,055 in 2013) which included: weight, height, rural / urban, gender and vulnerability obtained from JUNAEB's survey. BMI Z, % obesity and 3 categories of vulnerability (very vulnerable, moderate, non-vulnerable) were determined. For the descriptive analyses, we used t tests and for predictor variables (2 categories of vulnerability) and outcome (obesity) by sex and area, we used %2. Logistic regression models determined OR to develop obesity by. % obesity was 19.6% and 24.1% in 2009 and 2013, higher in boys. In urban and rural areas respectively, OR to develop obesity were: 0.85 (0.82-0.88) and 0.70 (0.64-0.75) in the most vulnerable students and 0.94 (0.91-0.97) and 0.81 (0.74-0.88) in those with moderate vulnerability in 2009 and 0.96 (0.93-0.98) and 0.89 (0.82-0.96) in the most vulnerable students and 0.99 (0.96-1.02) and 0.94 (0.86-1.02) in students with moderate vulnerability in 2013. The highest increase in obesity was observed among the most vulnerable group from rural areas (16, 6 to 24.3%). vulnerability. The non-vulnerable group had the highest % obesity. Although the most vulnerable students in rural areas had the lowest obesity risk in both years, the highest increase in obesity during the period, occurred in that group.
the concern for the long-term financial viability of existing government operated pension ... Thus, this study comparatively evaluates the Nigerian, Swedish and Chilean pension ... Keywords: Demographic crisis, Pension reform, Public policy .... care which employers owe their employees on retirement or in case of death.
Leihy, Peodair; Salazar, Jose M.
Chilean higher education has expanded greatly in recent decades, primarily through drawing on the private contributions of students and families, and an increased number and variety of institutions. In the context of attempts to address criticism that the sector is not free, public or high-quality enough, this article examines the association…
their system.” For example, glucose levels above normal not only indicate a risk for diabetes , but for a leader the impact of high blood glucose may...controversy, as can be expected, this stance has led to intermittent signs of animosity from both Peru and Bolivia. 23 The Chilean Army Home Page, http
Santos, José L; Ho-Urriola, Judith A; González, Andrea; Smalley, Susan V; Domínguez-Vásquez, Patricia; Cataldo, Rodrigo; Obregón, Ana M; Amador, Paola; Weisstaub, Gerardo; Hodgson, M Isabel
Inadequate eating behavior and physical inactivity contribute to the current epidemic of childhood obesity. The aim of this study was to assess the association between eating behavior scores and childhood obesity in Chilean children. We recruited 126 obese, 44 overweight and 124 normal-weight Chilean children (6-12 years-old; both genders) according to the International Obesity Task Force (IOTF) criteria. Eating behavior scores were calculated using the Child Eating Behavior Questionnaire (CEBQ). Factorial analysis in the culturally-adapted questionnaire for Chilean population was used to confirm the original eight-factor structure of CEBQ. The Cronbach's alpha statistic (>0.7 in most subscales) was used to assess internal consistency. Non-parametric methods were used to assess case-control associations. Eating behavior scores were strongly associated with childhood obesity in Chilean children. Childhood obesity was directly associated with high scores in the subscales "enjoyment of food" (P food responsiveness" (P Food-avoidant subscales "satiety responsiveness" and "slowness in eating" were inversely associated with childhood obesity (P < 0.001). There was a graded relation between the magnitude of these eating behavior scores across groups of normal-weight, overweight and obesity groups. Our study shows a strong and graded association between specific eating behavior scores and childhood obesity in Chile.
Full Text Available Abstract Background Inadequate eating behavior and physical inactivity contribute to the current epidemic of childhood obesity. The aim of this study was to assess the association between eating behavior scores and childhood obesity in Chilean children. Design and methods We recruited 126 obese, 44 overweight and 124 normal-weight Chilean children (6-12 years-old; both genders according to the International Obesity Task Force (IOTF criteria. Eating behavior scores were calculated using the Child Eating Behavior Questionnaire (CEBQ. Factorial analysis in the culturally-adapted questionnaire for Chilean population was used to confirm the original eight-factor structure of CEBQ. The Cronbach's alpha statistic (>0.7 in most subscales was used to assess internal consistency. Non-parametric methods were used to assess case-control associations. Results Eating behavior scores were strongly associated with childhood obesity in Chilean children. Childhood obesity was directly associated with high scores in the subscales "enjoyment of food" (P Conclusion Our study shows a strong and graded association between specific eating behavior scores and childhood obesity in Chile.
Martínez, M. Loreto; Pérez, J. Carola; Cumsille, Patricio
This study aims to understand Chilean parents' and adolescents' conceptions of autonomy and whether they hold different expectations for autonomous behaviors by generation and socioeconomic level. A qualitative approach to data collection was used through separate focus groups of parents and adolescents from different socioeconomic condition.…
The Nigerian, Swedish and Chilean Pension Systems: A Comparative Analysis of Schemes and Reforms. ... Ethiopian Journal of Economics ... While Chile and Nigeria completely moved from a defined benefit system to a defined contribution system, Sweden chose a “hybrid”, a model which has received wide acclaim by ...
Gonzalez Cruz, Francisco Javier; Acevedo Ferrer, Santiago
This article reviews the Chilean civil nuclear liability regime. The Nuclear Security Act (Law 18.302), enacted in 1984, and the Vienna Convention on Civil Liability for Nuclear Damage, ratified ed by Chile in 1989, are the fundamental laws of the current regime. Although Chile has no nuclear power plants, it is still important to analyze how the Chilean legislation would protect citizens from nuclear damages. This paper does not consider the policy reasons for and against the promotion of atomic energy. Rather, it critically examines the current status of the Chilean nuclear regime. Undoubtedly, if in the future Chile chooses to include nuclear sources in its energy mix, it will not be enough to introduce some isolated legal amendments, but it will be necessary to build a new Chilean Energy Regime which includes nuclear energy. In that scenario, though, it will be useful to know and understand how the current nuclear liability regime works. From this point of view, the reforms this article proposes to the current nuclear liability regime might be helpful to academics and policy makers alike
Gloria L. Gallardo Fernández
Full Text Available To halt degradation of benthic resources in Chile, management areas (MAs were set up under the Territorial Use Rights in Fisheries (TURFs framework in the late 1990s. Integrated into the global market, MAs have since expanded along the Chilean coast, involving thousands of small-scale artisanal fishers. This paper analyses how economic criteria relates to social and ecological performance of Chilean MAs, by applying TURFs, commons and co-management theory to two cases: MAs Peñuelas and Chigualoco. To collect and analyse data Participatory Rural Appraisal tools, interviews and official statistics and reports were used. Our results show that MAs’ economic benefits are connected to fluctuations on the global market. Adapting to changing world market prices then becomes paramount. TURFs’ main goal is ecological conservation, but achieving this seems to depend on meeting fishers’ livelihoods; failure to do so likely results in failure to meet conservation objectives. A serious weakness of the Chilean TURFs system is that it does not pay enough attention to fishers’ livelihoods or to the global market context. Furthermore, there is a strong relationship between good economic benefits and social sustainability. But irrespective of economic performance, fisher organizations have been empowered and gained increased resource control with the TURFs system. At policy level, a differentiated and more flexible system could be more suitable for existing heterogeneous MAs and their particular economic, social and ecological challenges. For improved economic sustainability and resource conservation, a system with multiple-species managing MAs could be promoted as well. Finally, to enhance theory of commons, co-management and TURFs, we argue for greater acknowledgement of TURFs’ social benefits in addition to economic assessments. More attention should also be paid to global market conditions of which MAs are dependent and in which they are embedded
Sapiain, Raul; Ovalle, Ricardo; Torres, Ariel; Brockmeyer, Ricarda; Schmidt, Reinhold [Centro de Energias Renovables/Universidad de Tarapaca, Arica, (Chile); Meer, Andreas V. [Solar Institute, Juelich (Germany)
Basic rural electrification programmes are already carried out in the rural areas of northern Chile by local communities and local governments using photovoltaic systems. Solar Home Systems, 12 VDC are installed for individual households while systems for schools, public lighting etc. are realized with bigger systems, 220 VAC. Within a cooperation with the Solar Institute of the Fachhochschule Juelich, Germany, the Renewable Energy Center of the University of Tarapaca designed, installed and evaluated the first solar/wind hybrid installation for basic electrification in northern Chile, realized in Colpitas, a typical small village in the chilean altiplano. The following paper presents results and experiences of this first pilot installation. [Espanol] Ya se estan llevando a cabo programas de electrificacion rural basica en las areas rurales del Norte de Chile por las comunidades y los gobiernos locales, usando sistemas fotovoltaicos. Se instalan Sistemas Domesticos Solares de 12VDC para casas-habitacion individuales, mientras que los sistemas para escuelas, alumbrado publico, etc., se ejecutan con sistemas mas grandes de 220VAC. Con la coperacion del Instituto Solar de la Fachhochschule en Julich, Alemania, el Centro de Energia Renovable de la Universidad de Tarapaca, diseno, instalo y evaluo, la primera instalacion hibrida solar/viento para electrificacion basica en el Norte de Chile, realizado en Colpitas, un pueblo tipico pequeno del altiplano chileno. El siguiete articulo presenta los resultados y experiencias de esta primera instalacion piloto.
Sapiain, Raul; Ovalle, Ricardo; Torres, Ariel; Brockmeyer, Ricarda; Schmidt, Reinhold [Centro de Energias Renovables/Universidad de Tarapaca, Arica, (Chile); Meer, Andreas V [Solar Institute, Juelich (Germany)
Basic rural electrification programmes are already carried out in the rural areas of northern Chile by local communities and local governments using photovoltaic systems. Solar Home Systems, 12 VDC are installed for individual households while systems for schools, public lighting etc. are realized with bigger systems, 220 VAC. Within a cooperation with the Solar Institute of the Fachhochschule Juelich, Germany, the Renewable Energy Center of the University of Tarapaca designed, installed and evaluated the first solar/wind hybrid installation for basic electrification in northern Chile, realized in Colpitas, a typical small village in the chilean altiplano. The following paper presents results and experiences of this first pilot installation. [Espanol] Ya se estan llevando a cabo programas de electrificacion rural basica en las areas rurales del Norte de Chile por las comunidades y los gobiernos locales, usando sistemas fotovoltaicos. Se instalan Sistemas Domesticos Solares de 12VDC para casas-habitacion individuales, mientras que los sistemas para escuelas, alumbrado publico, etc., se ejecutan con sistemas mas grandes de 220VAC. Con la coperacion del Instituto Solar de la Fachhochschule en Julich, Alemania, el Centro de Energia Renovable de la Universidad de Tarapaca, diseno, instalo y evaluo, la primera instalacion hibrida solar/viento para electrificacion basica en el Norte de Chile, realizado en Colpitas, un pueblo tipico pequeno del altiplano chileno. El siguiete articulo presenta los resultados y experiencias de esta primera instalacion piloto.
Weiland, Sandra A
This Gadamerian hermeneutic study was undertaken to understand the meaning of autonomy as interpreted by nurse practitioners (NPs) through their lived experiences of everyday practice in primary health care. A purposive sample of nine NPs practicing in primary health care was used. Network sampling achieved a broad swath of primary care NPs and practice settings. Data were collected by face-to-face interviews. Because NP autonomy is concerned with gender and marginalization, Gilligan's feminist perspective was utilized during interpretive analysis. Having Genuine NP Practice was the major theme, reflecting the participants' overall meaning of their autonomy. Practicing alone with the patient provided the context within which participants shaped the meaning of Having Genuine NP Practice. Having Genuine NP Practice had four subthemes: relationships, self-reliance, self-empowerment, and defending the NP role. The understanding of Having Genuine NP Practice will enable NPs to articulate their autonomy clearly and better influence healthcare reform. Implications for advanced practice nursing education include integrating findings into classroom discussion to prompt self-reflection of what autonomy means and socialization to the NP role. ©2014 American Association of Nurse Practitioners.
Alarcón, Ana M; Muñoz, Sergio; Kaufman, Jay S; Martínez, Carlos; Riedemann, Pablo; Kaliski, Sonia
The aim of this study was to estimate the contributions of ethnic group and socioeconomic status as social determinants related to disability and disease activity in Chilean Mapuche and non-Mapuche patients with rheumatoid arthritis (RA). Descriptive cross-sectional study with a stratified hospital-based sample of 189 patients in treatment with disease-modifying anti-rheumatic drugs. We assessed disability as categorical variable with the Health Assessment Questionnaire, disease activity with the Disease Activity Score instrument, and socioeconomic status with a standard questionnaire used by the Chilean government. Measures of association, stratified analyses and a multiple logistic regression model were used to analyze the data using the Stata 12.1 software package. Low socioeconomic status (annual income below US$ 7,200) is associated with disability (OR 3.87 CI 1.68-9.20) and Mapuche ethnic identity also contributes to disability (OR 2.48, CI 1.09-5.89). Relevant but not statistically significant in multivariable models were variables such as age, gender and place of residence. RA patients with a low socioeconomic status have almost three times the odds of having a moderate to high disability, independent of their ethnic group, gender or place of residence. Therefore, healthcare efforts should be aimed at promoting early diagnosis and prompt treatment among populations with high levels of poverty, which in the region of the Araucanía means primarily indigenous rural areas.
Holuby, Ronnie Scott; Pellegrin, Karen L; Barbato, Anna; Ciarleglio, Anita
Introduction: The availability of rural healthcare is a growing concern in the United States as fewer healthcare providers choose to work in rural areas. Accessing quality continuing education (CE) for rural healthcare practitioners (HCPs) remains a challenge and may pose a barrier to quality care.Methods: To maximize attendance at a live, in-person, free CE program focusing on geriatric medication and issues specifically targeted to HCPs in rural areas, two methods were implemented sequentia...
Larkner, Sebastian; Brenes Muñoz, Thelma; Aedo, Edinson Rivera; Brümmer, Bernhard
The Chilean economy is strongly export-oriented, which is also true for the Chilean agribusiness industry. This paper investigates the technical efficiency of the Chilean food processing industry between 2001 and 2007. We use a dataset from the 2,471 of firms in food processing industry. The observations are from the ‘Annual National Industrial Survey’. A stochastic meta-frontier approach is used in order to analyse the drivers of technical efficiency. We include variables capturing the effec...
Castro-Sepúlveda, Mauricio; Astudillo, Sebastian; Álvarez, Cristian; Zapata-Lamana, Rafael; Zbinden-Foncea, Hermann; Ramírez-Campillo, Rodrigo; Jorquera, Carlos
there is a lack of studies concerning hydration status before training in professional soccer player. to describe hydration status before regular training practices in professional soccer players. a total of 156 male soccer players (age 25.4 ± 5.2 y) from six professional Chilean clubs were included. No hydration or food intake recommendations were made before experiment, with the aim to assess hydration status under athlete's regular "real" conditions. Body mass, height and urine specific gravity (USG) measurements were performed before training practices. 98% of athletes showed dehydration (between moderate and severe) before regular training practices. dehydration is the most prevalent hydration status in professional Chilean soccer players before training, which may negatively affect athlete's performance and may increase their risk of heat-related injuries. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.
To examine food advertising aimed at childhood's audience broadcast on Chilean television. Cross-sectional study. Food advertising broadcast by 4 open signal TV channels was recorded for 12 hours daily on twelve days randomly selected. Notices were classified according to food groups and level of processing. The frequency of food advertisement aimed to childhood audience was compared with those for adults. Nutrient profile of foods advertised was described. In 144 hours of recording appeared 530 food advertisement; 53.2% were aimed to childhood audience. The most advertised foods were sugary dairy (28.4%), sweetened beverages (25.5%), and sweetened cereals (17.7%). Of the foods advertised to childhood audience, 75% exceeds the criterion for free sugars. Chilean television advertises ultra-processed foods that exceed the limits of free sugars.
Smiaroski, M S
The author argues that a new development model that encourages greater participation of women in the work force in domestic piecework, temporary work, and subcontracting may further lead to the exploitation of women in Chile. The importance of women in economic development in Chile should be based on building skills, providing support child care services, reorienting women's education, and tax incentives. Chile over the past decade has achieved relatively stable economic growth and increased employment of women. During 1990-93 the growth of women in the work force increased at a rate of 16.8%, while men's presence increased by only 9.8%. The Chilean economy is based on a sophisticated modern sector and a labor-intensive informal sector. The Chilean model of development relies on cheap, flexible labor and a government approval of this model. Increased participation of women in the labor force is usually perceived as increased economic empowerment. A 1994 Oxfam study found that women were being forced into the labor market due to declines in family income and low wages. 46% of men and women received wages that did not cover basic necessities. The Chilean labor market is gender-stratified. Men are paid better than women for the same work. Men are in more permanent positions. Labor laws are either inadequate or violated, particularly for hours of work and overtime pay and conditions of employment and benefits. Traditional female jobs are those that rely on women's natural attributes. These unskilled attributes are rewarded with low wages. Little opportunity is provided for upgrading skills or acquiring new skills. Some women turn down advancement because of a lack of role models. Women have little opportunity to develop their self-image as workers. Poor self-images affect women's work attitudes and motivation. Some firms use competition between women to boost production. Chilean women remain in subordinate roles.
52 LIST OF REFERENCES Armada de Chile, N. (1986). Manual de Logistica de la Armada de Chile [Manual of logistics of the Chilean Navy]. Chile... transportation • Quality control • Demand and supply planning • Receiving, materials handling, and storage 11 • Material or inventory control...Order purchasing • Production planning, scheduling, and control • Warehousing and distribution • Shipping • Outbound transportation • Customer
lifestyle, physical activity, and nutrition that continue around the world, increasing to one billion obese individuals by 2030.2 It is clear that these...statistics continue to reveal a disturbing and increasing trend upwards every year. Figure 2. Overweight and Obesity in Children Under 6 Years...problem is that most Chileans have not substantially improved the quality and amount of breakfast and dinner while increasing their fast food intake
Mancini, Joseph A.
This applied dissertation presented a mixed method design to gain a broader perspective of the perceptions of classroom management practitioners within a particular school district. Many teachers, or practitioners, experience issues with classroom management because of their understanding of strategies they use. Because of the researcher's…
Serguei Alejandro Martín
Full Text Available This paper proposes the Chilean natural zeolite as catalyst on bio-oil upgrade processes. The aim of this study was to analyze chemical composition of bio-oil samples obtained from catalytic pyrolysis of Chilean native oak in order to increase bio-oil stability during storage. In order to identify chemical compounds before and after storage, biomass pyrolysis was carried out in a fixed bed reactor at 623 K and bio-oil samples were characterized by gas chromatography/mass spectrophotometry (GC/MS. A bio-oil fractionation method was successfully applied here. Results indicate that bio-oil viscosity decreases due to active sites on the zeolite framework. Active acids sites were associated with an increment of alcohols, aldehydes, and hydrocarbon content during storage. Higher composition on aldehydes and alcohols after storage could be attributed to the occurrence of carbonyl reduction reactions that promotes them. These reactions are influenced by zeolite surface characteristics and could be achieved via the direct contribution of Brønsted acid sites to Chilean natural zeolite.
Olivares Cortés, Sonia; Zacarías Hasbún, Isabel; González González, Carmen Gloria; Fonseca Morán, Lilian; Mediano Stoltze, Fernanda; Pinheiro Fernandes, Anna Christina; Rodríguez Osiac, Lorena
Food-Based Dietary Guidelines (FBDG) are usually accompanied by an image for dissemination and implementation. to design and validate an image to represent the variety and proportions of the new Chilean dietary guidelines, include foods high in critical nutrients that should be avoided and physical activity guidelines. a panel of experts tested seven graphics and selected three that were validated with 12 focus groups of people aged 10-14 and 20-40 years, of both sexes, from different socioeconomic groups and from both rural and urban areas. We analyzed the perception of variety and proportions of the food groups for daily intake and motivation for action in diet and physical activity. We utilized the METAPLAN method used previously in the validation of FBDG. the final image was a circle that showed the variety and proportions of each food group for daily consumption (in pictures), included physical activity guidelines in a strip around the middle of the circle and a rectangle towards of bottom of the image with examples of foods high in critical nutrients in black and white. The chosen picture was modified using input from participants and validated with three additional focus groups, improving its understanding and acceptance. most participants understood that the image represented the relationship between healthy eating and daily physical activity, correctly identifying the food groups for which increased intake was suggested and those groups in which intake should be reduced or avoided. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.
Frutos-Llanes, R; Jiménez-Blanco, S; Blanco-Montagut, L E
To determine the level of burnout in general practitioners of Avila and the influence of social, occupational and health factors. A descriptive cross-sectional epidemiological study was conducted and aimed at all Primary Care medical staff of Avila during the first half of 2011, using two questionnaires: the Maslach Burnout Inventory and other sociodemographic, health and occupational variables. A response rate of 51.8% was obtained. The mean age was 48.55±8.16, and 52% were male, 77% married, 45% with tenure, 78% worked in rural centres, and, 82% performed out of hours home visits plus clinics. The prevalence of severe burn out was low (16%) in our study was low. A high prevalence (68%) of moderate/severe level of the condition was found. Being married (P=.012), do not guards (P<.0001), working in rural areas (P=.008), and to be an area doctor (p=.03), predisposes to suffer burnout in severe or moderate/severe burnout. A moderate level of burnout was found. Contrary to what many doctors thought, the prevalence of the condition in its severe form was low, but was high when taking the severe and moderate/severe forms together. Therefore, measures should be extended to reduce occupational stress of doctors, in order to improve working practices and professional efficiency. Copyright © 2013 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.
Leyva, Diana; Nolivos, Virginia
Research Findings: This study examined the relation between Chilean parents' narrative participatory styles (i.e., the way in which parents scaffold children's participation in conversations) and children's self-regulation skills. A total of 210 low-income Chilean parent-child dyads participated in the study. Dyads were videotaped talking about a…
Cabieses, Baltica; Tunstall, Helena; Pickett, Kate E; Gideon, Jasmine
International evidence indicates consistently lower rates of access and use of healthcare by international immigrants. Factors associated with this phenomenon vary significantly depending on the context. Some research into the health of immigrants has been conducted in Latin America, mostly from a qualitative perspective. This population-based study is the first quantitative study to explore healthcare provision entitlement and use of healthcare services by immigrants in Chile and compare them to the Chilean-born. Data come from the nationally representative CASEN (Socioeconomic characterization of the population in Chile) surveys, conducted in 2006 and 2009. Self-reported immigrants were compared to the Chilean-born, by demographic characteristics (age, sex, urban/rural, household composition, ethnicity), socioeconomic status (SES: education, household income, contractual status), healthcare provision entitlement (public, private, other, none), and use of primary services. Weighted descriptive, stratified and adjusted regression models were used to analyse factors associated with access to and use of healthcare. There was an increase in self-reported immigrant status and in household income inequality among immigrants between 2006 and 2009. Over time there was a decrease in the rate of immigrants reporting no healthcare provision and an increase in reporting of private healthcare provision entitlement. Compared to the Chilean-born, immigrants reported higher rates of use of antenatal and gynaecological care, lower use of well-baby care, and no difference in the use of Pap smears or the number of attentions received in the last three months. Immigrants in the bottom income quintile were four times more likely to report no healthcare provision than their equivalent Chilean-born group (with different health needs, i.e. vertical inequity). Disabled immigrants were more likely to have no healthcare provision compared to the disabled Chilean-born (with similar health
Never have there been such a vast number of career opportunities for all levels of staff within the perioperative environment including healthcare support workers, operating department practitioners and nurses.
... in finding a NCCAOM Certified Diplomate. The NCCAOM Find a Practitioner Directory is a voluntary directory designed ... by the NCCAOM. If you are unable to find an individual in our registry and would like ...
Miller, Katherine J; Couchie, Carol; Ehman, William; Graves, Lisa; Grzybowski, Stefan; Medves, Jennifer
rural settings. Remuneration models should facilitate interprofessional collaboration. 9. Practitioners skilled in neonatal resuscitation and newborn care are essential to rural maternity care. 10. Training of rural maternity health care providers should include collaborative practice as well as the necessary clinical skills and competencies. Sites must be developed and supported to train midwives, nurses, and physicians and provide them with the skills necessary for rural maternity care. Training in rural and northern settings must be supported. 11. Generalist skills in maternity care, surgery, and anaesthesia are valued and should be supported in training programs in family medicine, surgery, and anaesthesia as well as nursing and midwifery. 12. All physicians and nurses should be exposed to maternity care in their training, and basic competencies should be met. 13. Quality improvement and outcome monitoring should be integral to all maternity care systems. 14. Support must be provided for ongoing, collaborative, interprofessional, and locally provided continuing education and patient safety programs.
Department of Transportation — The Rural Airports database is the list of rural airports compiled annually by BTS for the Treasury Department/IRS. It is used by airlines to assist in establishing...
Martin, F.; Pasten, D.; Comte, D.
In recent years the earthquake complex networks have been used as a useful tool to describe and characterize the behavior of seismicity. The earthquake complex network is built in space, dividing the three dimensional space in cubic cells. If the cubic cell contains a hypocenter, we call this cell like a node. The connections between nodes follows the time sequence of the occurrence of the seismic events. In this sense, we have a spatio-temporal configuration of a specific region using the seismicity in that zone. In this work, we are applying complex networks to characterize the subduction zone along the coast of Chile using two networks: a directed and an undirected network. The directed network takes in consideration the time-direction of the connections, that is very important for the connectivity of the network: we are considering the connectivity, ki of the i-th node, like the number of connections going out from the node i and we add the self-connections (if two seismic events occurred successive in time in the same cubic cell, we have a self-connection). The undirected network is the result of remove the direction of the connections and the self-connections from the directed network. These two networks were building using seismic data events recorded by CSN (Chilean Seismological Center) in Chile. This analysis includes the last largest earthquakes occurred in Iquique (April 2014) and in Illapel (September 2015). The result for the directed network shows a change in the value of the critical exponent along the Chilean coast. The result for the undirected network shows a small-world behavior without important changes in the topology of the network. Therefore, the complex network analysis shows a new form to characterize the Chilean subduction zone with a simple method that could be compared with another methods to obtain more details about the behavior of the seismicity in this region.
Yáñez Sepúlveda, Rodrigo; Barraza, Fernando; Rosales Soto, Giovanni; Báez, Eduardo; Tuesta, Marcelo
The aim of the study was to characterize the anthropometric profile and somatotype of a sample of 50 players table tennis competitive with an average age 21.6 (± 3.1) years belonging to the Chilean team and institutions of higher education in the region of Valparaiso. The evaluation was conducted under the protocol marking the International Society for the Advancement of Kinanthropometry (ISAK) for the measurement procedure 25 restricted profile variables described by Drinkwater, Norton and Olds. Order to determine the body composition, fat, muscle, bone, skin and tissue residual was considered, using the equations proposed by Kerr. The body shape is characterized through somatotype method proposed by Carter. The sample was divided into 4 groups; Chilean Selection, Traditional Private Universities, State Universities and Private Universities Traditional Nontraditional. Regarding body composition; the Chilean team has the highest values of muscle tissue (45.6 ± 1.7%) and the lowest values of adipose tissue (25.2 ± 1.8%), also presenting lesser value in the Σ 6 skinfolds (mm) . The results showed no significant differences between groups in the aforementioned variables. In general somatotype compared by analyzing SANOVA no significant differences between groups (p = 0.409) was observed. The results show a biotype with such a characterization of endo-mesomorph with average values (4,1-4,9-1,8). This study provides updated data biotypological reference for this sport that can be used for decision-making. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.
Navia, Rodrigo; Bezama, Alberto
The new 'Hazardous Waste Management Regulation' was published in the Official Newspaper of the Chilean Republic on 12 June 2003, being in force 365 days after its publication (i.e., 12 June 2004). During the next 180 days after its publication (i.e., until 12 December 2004), each industrial facility was obligated to present a 'Hazardous Waste Management Plan' if the facility generates more than 12 ton/year hazardous wastes or more than 12 kg/year acute toxic wastes. Based on the Chilean industrial figures and this new regulation, hazardous waste management plans were carried out in three facilities of the most important sectors of Chilean industrial activity: a paper production plant, a Zn and Pb mine and a sawmill and wood remanufacturing facility. Hazardous wastes were identified, classified and quantified in all facilities. Used oil and oil-contaminated materials were determined to be the most important hazardous wastes generated. Minimization measures were implemented and re-use and recycling options were analyzed. The use of used oil as alternative fuel in high energy demanding facilities (i.e., cement facilities) and the re-refining of the used oil were found to be the most suitable options. In the Zn and Pb mine facility, the most important measure was the beginning of the study for using spent oils as raw material for the production of the explosives used for metals recovery from the rock. In Chile, there are three facilities producing alternative fuels from used oil, while two plants are nowadays re-refining oil to recycle it as hydraulic fluid in industry. In this sense, a proper and sustainable management of the used oil appears to be promissory
Laurence C. Breaker
Full Text Available The primary frequencies contained in the arrival sequence produced by the tsunami from the Chilean earthquake of 2010 in Monterey Bay were extracted to determine the seiche modes that were produced. Singular Spectrum Analysis (SSA and Ensemble Empirical Mode Decomposition (EEMD were employed to extract the primary frequencies of interest. The wave train from the Chilean tsunami lasted for at least four days due to multipath arrivals that may not have included reflections from outside the bay but most likely did include secondary undulations, and energy trapping in the form of edge waves, inside the bay. The SSA decomposition resolved oscillations with periods of 52-57, 34-35, 26-27, and 21-22 minutes, all frequencies that have been predicted and/or observed in previous studies. The EEMD decomposition detected oscillations with periods of 50-55 and 21-22 minutes. Periods in the range of 50-57 minutes varied due to measurement uncertainties but almost certainly correspond to the first longitudinal mode of oscillation for Monterey Bay, periods of 34-35 minutes correspond to the first transverse mode of oscillation that assumes a nodal line across the entrance of the bay, a period of 26- 27 minutes, although previously observed, may not represent a fundamental oscillation, and a period of 21-22 minutes has been predicted and observed previously. A period of ~37 minutes, close to the period of 34-35 minutes, was generated by the Great Alaskan Earthquake of 1964 in Monterey Bay and most likely represents the same mode of oscillation. The tsunamis associated with the Great Alaskan Earthquake and the Chilean Earthquake both entered Monterey Bay but initially arrived outside the bay from opposite directions. Unlike the Great Alaskan Earthquake, however, which excited only one resonant mode inside the bay, the Chilean Earthquake excited several modes suggesting that the asymmetric shape of the entrance to Monterey Bay was an important factor and that the
Full Text Available The p value misconceptions are based on certain beliefs and attributions about the significance of the results. Thus, they affect the professionals’ decisions and jeopardize the quality of interventions and the accumulation of valid scientific knowledge. We conducted a survey on 164 academic psychologists (134 Italians, 30 Chileans, questioned on this topic. Our findings are consistent with original research and suggest that some participants do not know how to correctly interpret p values. The inverse probability fallacy presents the greatest comprehension problems, followed by the replication fallacy. These results highlight the importance of the statistical re-education of researchers. Recommendations for improving statistical cognition are proposed.
Probability and statistics have become prominent subjects in school mathematics curricula. As an exemplary case, I investigate the role of decision making in the justification for probability and statistics in the current Chilean upper secondary mathematics curriculum. For addressing this concern......, I draw upon Fairclough’s model for Critical Discourse Analysis to analyse selected texts as examples of discourse practices. The texts are interconnected with politically driven ideas of stochastics “for all”, the notion of statistical literacy coined by statisticians’ communities, schooling...
Stuardo B, E. (Comision Chilena de Energia Nuclear, Santiago. Dept. de Aplicaciones Nucleares)
Natural and artificial gamma radiation, 1 m above the soil, is being investigated in 4 Chilean Antartic Stations. The measurements are performed with different types of TLD detectors. Preliminary results in the Tte. Marsh Station are reported and discussed. An average exposition of 3,5 ..mu..R/h was found during a 108 days period. This exposition corresponds to an annual dose of about 40 mrad, 8% of the annual dose limit for individual of the public. The presence of low energy artificial radioisotopes was not found.
Stuardo B, E.
Natural and artificial gamma radiation, 1 m above the soil, is being investigated in 4 Chilean Antartic Stations. The measurements are performed with different types of TLD detectors. Preliminary results in the Tte. Marsh Station are reported and discussed. An average exposition of 3,5 μR/h was found during a 108 days period. This exposition corresponds to an annual dose of about 40 mrad, 8% of the annual dose limit for individual of the public. The presence of low energy artificial radioisotopes was not found. (Author)
This report provides a comprehensive survey, in depth assessment of the activities overview of ENDESA, Chilean Electricity Company, highlighting economical information and including historical and technical aspects. Economics is its focal point, but other relevant data are shown, like technical data on hydroelectric and thermoelectric power plants. Main activities developed by ENDESA are described, such in Chile as in the foreign. Data on power generation, transmission and transport are also presented and an economical balance of each colligated company are done and analysed 35 figs., 115 tabs.
Weisberg, E; Fraser, I S; Carrick, S E; Wilde, F M
To assess the knowledge, attitudes and practices of general practitioners in New South Wales regarding the provision of emergency contraception. Randomised group comparison of 100 rural and 100 urban general practitioners (GPs) by questionnaire. Eighty-four rural and 76 urban GPs responded. More rural GPs were knowledgeable about emergency contraception than urban GPs (95% v. 78%), and more women knew about it than men. More urban GPs frequently prescribed emergency contraception than rural GPs (26% v. 6%) and female GPs prescribed it more readily than male GPs (22% v. 12%). There was great variation in the regimens prescribed, especially among rural GPs. Twenty-five per cent of urban GPs and 31% of rural GPs did not offer women information about emergency contraception, while 16% of both groups included such information in any discussion about contraceptive options, and 18% gave information only if requested by the woman. More than 60% of the GPs would provide information about emergency contraception as a back-up to use of barrier methods. The sex, attitude and knowledge of the GPs influence the likelihood of women being made aware of or being given emergency contraception in NSW. There is a need to further educate both the public and practitioners about emergency contraception.
Edwards, Lynn M.; Sullivan, Amanda L.
Delivering psychological services in rural communities presents a number of unique challenges for practitioners relative to their peers in urban and suburban communities. In this article, the authors describe the current context of rural schools and examine the ethical and legal issues school psychologists may face when practicing in rural…
McHenry-Sorber, Erin; Budge, Kathleen
This conceptual article challenges researchers and practitioners to reconsider the utility of current constructs used to understand the rural school superintendency. We evaluate the rural leadership literature through two waves of scholarship: insider/outsider conceptions and place-conscious/critical place-conscious constructs. We assert critical…
Nath, L M
In India, although the health care system infrastructure is extensive, the people often regard government facilities as family planning (FP) centers instead of primary health care centers. This problem has been compounded by the separation of health care and FP at all stages, even down to the storage of the same medication in two different locations depending upon whether it is to be used for "health" or for "FP." In rural areas where the government centers are particularly desolate, the community has chosen to erect its own health care system of private practitioners of all sorts and qualifications. Even in rural areas where a comprehensive health service is provided, with each household visited regularly by health workers, and where this service has resulted in a lowering of the crude death rate from 14.6 to 7 and the maternal mortality rate from 4.7 to 0.5/1000, people depend upon practitioners of various types. Upon analysis, it was discovered that the reason for using this multiplicity of practitioners had nothing to do with the level of satisfaction with the government service or with the accessibility of the services. Rather, when ill, the people make a diagnosis and then go to the proper place for treatment. If, for instance, they believe their malady was caused by the evil eye, they consult a magico-religious practitioner. These various types of practitioners flourish in areas with the best primary health care because they fulfill a need not met by the primary health care staff. If government agencies work with the local practitioners and afford them the proper respect, their skills can be upgraded in selected areas and the whole community will benefit.
Valle-Levinson, Arnoldo; Castro, Leonardo; Cáceres, Mario; Pizarro, Oscar
Time series of acoustic backscatter and vertical velocity profiles were obtained at three sites along a Chilean fjord with the purpose of determining dominant structures of vertical migrations of the sound scattering layer. Ancillary data obtained with stratified net samples indicated that the sound scattering layer may have been dominated by euphausiids and decapods. Therefore, distributions of acoustic backscatter anomalies and vertical velocities were attributed to vertical migrations of predominantly these organisms. Migration patterns were dominated by twilight excursions in which organisms swam toward the water surface at sunset, spent 100 m). This migration strategy can also be termed 'semidiel migration' as two double excursions were linked to light levels. The reasons for this twilight migration remain uncertain. But it is possible that the up and down motion around sunset was related to predation avoidance, hunger-satiation state, ontogeny, seaward transport evasion, or reaction to the environmental shock from the pycnocline, or a combination of all or some of them. In contrast, the sunrise double excursion was probably linked to feeding requirements by organisms that need to spend the day at great depth with no food available. This study demonstrated the existence of semidiel patterns throughout the fjord and through prolonged periods. In addition, identification of this pattern by acoustic backscatter was complemented by direct vertical velocity measurements. It is proposed that twilight vertical migration is a common strategy in Chilean fjords.
Marcela Mandiola Cotroneo
Full Text Available The aim of this paper is to understand the character and the role of higher education in business in relation to the wider institutional and structural contexts within which they function. Being loyal to that widespread background, business schools in Chile have become efficient providers of appropriate goods and services for their respective clients and consumers, behaving more like corporations and businesses rather than educational institutions. From this perspective, business education's alignment with the wider political and socio-economic shifts associated with the developments of market economies and economic globalization is a necessary reflection. In this paper we will provide an account of our problematization of management education practices in Chile. This practice was pictured as one of the main characters at the forefront of the Chilean neo-liberal revolution during the final years of the last century. In particular, we will unravel more closely the chain of signifiers articulating the meaning of Chilean higher business education. This articulation is recuperated mainly around how those involved in the management education practice talk about (ourthemselves. As well as specialised press writings, some academic accounts and fragments from our own 'ethnographic' involvement are used for this purpose. Particular attention is paid to the social, political and fantasmatic logics (GLYNOS; HOWARTH, 2007 as key elements of our own explanation of this practice, which in turn informs our critical standpoint.
Sánchez Delgado, Marcelo
Rejuvenation was a chapter of critical importance for the worldwide development of endocrinology in the 1920s. This work explores the acceptance of these techniques in Chile. Starting in the late 19th century, the Chilean Medical Journal (Revista Médica de Chile) incorporated references to experiments with endocrine gland preparations that were being conducted in Europe at the time. An appropriation of the experiments by the Austrian Eugen Steinach began in 1920, with prominent figures such as the Italian professor Juan Noe Crevani and the young Chilean student Ottmar Wilhelm. Between 1922 and 1924, Wilhelm developed a series of experiments on dogs, bulls, pigs, rats and Welfare Board patients through the so-called Steinach operation, which consisted of the sectioning of the efferent channel in one of the testicles. Professor Noe's scientific patronage policy and Wilhelm's strategy of succession in the field led the latter to hold a chair in the new School of Medicine of Universidad de Concepci6n at the age of 25. From this position, the. figure of Wilhelm was fundamental for the development of a line of endocrinological research that was able to position Universidad de Concepci6n as a scientific development centre, which was strengthened by the arrival of another disciple of Steinach in Chile, the Latvian professor Alejandro Lipschütz.
Retamal, Jaime; Castillo, Juan; Bugedo, Guillermo; Bruhn, Alejandro
In patients with an artificial airway, inspired gases can be humidified and heated using a passive (heat and moisture exchange filter - HMEF), or an active system (heated humidifier). To assess how humidification is carried out and what is the usual clinical practice in this field in Chilean intensive care units (ICUs). A specific survey to evaluate humidification system features as well as caregivers' preferences regarding humidification systems, was carried out on the same day in all Chilean ICUs. Fifty-five ICUs were contacted and 44 of them completed the survey. From a total of 367 patients, 254 (69%) required humidification because they were breathing through an artificial airway. A heated humidifier was employed only in 12 patients (5%). Forty-three ICUs (98%) used HMEF as their routine humidification system. In 52% of surveyed ICUs, heated humidifiers were not available. In Chile the main method to humidify and heat inspired gases in patients with an artificial airway is the HMEF. Although there are clear indications for the use of heated humidifiers, they are seldom employed.
Andrus, Len Hughes; Fenley, Mary D.
Describes a Family Nurse Practitioner Program that has effectively improved the distribution of primary health care manpower in rural areas. Program characteristics include selection of personnel from areas of need, decentralization of clinical and didactic training sites, competency-based portable curriculum, and circuit-riding institutionally…
Morgenroth, Eberhard Friedrich; van Loosdrecht, M. C. M.; Wanner, O.
Even though mathematical biofilm models are extensively used in biofilm research, there has been very little application of these models in the engineering practice so far. However, practitioners would be interested in models that can be used as tools to control plant operation under dynamic...... conditions or to help them handle complex interactions between particle removal, carbon oxidation, nitrification, denitrification and biological phosphorus removal. But even though there is a whole range of biofilm models available, it is difficult for the practitioner to select the appropriate modeling...
Ian Campbell's paper, originally delivered at a conference on the development of 'The reflective practitioner' while he was Unit General Manager of Sunderland Royal Infirmary, describes the liaison between general and nurse managers in the hospital. Management must give a hospital organisation direction and must set the parameters of corporate and individual performance, but it must also be responsive to the feedback received from practising clinicians. The key concept is quality of service, and in this managers and practitioners can work together towards a common goal.
Smith, Deborah M
Early postgraduate, or junior doctors, are still required to practise in rural and remote communities, and they continue to face numerous issues and difficulties. Within the hospital setting, exposure to rural practice appears to be very limited during internship, and also to some extent, during the second postgraduate year and beyond. This is a major issue for those required to undertake country relieving, rural terms or who will be bonded to rural and remote practice for several years after internship. This research investigated the current issues and difficulties faced by junior doctors, required to undertake rural and remote practice in Queensland, Australia. An exploratory study was undertaken. Primary data were collected through semi-structured interviews held with key stakeholders. Stakeholders included: directors of clinical training; medical educators; junior doctors; rural practitioners; academic rural practitioners; and medical administrators. Of the 23 people approached, a total of 19 agreed to be interviewed. The response rate was 82.6%. Similar to the issues identified in the literature, there are currently a number of barriers influencing the ability of junior doctors to practise competently and confidently when undertaking practice in rural and remote communities. Minimal clinical experience, lack of supervision and on-site support, inadequate orientation and uninformed expectations, limited access to relevant education, and the influence of isolation, results in an overall lack of preparation both professionally and personally. When asked, respondents supported the identification of core skills and knowledge, and integration of these and other issues affecting rural practice, into their hospital-based programs. Current hospital-based education and training programs were not adequately preparing junior doctors for rural and remote practice. It was commented that orientation and education, with a rural emphasis, could assist junior doctors in their
Bakker, A.B.; Schaufeli, W.B.; Sixma, H.J.; Bosveld, W.
This study used a representative sample of 507 general practitioners (GPs) to test the hypothesis that burnout is contagious. Following a two-dimensional conceptualization of burnout, it is assumed that burnout is comprised of emotional exhaustion and negative attitudes (i.e., depersonalization and
Erin Parks; Andrew Holdnak
Job satisfaction among recreation professionals can be affected by many working conditions. This study has investigated the impact fourteen variables had on the job satisfaction of recreation practitioners. The sample consisted of 106 responses from members of the Resort and Commercial Recreation Association (RCRA). The results of the regression analysis for job...
Wismeijer, A.A.J.; van Assen, M.A.L.M.
Introduction It has been generally thought that the practice of bondage-discipline, dominance-submission, sadism-masochism (BDSM) is in some form associated with psychopathology. However, several more recent studies suggest a relative good psychological health of BDSM practitioners. Aim The aim of
The most important event in Chilean public health in the XXth Century was the creation of the National Health Service (NHS), in 1952. Systematic public policies for the promotion of health, disease prevention, medical care, and rehabilitation were implemented, while a number of more specific programs were introduced, such as those on infant malnutrition, complementary infant feeding, medical control of pregnant women and healthy infants, infant and adult vaccination, and essential sanitation services. In 1981, a parallel private health care system was introduced in the form of medical care financial institutions, which today cover 15% of the population, as contrasted with the public system, which covers about 80%. From 1952 to 2014, public health care policies made possible a remarkable improvement in Chile's health indexes: downward trends in infant mortality rate (from 117.8 to 7.2 x 1,000 live births), maternal mortality (from 276 to 18.5 x 100,000), undernourished children purchasing power parity increased from US$ 3,827 to US$ 20,894 and poverty decreased from 60% to 14.4% of the population. Related indexes such as illiteracy, average schooling, and years of primary school education, were significantly improved as well. Nevertheless, compared with OECD countries, Chile has a relatively low public investment in health (45.7% of total national investment), a deficit in the number of physicians (1.7 x 1,000 inhabitants) and nurses (4.8 x 1,000), in the number of hospital beds (2.1 x 1,000), and in the availability of generic drugs in the market (30%). Chile and the USA are the two OECD countries with the lowest public investment in health. A generalized dissatisfaction with the current Chilean health care model and the need of the vast majority of the population for timely access to acceptable quality medical care are powerful arguments which point to the need for a universal public health care system. The significant increase in public expenditure on health care
Full Text Available Healthcare is a critical issue in rural communities throughout the world. Provision of timely and cost effective health care in these communities is a challenge since it is coupled with a lack of adequate infrastructure and manpower support. Twenty percent of the United States of America‘s population resides in rural communities, i.e., 59 million people; however, only nine percent of the nation’s physicians practice in rural communities. Shortage of health care personnel and the lack of equipment and facilities often force rural residents to travel long distances to receive needed medical treatment. Researchers and practitioners are in search of solutions to address these unique challenges. In this research, we present a proposed collaborative model of a health information system for rural communities and the challenges and opportunities of this global issue.
Llorca-Jaña, Manuel; Navarrete-Montalvo, Juan; Droller, Federico; Araya-Valenzuela, Roberto
This article provides the first height estimates for the adult population for any period of Chilean history. Based on military records, it gives an analysis of the average heights of male soldiers in the last eight decades of the colonial period, c.1730-1800s. The average height of Chilean men was around 167 centimetres, making them on average taller than men from Mexico, Italy, Portugal, Spain and Venezuela, but of a similar height to men from Sweden. However, Chilean men were clearly shorter than men in neighbouring Argentina, the USA and the UK. Chilean height remained stable during the 1740-1770s, but it declined by some 2-3 centimetres between the 1780 s and the 1800s, in line with a fall in real wages due to increasing food prices and population growth. Copyright © 2018 Elsevier B.V. All rights reserved.
Lobos, G; Schnettler, B; Grunert, K G; Adasme, C
The main objective of this study is to show why perceived resources are a strong predictor of satisfaction with food-related life in Chilean older adults. Design, sampling and participants: A survey was conducted in rural and urban areas in 30 communes of the Maule Region with 785 participants over 60 years of age who live in their own homes. The Satisfaction with Food-related Life (SWFL) scale was used. Generalized linear models (GLM) were used for the regression analysis. The results led to different considerations: First, older adults' perceived levels of resources are a good reflection of their actual levels of resources. Second, the individuals rated the sum of the perceived resources as 'highly important' to explain older adults' satisfaction with food-related life. Third, SWFL was predicted by satisfaction with economic situation, family importance, quantity of domestic household goods and a relative health indicator. Fourth, older adults who believe they have more resources compared to others are more satisfied with their food-related life. Finally, Poisson and binomial logistic models showed that the sum of perceived resources significantly increased the prediction of SWFL. The main conclusion is that perceived personal resources are a strong predictor of SWFL in Chilean older adults.
Morris, Stephen; Goudie, Rosalind; Sutton, Matt; Gravelle, Hugh; Elliott, Robert; Hole, Arne Risa; Ma, Ada; Sibbald, Bonnie; Skåtun, Diane
We analyse the determinants of annual net income and wages (net income/hours) of general practitioners (GPs) using data for 2271 GPs in England recorded during Autumn 2008. The average GP had an annual net income of £97,500 and worked 43 h per week. The mean wage was £51 per h. Net income and wages depended on gender, experience, list size, partnership size, whether or not the GP worked in a dispensing practice, whether they were salaried of self-employed, whether they worked in a practice with a nationally or locally negotiated contract, and the characteristics of the local population (proportion from ethnic minorities, rurality, and income deprivation). The findings have implications for pay discrimination by GP gender and ethnicity, GP preferences for partnership size, incentives for competition for patients, and compensating differentials for local population characteristics. They also shed light on the attractiveness to GPs in England of locally negotiated (personal medical services) versus nationally negotiated (general medical services) contracts.
Víctor Fernando Figueroa Arcila
Full Text Available This paper defends the use of convergence models to study the temporary evolution of the Chilean communes socioeconomic development. To do so, we will use an indicator made up of using multivariate analysis techniques. By means of regression models of transversal section and models of distributional dynamics we will outline, on the basis of the historic function of communal economies, the behaviour expected for those economies in future and, therefore, the tendencial evolution of Chilean territorial economic model.
Han, Gil-Soo; Wearne, Ben; O'Meara, Peter; McGrail, Matthew; Chesters, Janice
Medical education in Australia is currently entering a new era, including support for the significant extension of medical students and general practitioner (GP) registrars' training programs in rural communities. This commitment to rural medical student and general practitioner recruitment and retention has made the provision of accommodation in rural communities a vital issue. This study has found that approximately half of all medical students on placement with rural GPs are currently accommodated with their GP supervisor or with other practice staff. This is a burden for many GPs and when the anticipated increase in the frequency and length of rural placements occurs what is currently a burden will become unsustainable. The changing gender and cultural demographics of medical students and rural general practitioners will also contribute to stresses on this accommodation system. It is important to have a systematic approach towards more appropriate and sustainable models of accommodation for both medical students and GP registrars.
Manuel Escobar Farfán
Full Text Available Chilean pension fund industry is largely questioned by public; therefore it becomes essential to work on a strategy to enhance brand’s credibility and positioning. This study objective is to analyze and build a brand personality scale to identify consumer’s perception. An exploratory study aided by qualitative tools was carried out to track those brand’s personality traits not considered in Latorre, Martínez and Sotelo (2016. As a result, 38 personality traits have been evidenced in the pension fund administrators industry, some of which are specific to this industrial sector, such as transparency and ambition. This study findings come to complement the five dimensions identified by Aaker (1997 and subsequently validated by Latorre, Martínez y Sotelo (2016.
Schmeda-Hirschmann, Guillermo; Quispe, Cristina; Soriano, Maria Del Pilar C; Theoduloz, Cristina; Jiménez-Aspée, Felipe; Pérez, Maria Jorgelina; Cuello, Ana Soledad; Isla, Maria Inés
In South America, the mesocarp flour of Prosopis species plays a prominent role as a food resource in arid areas. The aim of this work was the characterization of the phenolic antioxidants occurring in the pod mesocarp flour of Chilean Prosopis. Samples were collected in the Copiapo, Huasco and Elqui valleys from the north of Chile. The samples of P. chilensis flour exhibited a total phenolic content ranging between 0.82-2.57 g gallic acid equivalents/100 g fresh flour weight. The highest antioxidant activity, measured by the DPPH assay, was observed for samples from the Huasco valley. HPLC-MS/MS analysis allowed the tentative identification of eight anthocyanins and 13 phenolic compounds including flavonol glycosides, C-glycosyl flavones and ellagic acid derivatives. The antioxidant activity and the phenolic composition in the flour suggest that this ancient South American resource may have potential as a functional food.
Marcelo Moriconi Bezerra
Full Text Available The Chilean civil service is considered one of the most efficient in Latin America. However, different studies describe the informal institutions that operate between the Legislative Power and the bureaucracy to fill positions in the public administration. Although some of these clientelistic practices are against the law, they have been accepted and defended in both the political and scientific spheres. Legality is not considered an important value if certain indexes have a positive development. In this context, it is important to study how corruption and clientelism have been ignored, or hidden, through political discourses and technical reports about the situation of bureaucracy. All of this allows a better understanding of why after 20 years of administrative reforms there are damaging practices which negatively affect democracy that have not been eradicated.
Lomstein, Bente Aagaard; Jørgensen, Bo Barker; Schubert, Carsten J.
The spatial distribution of total hydrolysable amino acids (THAA) and amino acid enantiomers (D- and L-forms) was investigated in sediments underlying two contrasting Chilean upwelling regions,: at ~23°S off Antofagasta and at ~36°S off Concepcion. The contribution of amino acids to total organic...... carbon (%TAAC: 7-14%) and total nitrogen (%TAAN: 23-38%) in surface sediments decreased with increasing water depth (from 126 to 1350 m) indicating that organic matter becomes increasingly decomposed in surface sediments at greater water depth. Changes in the ratio between the protein amino acid...... aspartate and its non-protein degradation product β-alanine confirmed this observation. Furthermore, estimates of THAA mineralization showed that sedimentary amino acid reactivity decreased with both increasing water depth as well as progressive degradation status of the organic matter that was incorporated...
Ambinakudige, S.; Tetteh, L.
Glaciers in Chile range from very small glacierets found on the isolated volcanoes of northern Chile to the 13,000 sq.km Southern Patagonian Ice Field. Regular monitoring of these glaciers is very important as they are considered as sensitive indicators of climate change. Millions of people's lives are dependent on these glaciers for fresh water and irrigation purpose. In this study, mass balances of several Chilean glaciers were estimated using Aster satellite images between 2007 and 2012. Highly accurate DEMs were created with supplementary information from IceSat data. The result indicated a negative mass balance for many glaciers indicating the need for further monitoring of glaciers in the Andes.
Full Text Available In South America, the mesocarp flour of Prosopis species plays a prominent role as a food resource in arid areas. The aim of this work was the characterization of the phenolic antioxidants occurring in the pod mesocarp flour of Chilean Prosopis. Samples were collected in the Copiapo, Huasco and Elqui valleys from the north of Chile. The samples of P. chilensis flour exhibited a total phenolic content ranging between 0.82–2.57 g gallic acid equivalents/100 g fresh flour weight. The highest antioxidant activity, measured by the DPPH assay, was observed for samples from the Huasco valley. HPLC-MS/MS analysis allowed the tentative identification of eight anthocyanins and 13 phenolic compounds including flavonol glycosides, C-glycosyl flavones and ellagic acid derivatives. The antioxidant activity and the phenolic composition in the flour suggest that this ancient South American resource may have potential as a functional food.
Luis Rubilar Solís
Full Text Available Given the geo-physic consistency of the narrow Chilean territory, extended between volcanoes and tectonic plates, the occurrence of natural catastrophes has been diachronic in its bicentennial existence as a nation. The oral as well as the written traditions have expressed this seismic nature as an ancestral ingredient of national identity. In Neruda's vital circumstances (1904-1973 four earthquakes took place, whose semiotic aftershocks resound in his writing. Noticing the telluric fate in this fi nis terrae, the poet's voice invites us to avoid mechanical and collective forgetfulness, warning us to install in the social imagination preventive attitudes to face futures disasters.
Alvarez de Araya, C; Farah, M; Zuccarelli, M T; Masson, L
Sodium and potassium contents of 40 high-protein dietary products were determined in order to complete the Table de Composición Química se Alimentos Chilenos (Chemical Composition Table of Chilean Foods). These cations' level must be strictly controlled in diets of many renal and heart patients. In Chile, Nutritionists who are in charge of preparing these diets, do not have a national composition table related to the sodium and potassium content for most of the food products. Samples of fluid cow's milk, dried milk with different fat contents, some cheeses, hen eggs, bovine entrails, some meat derivates and several meat cuts, including bovine, pork, lamb and chicken were studied.
Full Text Available Suicides account for 2000 deaths in Chile each year. With a suicide rate of 11.3, it is classified as a country with high suicide risk. Aims: to identify personality and cognitive characteristics of the group of Chilean suicides that left suicide notes, through a content analysis. Methods: descriptive field study with an ex post facto design. All suicides registered between 2010 and 2012 by the Investigations Police of Chile were analyzed, obtaining 203 suicide notes from 96 cases. The Darbonne categories for content analysis were used with the inter-judge method. Results: The mean age of the suicides was 44.2 (SD = 18.53. Most of the notes were addressed to family members (51.7%. The most expressed reasons were marital- or interpersonal-related (24.6%; another 23.6% expressed a lack of purpose or hopelessness (including depression, wish to die, low self-esteem. The most frequent content expressed were instructions (about money, children, and funeral. All of the notes showed logical thinking and were written with coherence and clarity. Notably 42% of the notes were marked by affections of fondness, love or dependence of others. Regarding attitudes, the most common were of escape or farewell (42.4%, followed by fatalism, hopelessness, frustration or tiredness (40%. 24 statistically significant differences were found throughout the categories of analysis, according to cohorts of age, marital status and sex. Conclusions: the findings contribute to the profiling of Chilean suicides and to the implementation of suicide prevention programs
Full Text Available The Chilean sclerophyllous matorral is a Mediterranean semiarid ecosystem affected by erosion, with low soil fertility and limited by nitrogen. However, limitation of resources is even more severe for desert soils such as from the Atacama Desert, one of the most extreme arid deserts on Earth. Topsoil organic matter, nitrogen and moisture content were significantly higher in the semiarid soil compared to the desert soil. Although the most significant loss of biologically preferred nitrogen from terrestrial ecosystems occurs via denitrification, virtually nothing is known on the activity and composition of denitrifier communities thriving in arid soils. In this study, we explored denitrifier communities from two soils with profoundly distinct edaphic factors. While denitrification activity in the desert soil was below detection limit, the semiarid soil sustained denitrification activity. To elucidate the genetic potential of the soils to sustain denitrification processes we performed community analysis of denitrifiers based on nitrite reductase (nirK and nirS genes as functional marker genes for this physiological group. Presence of nirK-type denitrifiers in both soils was demonstrated but failure to amplify nirS from the desert soil suggests very low abundance of nirS-type denitrifiers shedding light on the lack of denitrification activity. Phylogenetic analysis showed a very low diversity of nirK with only three distinct genotypes in the desert soil which conditions presumably exert a high selection pressure. While nirK diversity was also limited to only few, albeit distinct genotypes, the semiarid matorral soil showed a surprisingly broad genetic variability of the nirS gene. The Chilean matorral is a shrub land plant community which form vegetational patches stabilizing the soil and increasing its nitrogen and carbon content. These islands of fertility may sustain the development and activity of the overall microbial community and of
Orlando, Julieta; Carú, Margarita; Pommerenke, Bianca; Braker, Gesche
The Chilean sclerophyllous matorral is a Mediterranean semiarid ecosystem affected by erosion, with low soil fertility, and limited by nitrogen. However, limitation of resources is even more severe for desert soils such as from the Atacama Desert, one of the most extreme arid deserts on Earth. Topsoil organic matter, nitrogen and moisture content were significantly higher in the semiarid soil compared to the desert soil. Although the most significant loss of biologically preferred nitrogen from terrestrial ecosystems occurs via denitrification, virtually nothing is known on the activity and composition of denitrifier communities thriving in arid soils. In this study we explored denitrifier communities from two soils with profoundly distinct edaphic factors. While denitrification activity in the desert soil was below detection limit, the semiarid soil sustained denitrification activity. To elucidate the genetic potential of the soils to sustain denitrification processes we performed community analysis of denitrifiers based on nitrite reductase (nirK and nirS) genes as functional marker genes for this physiological group. Presence of nirK-type denitrifiers in both soils was demonstrated but failure to amplify nirS from the desert soil suggests very low abundance of nirS-type denitrifiers shedding light on the lack of denitrification activity. Phylogenetic analysis showed a very low diversity of nirK with only three distinct genotypes in the desert soil which conditions presumably exert a high selection pressure. While nirK diversity was also limited to only few, albeit distinct genotypes, the semiarid matorral soil showed a surprisingly broad genetic variability of the nirS gene. The Chilean matorral is a shrub land plant community which form vegetational patches stabilizing the soil and increasing its nitrogen and carbon content. These islands of fertility may sustain the development and activity of the overall microbial community and of denitrifiers in particular.
Robinson, P A; Epperson, W B
Diagnostic sampling of farm animals by private veterinary practitioners can be an important contributing factor towards the discovery of emerging and exotic diseases. This focus group study of farm animal practitioners in Northern Ireland investigated their use and expectations of diagnostic veterinary laboratories, and elicited their opinions on the role of the private practitioner in veterinary surveillance and the protection of rural public health. The veterinarians were enthusiastic users of diagnostic laboratories, and regarded their own role in surveillance as pivotal. They attached great importance to their veterinary public health duties, and called for more collaboration with their medical general practitioner counterparts. The findings of this research can be used to guide future development of veterinary diagnostic services; provide further insights into the mechanics of scanning surveillance; and measure progress towards a 'One Health' approach between veterinarians and physicians in one geographical region of the UK.
Holmes, William H
This textbook on statistics is written for students in medicine, epidemiology, and public health. It builds on the important role evidence-based medicine now plays in the clinical practice of physicians, physician assistants and allied health practitioners. By bringing research design and statistics to the fore, this book can integrate these skills into the curricula of professional programs. Students, particularly practitioners-in-training, will learn statistical skills that are required of today’s clinicians. Practice problems at the end of each chapter and downloadable data sets provided by the authors ensure readers get practical experience that they can then apply to their own work. Topics covered include: Functions of Statistics in Clinical Research Common Study Designs Describing Distributions of Categorical and Quantitative Variables Confidence Intervals and Hypothesis Testing Documenting Relationships in Categorical and Quantitative Data Assessing Screening and Diagnostic Tests Comparing Mean...
Recent publications in Dutch national newspapers on palliative sedation have raised concerns about its use in general practice. There is now evidence that there is no significant increase in the incidence of palliative sedation. Euthanasia requests were pending in 20.8% of the cases in which palliative sedation was performed, but the general practitioners could clearly justify why they made this choice. This is important because it indicates that they are aware of a sharp distinction between euthanasia and palliative sedation. Although the decision to perform palliative sedation was discussed with almost all cancer patients, patient involvement was less present in non-cancer conditions. This may be related to different disease trajectories, but it also indicates that attention should be devoted to earlier identification of patients in need of palliative care. The findings confirm that the practice of palliative sedation by general practitioners largely reflects the recommendations of the Dutch National Guideline on Palliative Sedation.
Galina Nielsen, Helena; Sofie Davidsen, Annette; Dalsted, Rikke
AIM: Group supervision is a sparsely researched method for professional development in general practice. The aim of this study was to explore general practitioners' (GPs') experiences of the benefits of group supervision for improving the treatment of mental disorders. METHODS: One long-establish......AIM: Group supervision is a sparsely researched method for professional development in general practice. The aim of this study was to explore general practitioners' (GPs') experiences of the benefits of group supervision for improving the treatment of mental disorders. METHODS: One long...... considered important prerequisites for disclosing and discussing professional problems. CONCLUSION: The results of this study indicate that participation in a supervision group can be beneficial for maintaining and developing GPs' skills in dealing with patients with mental health problems. Group supervision...... influenced other areas of GPs' professional lives as well. However, more studies are needed to assess the impact of supervision groups....
Paixão, Jairo Antônio da; Tucher, Guilherme
As an adventure sport, paragliding exposes participants to different levels of life risk. However, the boundary between calculated risk and real risk is a subtle one, depending on the practitioner’s perception. Thus, this study aimed to analyze risk perception of 73 paragliding practitioners. The descriptive-exploratory study method was used. Data was col-lected via a questionnaire validated according to the Delphi technique. Variables were evaluated from a bipolar Likert type scale, ranging ...
Pressman, Roger S
This indispensable guide to software engineering exploration enables practitioners to navigate the ins and outs of this rapidly changing field. Pressman's fully revised and updated Fourth Edition provides in-depth coverage of every important management and technical topic in software engineering. Moreover, readers will find the inclusion of the hottest developments in the field such as: formal methods and cleanroom software engineering, business process reengineering, and software reengineering.
... Parts 60 and 61 National Practitioner Data Bank; Proposed Rule #0;#0;Federal Register / Vol. 77, No. 31... CFR Parts 60 and 61 RIN 0906-AA87 National Practitioner Data Bank AGENCY: Health Resources and... section 1921 of the Social Security Act, governing the National Practitioner Data Bank, to incorporate...
Young, Louise; Lindsay, Daniel B; Ray, Robin A
Medical schools may select students for their attitudes towards rural medical practice, yet the rural-urban disparity in availability of medical practitioners and services has not diminished in recent times despite government initiatives and increasing numbers being trained for a career in medicine. One medical school, with a focus on rural and remote medicine, aims to select students with positive perceptions for rural medical practice. A research project collected data on the perceptions of these medical students in the first week of their medical studies. Students completed a low stakes essay on the life and work of a rural doctor. Initially, this formed part of a literacy assessment to determine any students requiring remediation. All students were asked if they would consent to their essay being reviewed for a research project. Data was obtained from those students who consented and handed their essays in for review. The 103 student essays underwent thematic analysis and sentences were coded into three main themes of rural lifestyle, doctor role and rural practice. Second level themes were further elicited and results were quantified according to whether they were positive or negative. Positive themes included rural lifestyle, doctor role, views of doctor, impact on community, broader work and skills knowledge, and better relationships with community and patients. Negative themes included doctor's health, pressure on doctor, family problems, greater workload, privacy and confidentiality issues, cultural issues, isolation, limited resources and financial impacts. Quantitisation of this data was used to transform essay sentences into a numerical form which allowed statistical analysis and comparison of perceptions using Z tests. No significant differences on the number of positive and negative responses for rural lifestyle and rural practice were found. The rural doctor role had a significantly more positive than negative views. Significant differences were
Full Text Available Jacqueline Fong,1,2 Thomas Buckley,2 Andrew Cashin3 1St George Hospital, Kogarah, 2Sydney Nursing School, University of Sydney, Camperdown, NSW, Australia; 3School of Health and Human Sciences, Southern Cross University, Lismore, NSW, Australia Background: Internationally, the delivery of care provided by nurses and midwives has undergone a significant change due to a variety of interrelated factors, including economic circumstances, a diminishing number of medical providers, the unavailability of adequate health care services in underserved and rural areas, and growing specialization among the professions. One solution to the challenges of care delivery has been the introduction of nurse practitioners (NPs and the authorization of NPs to prescribe medicines. Aim: The aim of this paper was to review the current international literature related to NP prescribing and compare the findings to the Australian context. The review focuses on literature from the United States, Canada, Europe, Australia, and New Zealand. Methods: Databases were searched from January 2000 to January 2015. The following keywords: “nurse practitioner”, “advanced nurse”, “advanced practice nurse”, “prescri*”, “Australia”, “United States America”, “UK”, “New Zealand”, “Canada”, “Europe”, “drug prescri*”, “prescri* authority”, and “prescri* legislation” were used. Findings: NPs tend to prescribe in differing contexts of practice to provide care in underserved populations and require good systems literacy to practice across complex systems. The key themes identified internationally related to NP prescribing relate to barriers to prescribing, confidence in prescribing, and the unique role of NPs in prescribing medicines, eg, the high prevalence of prescribing pain medicines in several countries, including Australia. Conclusion: Across all countries reviewed, there appears a need for further research into the organizational and
Full Text Available Abstract There have been few formal studies on stress in veterinary surgeons and, in the rare studies available, stress is not examined jointly through the levels of job strain and job engagement, the sources of stress in the issue of work environment and the work-home interference. The authors' goal in this study was to analyse job engagement, job strain, burnout, work-home interference and job stress factors among 216 Belgian veterinary surgeons. Rural practice was compared to small animal and mixed activity. The mean job strain and job engagement level in veterinary surgeons was not higher than what we found in other working populations. However, 15.6% of the group were found to be suffering from high burnout. Rural practitioners had a lower level of job engagement than small animal veterinary surgeons. These small animal practitioners had a lower level of job strain than the mixed practitioners. The level of burnout did not differ significantly across the three types of activity. In comparison to other Belgian and Dutch workers, veterinary surgeons perceived more negative work-home interference. Bovine and mixed practitioners were the most concerned with this problem. The two most important sources of stress reported by bovine practitioners were relations to farmers and working time management (including emergencies and availability.
Hansez, I; Schins, F; Rollin, F
There have been few formal studies on stress in veterinary surgeons and, in the rare studies available, stress is not examined jointly through the levels of job strain and job engagement, the sources of stress in the issue of work environment and the work-home interference. The authors' goal in this study was to analyse job engagement, job strain, burnout, work-home interference and job stress factors among 216 Belgian veterinary surgeons. Rural practice was compared to small animal and mixed activity. The mean job strain and job engagement level in veterinary surgeons was not higher than what we found in other working populations. However, 15.6% of the group were found to be suffering from high burnout. Rural practitioners had a lower level of job engagement than small animal veterinary surgeons. These small animal practitioners had a lower level of job strain than the mixed practitioners. The level of burnout did not differ significantly across the three types of activity. In comparison to other Belgian and Dutch workers, veterinary surgeons perceived more negative work-home interference. Bovine and mixed practitioners were the most concerned with this problem. The two most important sources of stress reported by bovine practitioners were relations to farmers and working time management (including emergencies and availability).
. Kelly. The Chilean teachers are visiting Magdalena while they are on their Southern Hemisphere summer vacation, and Magdalena's schools are in session. Two Magdalena teachers, Joleen Welborn and Sandra Montoya, will visit San Pedro in June, while they are on summer vacation and the Chilean schools will be in session. Dr. Eduardo Hardy, the AUI/NRAO representative in Chile, will accompany the Chilean teachers on their visit, which has been coordinated by Harrison. "ALMA is a groundbreaking example of the type of international cooperation that marks the future of astronomy. We are especially pleased to sponsor a program that brings together two communities that both enjoy proximity to world-class astronomical research facilities," said Dr. Fred K.Y. Lo, NRAO Director. "While separated by many miles, San Pedro de Atacama and Magdalena have much in common. Both are small communities in high desert environments, and both are next to telescopes where the world's astronomers will be making many exciting discoveries in the coming decades. Bringing these two communities together will advance education and international understanding," Harrison said. The National Radio Astronomy Observatory is a facility of the National Science Foundation, operated under cooperative agreement by Associated Universities, Inc.
... for Success Am I Rural? Evidence-based Toolkits Economic Impact Analysis Tool Community Health Gateway Sustainability Planning ... Transportation to medical appointments, grocery shopping, and other essential and leisure activities Housing quality and affordability, including ...
Gras, Nuri; Munoz, Luis; Cortes, Eduardo
The National Standardization Institute's (INN) Metrology unit prepared a study in 1996 to evaluate the impact of metrological activity in Chile. This study was based on a survey of the supply and demand of metrological services and on studies of the behavior of the production system and technological services in Chile during the period 1990-1996. With the information obtained in this study the economic impact resulting from the lack of a national metrology system could be evaluated. This impact was estimated to be a 5% loss in gross national product equal to 125-500 million dollars because of direct product rejection in the mining, fisheries, agricultural and manufacturing sectors. Chemical measurements are responsible for 50% of these losses. In response to this need and coordinated by the INN, a metrological network of reference laboratories began to operate in 1997 for the principal physical magnitudes (mass, temperature, longitude and force) and a CORFO-FDI project began in 2001 that includes the chemical magnitudes. The Chilean Nuclear Energy Commission, aware of the problem's importance and the amount of economic damage that the country may suffer, as a result of these deficiencies, has formed a Chemical Metrology Unit to provide technical support. It aims to raise the standards of local analytical laboratories by providing international recognition to the export sector. Nuclear analytical techniques are used as reference methods. This work describes the laboratories that are included in this Chemical Metrology Unit and the historical contribution to the development of local analytical chemistry. The national and international projects are described together with the publications they have generated. The quality assurance program applied to the laboratories is described as well, which has led to the accreditation of the analytical chemical assays. The procedures used for validation and calculation of uncertain nuclear methodologies are described together with
Sträter, E.; Klemm, O.; Westbeld, A.
oceanic dimethylsulfide (DMS). With regard to the back trajectories, the air masses generally reach the study site from southerly directions after travelling along the Chilean coast. Presumably the air masses pick up pollutants in the densely populated cities, industrial plants and power plants along the Chilean coast and transport them over hundreds of kilometers to Patache. Here, they were detected as ingredients in fog water and lead to high pollution levels therein.
Healthcare is leaking away from the hospital and clinic into everyday life, disrupting work and play. It is no longer confined to a strictly medical sphere. Overwhelmed medical practitioners care for the expanding ranks of chronic dependents. One solution has to been to expand healthcare activities...... and create duties for patients. For the patient at home, it is not just about applying bandages to a wound. They now configure dialysis machines, inject insulin and stock medical supplies. Information technology produces data to be transformed into meaningful knowledge about one’s own body. However, with all...
Identidades en movimiento: familias chilenas en la fruticultura del Alto Valle de Río Negro, Argentina Identities in movement: chilean families in the fruit production of the Alto Valle de Río Negro, Argentina
Full Text Available Este artículo, basado en el trabajo de campo realizado en áreas rurales del Alto Valle de Río Negro, Argentina, desde el año 1999, tiene como propósito presentar las relaciones en las cuales se insertan hombres y mujeres chilenas que residen y trabajan en "chacras" destinadas a la producción frutícola. Las diferentes actividades en las chacras se organizan según el sexo y la edad, definiéndose una segmentación del mercado de trabajo en la que se ven involucrados los diferentes miembros de la familia. Como desarrollaré, ser trabajadores chilenos en la fruticultura del Alto Valle de Río Negro reproduce una identidad étnica y nacional en el seno de la cotidianeidad familiar y laboral.This article, based on field work conducted in rural areas of the Alto Valle de Río Negro, Argentina, from 1999 on, analyzes the relations in which Chilean men and women who reside and work in small farms destined to fruit production are inserted. The different activities in the small farms are organized according to sex and age, circumscribing a segment of the labor market in which different members of the family are involved. As I will demonstrate, to be a Chilean worker in the fruit growing region of the Alto Valle is to reproduce an ethnic and national identity through work routines mediated by family relations.
Full Text Available The measurement of waist circumference (WC is considered to be an important means to control overweight and obesity in children and adolescents. The objectives of the study were to (a compare the WC measurements of Chilean students with the international CDC-2012 standard and other international standards, and (b propose a specific measurement value for the WC of Chilean students based on age and sex. A total of 3892 students (6 to 18 years old were assessed. Weight, height, body mass index (BMI, and WC were measured. WC was compared with the CDC-2012 international standard. Percentiles were constructed based on the LMS method. Chilean males had a greater WC during infancy. Subsequently, in late adolescence, males showed values lower than those of the international standards. Chilean females demonstrated values similar to the standards until the age of 12. Subsequently, females showed lower values. The 85th and 95th percentiles were adopted as cutoff points for evaluating overweight and obesity based on age and sex. The WC of Chilean students differs from the CDC-2012 curves. The regional norms proposed are a means to identify children and adolescents with a high risk of suffering from overweight and obesity disorders.
Gómez-Campos, Rossana; Lee Andruske, Cinthya; Hespanhol, Jefferson; Sulla Torres, Jose; Arruda, Miguel; Luarte-Rocha, Cristian; Cossio-Bolaños, Marco Antonio
The measurement of waist circumference (WC) is considered to be an important means to control overweight and obesity in children and adolescents. The objectives of the study were to (a) compare the WC measurements of Chilean students with the international CDC-2012 standard and other international standards, and (b) propose a specific measurement value for the WC of Chilean students based on age and sex. A total of 3892 students (6 to 18 years old) were assessed. Weight, height, body mass index (BMI), and WC were measured. WC was compared with the CDC-2012 international standard. Percentiles were constructed based on the LMS method. Chilean males had a greater WC during infancy. Subsequently, in late adolescence, males showed values lower than those of the international standards. Chilean females demonstrated values similar to the standards until the age of 12. Subsequently, females showed lower values. The 85th and 95th percentiles were adopted as cutoff points for evaluating overweight and obesity based on age and sex. The WC of Chilean students differs from the CDC-2012 curves. The regional norms proposed are a means to identify children and adolescents with a high risk of suffering from overweight and obesity disorders. PMID:26184250
Dorsch, J L
This review analyzes the existing research on the information needs of rural health professionals and relates it to the broader information-needs literature to establish whether the information needs of rural health professionals differ from those of other health professionals. The analysis of these studies indicates that rural health practitioners appear to have the same basic needs for patient-care information as their urban counterparts, and that both groups rely on colleagues and personal libraries as their main sources of information. Rural practitioners, however, tend to make less use of journals and online databases and ask fewer clinical questions; a difference that correlates with geographic and demographic factors. Rural practitioners experience pronounced barriers to information access including lack of time, isolation, inadequate library access, lack of equipment, lack of skills, costs, and inadequate Internet infrastructure. Outreach efforts to this group of underserved health professionals must be sustained to achieve equity in information access and to change information-seeking behaviors.
Försterra, G.; Häussermann, V.
South Chilean fjords contain an astonishing diverse benthic macrofauna of which anthozoans form a major portion. Azooxanthellate solitary scleractinians, which were hitherto known from major depths, were found as shallow as 8 m during several expeditions to the south Chilean fjord region. At some
Hermes, N; Lensink, R
This article investigates whether the Chilean banking reforms of the 1980s have contributed to reducing market imperfections in Chilean financial markets in the late 1980 and early 1990s. To analyse this issue, patterns of investment and its finance for different types of firms are studied, based on
LaMarche, Kimberley; Tullai-McGuinness, Susan
To examine the level of job satisfaction and its association with extrinsic and intrinsic job satisfaction characteristics among Canadian primary healthcare nurse practitioners (NPs). A descriptive correlational design was used to collect data on NPs' job satisfaction and on the factors that influence their job satisfaction. A convenience sample of licensed Canadian NPs was recruited from established provincial associations and special-interest groups. Data about job satisfaction were collected using two valid and reliable instruments, the Misener Nurse Practitioner Job Satisfaction Survey and the Minnesota Satisfaction Questionnaire. Descriptive statistics, Pearson correlation and regression analysis were used to describe the results. The overall job satisfaction for this sample ranged from satisfied to highly satisfied. The elements that had the most influence on overall job satisfaction were the extrinsic category of partnership/collegiality and the intrinsic category of challenge/autonomy. These findings were consistent with Herzberg's Dual Factor Theory of Job Satisfaction. The outcomes of this study will serve as a foundation for designing effective human health resource retention and recruitment strategies that will assist in enhancing the implementation and the successful preservation of the NP's role.
Verdejo, Humberto; Becker, Cristhian; Echiburu, Diego; Escudero, William; Fucks, Emiliano
Since 1970 Chile has had a Daylight Saving Time (DST) policy in order to reduce residential electricity consumption in the country. The time change was set for the first time by executive decree in 1970, and since that date it was applied every year without great changes until 2010. Since then, and to date, decrees have been set in order to increase the duration of the DST, arguing that there are reasons associated with energy savings that justify the extension of the measure that has been adopted by the authority in recent years. In the present study the impact of the application of DST in terms of decreased household electricity consumption is analyzed using two complementary methods, one based on a heuristic approach and the other using an econometric model. The results indicate that there is indeed a marginally small reduction in residential electricity consumption, although these results are not homogeneous throughout the country. - Highlights: • The impact of the application of DST is analyzed in Chilean distribution networks. • The results indicate that there is indeed a marginally small reduction in residential electricity consumption. • A total energy reduction is estimated based on the proposed methodology.
Durán Aguero, Samuel; Reyes García, Susanne; Gaete, María Cristina
The lifestyle changes in college, students go through periods of physical inactivity and irregular meal times, which leads to increased consumption of processed foods and fast food. To calculate vitamins and minerals intakes for groups in the diet of Chilean university students. We studied 654 university students (18 to 24 years, 54% female), a 7-day food frequency questionnaire was used for dietary assessment, the information collected was classified into 12 groups representing each set of food, and then nutrient intake was determined. The main results were: (a) women had lower intake of most micronutrients than men (b) pantothenic acid, vitamin B12 and E, calcium, magnesium and iron are nutrients that showed mean intakes below the daily recommendations, (c) the consumption of bread is essential for the supply of B vitamins, iron, copper and selenium. In the usual diet of college students, bread is a key to the dietary intake of B vitamins, iron, copper and selenium, as well as dairy products for calcium, meat and fish for vitamin B12 and zinc; vegetables for vitamin A and fruits for vitamin C. Copyright © AULA MEDICA EDICIONES 2013. Published by AULA MEDICA. All rights reserved.
Campos, V; Cantarero, S; Urrutia, H; Heinze, R; Wirsing, B; Neumann, U; Weckesser, J
Cyanobacterial blooms dominated by Microcystis sp. occurred in lake Rocuant ("marisma", near Concepción/Chile) in February 1995 and 1996. In the bloom samples collected in both years the hepatotoxin microcystin was detected by RP-HPLC in both samples and in the sample of 1995 also by a toxicity assay using primary rat hepatocytes. In the bloom of 1995, the microcystin content of the dry bloom biomass was determined to be 130 micrograms/g on the basis of the RP-HPLC peak area and 800 micrograms/g on the basis of the rat hepatotoxicity assay, respectively. In the bloom of 1996, RP-HPLC analysis revealed a microcystin content of 8.13 micrograms/g bloom material dry weight. In this year no hepatotoxicity was measured using a concentration range up to 0.8 mg (d. w.) of bloom material per ml in the rat hepatotoxicity assay. This is the first report on the detection of microcystins in Chilean water bodies.
Santander, Jaime T; Pinedo, José P; Repetto, Paula L
Physicians should be exposed, during their training to basic concepts in psychology. To describe the current status of the formal teaching of health psychology or medical psychology in Chilean medical schools. We reviewed the programs of the courses including topics of Medical Psychology, Health Psychology and Behavioral Medicine at 18 medical schools in Chile, using a focused coding method. The contents and the time spent on these courses were considered and analyzed. Eighty three percent of medical schools have a Medical Psychology or related program, 56.3% are carried out during the first year of medical School teaching and the weekly load has an average of 4 hours. The contents are mixed and predominantly concerning general and developmental psychology, but also address specific issues of Medical Psychology in most cases. There is little clarity about the training issues to be addressed in medical psychology for medical students in Chile. It is necessary to define the minimum content that all medical graduates should learn.
Irarrázaval, M Elisa; Kleinman, Pascale; Silva R, Fernando; Fernández González, Loreto; Torres, Camilo; Fritis, Marcela; Barriga, Carolina; Waintrub, Herman
Quality of Life (QOL) assessment may evaluate the impact of diseases and their treatment on the overall well-being of patients. To assess QOL in Chilean breast cancer survivors. Ninety one female breast cancer patients aged 60 ± 10 years, who finished their oncologic treatment at least a year prior to the assessment, who were disease free and in medical follow-up were included in the study. They completed the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 core questionnaire and the breast cancer module QLQ-BR23. Forty eight percent of respondents were long term survivors (more than five years). Global QOL scores were high (73.6 ± 18.2), emotional scale had the lowest scores in QLQ-C30 functional scales (72.1). Symptoms with the highest scores were: Insomnia (= 21.2), pain (= 20.8), and fatigue (= 19.1). Body image, sexual function, and concern about the future were the most relevant problems. Body image was superior in patients with breast-conserving surgery (p = 0.008), and cognitive function was better in patients in early disease stage (p = 0.03) and in those with more than five years of survival (p = 0.04). Even when global QOL scores were high, some symptoms were prevalent. Awareness about these problems and symptoms should improve their diagnosis and treatment.
Zurita-Ortega, Félix; Castro-Sánchez, Manuel; Rodríguez-Fernández, Sonia; Cofré-Boladós, Cristian; Chacón-Cuberos, Ramón; Martínez-Martínez, Asunción; Muros-Molina, José Joaquín
Obesity is a worldwide epidemic disease and a problem for the Chilean society. To analyze the relationship between physical condition, body mass index (BMI), level of physical activity and self-esteem. Material ad Methods: Questionnaires to assess self-esteem (Rosemberg scale) and levels of physical activity (Physical Activity Questionnaire for older Children, PAQ-C) were answered by 515 children aged 10.5 ± 0.5 years from 27 schools of Santiago de Chile. BMI was calculated. Course-Navette test was carried out, vertical jump and hand dynamometry were measured. For statistical analysis, structural equations were used. An acceptable goodness of fit for the models was found. There was a positive relationship between BMI and hand dynamometry, as well as a negative relationship between BMI and maximal oxygen consumption, jumping ability, physical activity and self-esteem. Finally, self-esteem was positively related to physical activity engagement. In these children, self-esteem was related to physical activity variables.
Full Text Available This paper presents the results of a study about peer intimidation and victimization with 1167 school students from 6th, 7th, and 8th grade from the Valparaiso Region of Valparaíso, Chile. The instrument used was the Insebull Battery (Avilés & Elices, 2007. Results show that approximately 9% of students have been victim of peer victimization many times or almost every day during the school year. Psychological victimization was more frequent thanphysical aggression, particularly through virtual communication such as cell-phone messages and e-mails. Participants tend to be groups of male students. Although male students participate more in physical aggression, they also receive more physical and psychological aggression. The most frequent places were inside the classroom and the school yard, when the teacher is not present. Most students inform not knowing, or vaguely knowing, thereasons underlying these aggressions, and do not do anything to deal with them. These results coincide with international studies and allow a better understanding of the characteristics of peer victimization in specific educational contexts within the Chilean school system.
Obregón, Ana; Fuentes, Jessica; Pettinelli, Paulina
High calorie foods, especially high in sugar and sodium may have an addictive potential. Experimental rats are able to develop symptoms and neurochemical changes, comparable to those observed in drug abuse, when they are exposed intermittently to sucrose. To evaluate the association between nutritional status and the prevalence of food addiction in Chilean college students. Food addiction was assessed using the Yale Food Addiction Scale in 292 Chilean students aged 18-39 years (35% males). Height and weight were measured and body mass index (weight/height²) was calculated. Eleven percent of participants met the criteria for food addiction. Women had a higher prevalence than men (14.4% and 4.8%, respectively). Thirty percent of individuals with a body mass index over 30 kg/m² met the criteria for food addiction. In these Chilean students, food addiction was more prevalent in women and a higher prevalence was observed in obese individuals.
Cianelli, Rosina; Ferrer, Lilian; McElmurry, Beverly J
Socio-cultural factors and HIV-related misinformation contribute to the increasing number of Chilean women living with HIV. In spite of this, and to date, few culturally specific prevention activities have been developed for this population. The goal of the present study was to elicit the perspectives of low-income Chilean women regarding HIV and relevant socio-cultural factors, as a forerunner to the development of a culturally appropriate intervention. As part of a mixed-methods study, fifty low-income Chilean women participated in a survey and twenty were selected to participate in prevention, in-depth interviews. Results show evidence of widespread misinformation and misconceptions related to HIV/AIDS. Machismo and marianismo offer major barriers to prevention programme development. Future HIV prevention should stress partner communication, empowerment and improving the education of women vulnerable to HIV.
Full Text Available The Chilean water model has been described as a textbook example of a free-market water system. This article contributes to the critiques of this model by showing the effect of its implementation in the Atacameño community of Chiu-Chiu, located in the Atacama Desert in the south-central Andes. In this community, the privatization of water rights ignored local water management practices that had produced a high-altitude wetland (known as a vega. This led to the inhabitants’ dispossession of crucial water rights and to wetland degradation. This process belies statements that the Chilean model relies on an unregulated market and instead highlights the state’s role in marginalizing local irrigation practices by reducing the water consumption of the indigenous population while keeping the copper mining industry (the main source of Chilean income and related growing urban populations supplied with water.
This position paper addresses an important question for the discipline of Empirical or Evidence-based Software Engineering (SE), namely ´what information do software engineering practitioners need from the empirical studies´. The paper contributes to answering this question by presenting survey results on two sub-questions: 1) what are the topics that interest practitioners? and 2) what type of information is needed by practitioners? Answering the first question results in a set of SE topics,...
Robotham, Antony John
designers must have more physical contact with engineering products, learn about product quality and how it is achieved, and develop a quality mind-set. They should be challenged to create novel and innovative solutions. Industrial designers require a formal awareness and knowledge of performance qualities...... the design research community needs to face.The paper argues that Design for Quality provides a robust framework, which can be used by the industrial, research, and educational communities as a platform for improving the skills and capability of the practitioners of Design for Quality.If engineering...... and the DFQ framework.Design Research needs to provide deeper insight in to the soft aspects of quality and DFQ, e.g. understanding the quality mind-set and how it is developed, understanding the perception of quality and its relationships to the product characteristics, and what mix of skills and knowledge...
Paul Anthony Dissington
Full Text Available Studies of second language learning have revealed a connection between first language transfer and errors in second language production. This paper describes an action research study carried out among Chilean university students studying English as part of their degree programmes. The study focuses on common lexical errors made by Chilean Spanish-speakers due to negative first language transfer and aims to analyse the effects of systematic instruction and practice of this problematic lexis. It is suggested that raising awareness of lexical transfer through focused attention on common transfer errors is valued by students and seems essential for learners to achieve productive mastery.
Granillo, M. Teresa; Grogan-Kaylor, Andrew; Delva, Jorge; Castillo, Marcela
The purpose of this study was to explore the prevalence and correlates of eating disorders among a community-based sample of female Chilean adolescents. Data were collected through structured interviews with 420 female adolescents residing in Santiago, Chile. Approximately 4% of the sample reported ever being diagnosed with an eating disorder. Multivariate logistic regression analyses revealed that those with higher symptoms of anxiety and who had tried cigarettes were significantly more likely to have been diagnosed with an eating disorder. Findings indicate that Chilean female adolescents are at risk of eating disorders and that eating disorders, albeit maladaptive, may be a means to cope with negative affect, specifically anxiety. PMID:22121329
dependency on state institutions under the Vietnamese transition to a market society. It discusses present poverty definitions and measures by comparing survey data with the formal economic categorization of rural households. Both the overall characteristics of rural society and qualitative data indicate...... that the reforms have set in motion a process by which a mix of new opportunities and increasing pressures creates new winners and losers. Second, the chapter draws attention to the nature of interactions between households, local communities and the Vietnamese state. This shows both potentials and limitations...
The private sector accounts for about 75 percent of outpatient as well as inpatient medical care in Andhra Pradesh. The presence of a large number of unqualified medical practitioners in the rural areas and urban slums indicate that they provide most of the outpatient services in the private sector. Given the huge quantum of services provided by the RMPs, the present study aims at identifying their number, characteristics and the nexus with the qualified doctors through a case study of one di...
Gelcich, Stefan; Hughes, Terry P.; Olsson, Per; Folke, Carl; Defeo, Omar; Fernández, Miriam; Foale, Simon; Gunderson, Lance H.; Rodríguez-Sickert, Carlos; Scheffer, Marten; Steneck, Robert S.; Castilla, Juan C.
Marine ecosystems are in decline. New transformational changes in governance are urgently required to cope with overfishing, pollution, global changes, and other drivers of degradation. Here we explore social, political, and ecological aspects of a transformation in governance of Chile's coastal marine resources, from 1980 to today. Critical elements in the initial preparatory phase of the transformation were (i) recognition of the depletion of resource stocks, (ii) scientific knowledge on the ecology and resilience of targeted species and their role in ecosystem dynamics, and (iii) demonstration-scale experimental trials, building on smaller-scale scientific experiments, which identified new management pathways. The trials improved cooperation among scientists and fishers, integrating knowledge and establishing trust. Political turbulence and resource stock collapse provided a window of opportunity that triggered the transformation, supported by new enabling legislation. Essential elements to navigate this transformation were the ability to network knowledge from the local level to influence the decision-making processes at the national level, and a preexisting social network of fishers that provided political leverage through a national confederation of artisanal fishing collectives. The resultant governance scheme includes a revolutionary national system of marine tenure that allocates user rights and responsibilities to fisher collectives. Although fine tuning is necessary to build resilience of this new regime, this transformation has improved the sustainability of the interconnected social–ecological system. Our analysis of how this transformation unfolded provides insights into how the Chilean system could be further developed and identifies generalized pathways for improved governance of marine resources around the world. PMID:20837530
Mundt, Adrian P.; Alvarado, Rubén; Fritsch, Rosemarie; Poblete, Catalina; Villagra, Carolina; Kastner, Sinja; Priebe, Stefan
Objective High rates of mental disorders have been reported for prison populations worldwide, particularly in low- and middle-income countries (LMICs). The present study aimed to establish prevalence rates of mental disorders in Chilean prisoners. Method A nationwide random sample of 1008 prisoners was assessed in 7 penal institutions throughout Chile. Twelve-month prevalence rates were established using the Composite International Diagnostic Interview (CIDI) and compared to the prevalence rates previously published for the general population. Results Prevalence rates were 12.2% (95% CI, 10.2-14.1) for any substance use disorder, 8.3% (6.6-10.0) for anxiety disorders, 8.1% (6.5-9.8) for affective disorders, 5.7% (4.4-7.1) for intermittent explosive disorders, 2.2% (1.4-3.2) for ADHD of the adult, and 0.8% (0.3-1.3) for non-affective psychoses. Significantly higher prevalence rates among prisoners as compared to the general population in Chile were seen for major depression (6.1% vs. 3.7% males, Z=2.58, pprison population than in the general population. One-year prevalence rates of alcohol abuse (2.3% vs. 3.9%; Z=-2.04; pprison population than in the general population. Conclusions Service provision for prison populations in Chile should acknowledge high rates of depression and illicit drug use. Overall prevalence rates are lower than reported in other LMICs. Previous research in prison populations in LMICs might have overestimated prevalence rates of mental disorders. PMID:23894415
Garmendia, María Luisa; Lera, Lydia; Sánchez, Hugo; Uauy, Ricardo; Albala, Cecilia
The homeostasis assessment model for insulin resistance (HOMA-IR) estimates insulin resistance using basal insulin and glucose values and has a good concordance with values obtained with the euglycemic clamp. However it has a high variability that depends on environmental, genetic and physiologic factors. Therefore it is imperative to establish normal HOMA values in different populations. To report HOMA-IR values in Chilean elderly subjects and to determine the best cutoff point to diagnose insulin resistance. Cross sectional study of 1003 subjects older than 60 years of whom 803 (71% women) did not have diabetes. In 154 subjects, an oral glucose tolerance test was also performed. Insulin resistance (IR) was defined as the HOMA value corresponding to percentile 75 of subjects without over or underweight. The behavior of HOMA-IR in metabolic syndrome was studied and receiver operating curves (ROC) were calculated, using glucose intolerance defined as a blood glucose over 140 mg/dl and hyperinsulinemia, defined as a serum insulin over 60 microU/ml, two hours after the glucose load. Median HOMA-IR values were 1.7. Percentile 75 in subjects without obesity or underweight was 2.57. The area under the ROC curve, when comparing HOMA-IR with glucose intolerance and hyperinsulinemia, was 0.8 (95% confidence values 0.72-0.87), with HOMA-IR values ranging from 2.04 to 2.33. HOMA-IR is a useful method to determine insulin resistance in epidemiological studies. The HOMA-IR cutoff point for insulin resistance defined in thi spopulation was 2.6.
Pantoja, Silvio; Gutiérrez, Marcelo; Tapia, Fabián; Abarzúa, Leslie; Daneri, Giovanni; Reid, Brian; Díez, Beatriz
The Southern Ice Field in Chilean Patagonia is the largest (13,000 km2) temperate ice mass in the Southern hemisphere, yearly transporting ca. 40 km3 of freshwater to fjords. This volume of fresh and cold water likely affects adjacent marine ecosystems by changing circulation, productivity, food web dynamics, and the abundance and distribution of planktonic and benthic organisms. We hypothesize that freshwater-driven availability of inorganic nutrient and transport of organic and inorganic suspended matter, as well as microbes, become a controlling factor for productivity in the fjord associated with the Baker river and Jorge Montt glacier. Both appear to be sources of silicic acid, but not of nitrate and particulate organic carbon, especially during summer, when surface PAR and glacier thawing are maximal. In contrast to Baker River, the Jorge Montt glacier is also a source of dissolved organic carbon towards a proglacial fjord and the Baker Channel, indicating that a thorough chemical description of sources (tidewater glacier and glacial river) is needed. Nitrate in fiord waters reaches ca. 15 μM at 25 m depth with no evidence of mixing up during summer. Stable isotope composition of particulate organic nitrogen reaches values as low as 3 per mil in low-salinity waters near both glacier and river. Nitrogen fixation could be depleting δ15N in organic matter, as suggested by the detection at surface waters of nif H genes belonging to diazotrophs near the Montt glacier. As diazotrophs have also been detected in other cold marine waters (e.g. Baltic Sea, Arctic Ocean) as well as glaciers and polar terrestrial waters, there is certainly a potential for both marine and freshwater microbes to contribute and have a significant impact on the Patagonian N and C budgets. Assessing the impact of freshwater on C and N fluxes and the microbial community structure in Patagonian waters will allow understanding future scenarios of rapid glacier melting. This research was funded
Sypek, Scott; Clugston, Gregory; Phillips, Christine
To explore the reported impact of regional resettlement of refugees on rural health services, and identify critical health infrastructure for refugee resettlement. Comparative case study, using interviews and situational analysis. Four rural communities in New South Wales, which had been the focus of regional resettlement of refugees since 1999. Refugees, general practitioners, practice managers and volunteer support workers in each town (n = 24). The capacity of health care workers to provide comprehensive care is threatened by low numbers of practitioners, and high levels of turnover of health care staff, which results in attrition of specialised knowledge among health care workers treating refugees. Critical health infrastructure includes general practices with interest and surge capacity, subsidised dental services, mental health support services; clinical support services for rural practitioners; care coordination in the early settlement period; and a supported volunteer network. The need for intensive medical support is greatest in the early resettlement period for 'catch-up' primary health care. The difficulties experienced by rural Australia in securing equitable access to health services are amplified for refugees. While there are economic arguments about resettlement of refugees in regional Australia, the fragility of health services in regional Australia should also be factored into considerations about which towns are best suited to regional resettlement.
Nichols, Sue; Cormack, Phil
How does practitioner inquiry impact education? Examining the experiences of practitioners who have participated in inquiry projects, the authors present ways in which this work has enabled educators to be positive change agents. They reveal the difference that practitioner inquiry has made in their professional practice, their understanding of…
Taylor, Anita; Staruchowicz, Lynda
nurse practitioners in Australia. In order for the nurse practitioner to be endorsed by the Australian Health Practitioner Regulation Agency (AHPRA) to practise as a nurse practitioner they must have met the competency standards and be endorsed to practise by the Nursing and Midwifery Board of Australia (NMBA) as a nurse practitioner under section 95 of the National Law. The nurse practitioner's endorsement in Australia is contextualised by their scope of practice, as is the case internationally.At September 2011, 450 endorsed nurse practitioners were nationally registered with AHPRA; 54 of these were endorsed to practise in South Australia. The first orthopaedic nurse practitioner was authorised in South Australia in 2005. To date there are eight endorsed orthopaedic nurse practitioners in Australia authorised to practise in a diverse range of orthopaedic settings that include acute care, community care, outpatient settings, rehabilitation, private practice and rural settings. The current scope of practice for Australian orthopaedic nurse practitioners spans the clinical range of trauma, arthroplasty, fragility fracture and ortho-geriatric care, surgical care: spinal/neurology and paediatric care. Orthopaedic nurse practitioners work within contemporary orthopaedic/musculoskeletal client disease models. These clinical models of care articulate the health care needs of populations living with musculoskeletal conditions, disorders and disease. Osteoarthritis and osteoporosis are 'highly prevalent long term [musculoskeletal] conditions known to predominantly affect the elderly and comprise the most common cause of disability in Australia'. Musculoskeletal trauma or injury as a result of an 'external force' such as vehicle accident, a fall, industrial or home environment accident or assault comprises a leading cause of hospital admission that requires orthopaedic management and care.There is some evidence to suggest that orthopaedic nursing is a 'specialty under threat' as
Jugenheimer, Donald W.
A questionnaire survey of 300 advertising practitioners was used to determine the degree of job and career satisfaction among advertising practitioners. The subjects were separated according to whether they worked for advertising agencies, advertisers, or advertising media; 100 subjects in each area were selected from the prestigious directories…
Cox, Rebecca D.
Practitioner-researchers are well-positioned to apply qualitative methods to the study of significant problems of educational practice. However, while learning the skills of qualitative inquiry, practitioners may be compelled by forces outside of qualitative research classrooms to think quantitatively. In this article, the author considers two…
Moyo, Mpatisi; Goodyear-Smith, Felicity A.; Weller, Jennifer; Robb, Gillian; Shulruf, Boaz
Personal and professional values of healthcare practitioners influence their clinical decisions. Understanding these values for individuals and across healthcare professions can help improve patient-centred decision-making by individual practitioners and interprofessional teams, respectively. We aimed to identify these values and integrate them…
Neff, Bonita Dostal; Walker, Gael; Smith, Michael F.; Creedon, Pam J.
Uses data from the national survey described elsewhere in this issue to develop profiles of the desired characteristics of entry-level and advanced-level practitioners, and for educators teaching public relations in undergraduate and graduate programs. Finds unexpectedly strong agreement between educators and practitioners regarding these issues,…
Wong, Cecilia H.M.; Ho, Wing-chung
The effectiveness of social impact assessment (SIA) hinges largely on the capabilities and ethics of the practitioners, yet few studies have dedicated to discuss the expectations for these professionals. Recognising this knowledge gap, we employed the systemic review approach to construct a framework of roles of SIA practitioners from literature. Our conceptual framework encompasses eleven roles, namely project manager of SIA, practitioner of SIA methodologies, social researcher, social strategy developer, social impact management consultant, community developer, visionary, public involvement specialist, coordinator, SIA researcher, and educator. Although these roles have been stratified into three overarching categories, the project, community and SIA development, they are indeed interrelated and should be examined together. The significance of this study is threefold. First, it pioneers the study of the roles of SIA practitioners in a focused and systematic manner. Second, it informs practitioners of the expectations of them thereby fostering professionalism. Third, it prepares the public for SIAs by elucidating the functions and values of the assessment. - Highlights: • We adopt systematic review to construct a framework of roles of social impact assessment (SIA) practitioners from literature. • We use three overarching categorises to stratify the eleven roles we proposed. • This work is a novel attempt to study the work as a SIA practitioner and build a foundation for further exploration. • The framework informs practitioners of the expectations on them thus reinforcing professionalism. • The framework also prepares the public for SIAs by elucidating the functions and values of the assessment
... Data Bank AGENCY: Health Resources and Services Administration (HRSA), HHS. ACTION: Final rule... ``National Practitioner Data Bank'' which appeared in the April 5, 2013, issue of the Federal Register. The... FURTHER INFORMATION CONTACT: Director, Division of Practitioner Data Banks, Bureau of Health Professions...
Wong, Cecilia H.M., E-mail: email@example.com; Ho, Wing-chung, E-mail: firstname.lastname@example.org
The effectiveness of social impact assessment (SIA) hinges largely on the capabilities and ethics of the practitioners, yet few studies have dedicated to discuss the expectations for these professionals. Recognising this knowledge gap, we employed the systemic review approach to construct a framework of roles of SIA practitioners from literature. Our conceptual framework encompasses eleven roles, namely project manager of SIA, practitioner of SIA methodologies, social researcher, social strategy developer, social impact management consultant, community developer, visionary, public involvement specialist, coordinator, SIA researcher, and educator. Although these roles have been stratified into three overarching categories, the project, community and SIA development, they are indeed interrelated and should be examined together. The significance of this study is threefold. First, it pioneers the study of the roles of SIA practitioners in a focused and systematic manner. Second, it informs practitioners of the expectations of them thereby fostering professionalism. Third, it prepares the public for SIAs by elucidating the functions and values of the assessment. - Highlights: • We adopt systematic review to construct a framework of roles of social impact assessment (SIA) practitioners from literature. • We use three overarching categorises to stratify the eleven roles we proposed. • This work is a novel attempt to study the work as a SIA practitioner and build a foundation for further exploration. • The framework informs practitioners of the expectations on them thus reinforcing professionalism. • The framework also prepares the public for SIAs by elucidating the functions and values of the assessment.
Full Text Available Resumen: El diario chileno El Mercurio incluye algunas veces en sus artículos la mención «ver infografía» para invitar a los lectores a completar la lectura con la observación de un cuadro anexo. Este cuadro, sin embargo, no siempre incluye un elemento icónico: como lo demostramos aquí, este diario utiliza una definición extremadamente amplia del concepto de infografía. Además de presentar aquí las características de todos los infográficos publicados en enero y febrero de 2009, mostramos también que los casos en que aparece la mención «ver infografía» no son predecibles a partir de estos cuadros y que éstos no se distinguen, por sus características, del resto de los publicados.Abstract:The chilean newspaper El Mercurio sometimes include in their articles the words «see infographics» inviting readers to complete the reading with the observation of an annexed table. This table, however, does not always include an iconic: as we demonstrated here, this newspaper uses an extremely broad definition of the concept of infographics. Apart from presenting here the characteristics of all infographics published in January and February 2009, we also show that cases in which the words «see infographics» are not predictable from these graphics and they are not distinguished by their characteristics from the rest of them.
Dorsch, Josephine L.
This review analyzes the existing research on the information needs of rural health professionals and relates it to the broader information-needs literature to establish whether the information needs of rural health professionals differ from those of other health professionals. The analysis of these studies indicates that rural health practitioners appear to have the same basic needs for patient-care information as their urban counterparts, and that both groups rely on colleagues and personal...
Shea, Mary L
Job satisfaction of nurse practitioners (NPs) has been studied using quantitative methods. A grounded theory approach was used in this study to understand the contextual nature of the NPs' description of job satisfaction from a personal perspective. A grounded theory approach as described by Glaser and Strauss was used in this study. The study took place in a rural northeastern state. The researcher conducted face-to-face interviews using open-ended questions with 15 participants. Constant comparative method was utilized to analyze data culminating in a basic social process. The participants described holistic care as the foundation of their work and their relationship with patients as determining factors of job satisfaction. When NPs felt as though patient care was compromised, they became dissatisfied. NPs were highly satisfied when providing holistic care and within an environment that respected their professional values. In order to maintain accessibility to high-quality health care, it is imperative to understand the factors that contribute to job satisfaction of NPs. As the healthcare system evolves, healthcare policymakers and healthcare organizations must develop strategies to ensure job satisfaction among NPs. ©2014 American Association of Nurse Practitioners.
Hemphill, Elizabeth; Kulik, Carol T
Recruitment is an ongoing challenge in the health industry with general practitioner (GP) shortages in many areas beyond rural and Indigenous communities. This paper suggests a marketing solution that identifies different segments of the GP market for recruitment strategy development. In February 2008, 96 GPs in Australia responded to a mail questionnaire (of which 85 questionnaires were useable). A total of 350 GPs were sent the questionnaire. Respondents considered small sets of attributes in the decision to accept a new job at a general practice and selected the most and least important attribute from each set. We identified latent class clusters (cohorts) of GPs from the most-least important data. Three cohorts were found in the GP market, distinguishing practitioners who emphasised job, family or practice attributes in their decision to join a practice. Few significant demographic differences exist between the cohorts. A segmented GP market suggests two alternative recruitment strategies. One option is for general practices to target members of a single cohort (family-, job-, or practice-focussed GPs). The other option is for general practices to diversify their recruitment strategies to target all three cohorts (family-, job- and practice-focussed GPs). A single brand (practice) can have multiple advertising strategies with each strategy involving advertising activities targeting a particular consumer segment.
Maria Gabriela Huidobro Salazar
How and why classics became models to follow? Which were the model authors in the context of the independence? A review on the circulation of books and the writing and reading practices, which were predominant since the 18th century in Spanish America, will allow discovering the process through which the classic nourished part of the imaginary of the Chilean patriots.
Dissington, Paul Anthony
Studies of second language learning have revealed a connection between first language transfer and errors in second language production. This paper describes an action research study carried out among Chilean university students studying English as part of their degree programmes. The study focuses on common lexical errors made by Chilean…
Figueroa, Guillermo; Troncoso, Miriam; López, Cristián; Rivas, Patricia; Toro, Magaly
Abstract Background Thermotolerant Campylobacter is among the more prevalent bacterial pathogens that cause foodborne diseases. This study aimed at evaluating the occurrence of thermotolerant Campylobacter contamination in chicken carcasses and processing plant stations (chilling water, scalding water, defeathering machinery, evisceration machine, and transport crates) in two of the Chilean main slaughterhouses. In addition, the isolation rates of thermotolerant Campylobacter during eviscerat...
Glas, Katharina; Cardenas-Claros, Monica S.
Chilean youth are currently demanding access to better-quality education for all: greater democracy and curricula that respect the country's indigenous cultural roots form part of their petitions. This article puts forward a twofold pedagogical proposal for English Language Teaching intended to foster intrinsic motivation and democratic…
Granillo, M. Teresa; Grogan-Kaylor, Andrew; Delva, Jorge; Castillo, Marcela
The purpose of this study was to explore the prevalence and correlates of eating disorders among a community-based sample of female Chilean adolescents. Data were collected through structured interviews with 420 female adolescents residing in Santiago, Chile. Approximately 4% of the sample reported ever being diagnosed with an eating disorder.…
International policy institutions claim that Chile's remarkable economic performance testifies to the merits of a neo-liberal development model. This book argues, however, that 'the Chilean miracle' did not result from the adoption ofneoliberalismitself, but from the
Familial Mediterranean fever (FMF) is an autosomal recessive disease which is characterized by recurrent fever and inflammation of serous membranes. A Chilean FMF patient was investigated for MEFV mutations. After DNA extraction, exons 3, 5, 10 and 30UTR region of MEFV gene were analyzed by DNA sequencing ...
Full Text Available The aim of this study is to determine the geographic origin and level of evidence (LE of articles published in Chilean dental journals during 2012. The target population for the bibliometric study was articles published in exclusively-scientific Chilean dental journals. These variables were analyzed: journal, area, language, country, region, design, scenario, and LE. A total of 120 articles were published in four journals: International Journal of Odontostomatology (IJOS=59, Revista Clínica de Periodoncia, Implantología y Rehabilitación Oral (PIRO=28, Journal of Oral Research (JOR=18, and Revista Dental de Chile (RDC=15. From the total, 80.83% were published in Spanish and 70% had a Chilean affiliation. Most publications corresponded to areas of pathology (21 others (20 and prosthodontics (20. None of the articles was Level 1 Evidence, 6.49% was 2b, 14.29% was 2c, 63.64% was 4, and 15.58% was 5. Chilean dental journals mainly publish articles of domestic origin and low LE.
Gómez, Mariel; Ford, Laurie
This article presents the results of a study on professional development in Chilean state-funded early childhood education. Based on a multiple-case study design and drawing on qualitative methods we explored teachers' perspectives on professional development at two early childhood educational centers. Two centers' directors and four early…
Crovetto, Mirta M; Uauy, Ricardo
Nowadays, Chilean population tends to replace or eat a lower amount of food with health protective properties and a higher proportion of unhealthy foodstuff. To describe and compare the intake of dairy products, sugary drinks and processed juices among Chileans. An analysis of data compiled from the Survey on Household Budget and Expenses carried out by the Chilean National Institute of Statistics (INE), using a representative sample of households. The sample was surveyed between 1987 and 2007. The analysis was performed for all households surveyed and for households belonging to the second (highest incomes) and fifth quintile (lowest incomes). The Chilean Food Guide and the international recommendations of the Institute of Medicine of the United States and the American Heart Association (in the case of sugars) were used as reference. Even though the intake of dairy products increased during the period of the survey, it was lower than the intake of sugary drinks and juices, which increased. Also, calcium recommendations were not covered. On the other hand, the intake of added sugars increased to figures over current recommendations. The intake of dairy products and calcium is below the recommended amounts established by international organisms, and added sugars intake is greater than the advisable levels recommended by international organisms.
Visser, E.J.; Langen, de P.W.
The central theme of this paper is the issue of the governance of cooperation within the Chilean wine industry. The effects of the internationalization of this industry for the importance and the quality of governance of intra-cluster cooperation involving firms and other actors are analysed. Two
Zambrano-Bigiarini, M.; Alfieri, L.; Naumann, G.; Garreaud, R. D.
Precipitation deficit is traditionally considered as the main driver of drought events, however the evolution of drought conditions is also influenced by other variables such as temperature, wind speed and evapotranspiration. In view of global warming, the effect of rising temperatures may lead to increased socio-economic drought impacts, particularly in vulnerable developing countries. In this work, we used two drought indices to analyze the impacts of precipitation and temperature on the frequency, severity and duration of Chilean droughts (25°S-56°S) during the XXI century, using multi-model climate projections consistent with the high-end RCP 8.5 scenario. An ensemble of seven global CMIP5 simulations were used to drive the Earth System Model EC-EARTH3-HR v3.1 over the 1976-2100 period, in order to increase the spatial resolution from the original grid to 0.35°. The Standardized Precipitation Index (SPI) was used to describe the impact of precipitation on drought conditions, while the Standardized Precipitation-Evapotranspiration Index (SPEI) was used to assess the effect of temperature -throughout changes in potential evapotranspiration- on drought characteristics at different time scales. Drought indices along with duration, severity and frequency of drought events were computed for a 30-year baseline period (1976-2005) and then compared to three 30-year periods representing short, medium and long-term scenarios (2011-2040, 2041-2070 and 2071-2100). Indices obtained from climate simulations during the baseline period were compared against the corresponding values derived from ground observations. Results obtained with SPI-12 reveal a progressive decrease in precipitation in Chile, which is consistent through all climate models, though each of them shows a different spatial pattern. Simulations based on SPEI-12 show that the expected increase in evaporative demand (driven by the temperature increase) for the region is likely to exacerbate the severity and
Full Text Available Electrophoretic variation of proteins encoded by 14 loci was analyzed in eight (five continental and three insular populations of the Chilean leptodactylid frog Batrachyla leptopus. The overall proportion of polymorphic loci was estimated to be 18.7% and the average number of alleles per locus, 1.2, while observed and expected heterozygosities were 1.7 and 5.1%, respectively. The estimated coefficient of genetic identity was 0.940; the corresponding figure for genetic distance was 0.063. F-statistics analysis showed a total inbreeding coefficient (Fit of 0.855 and high levels of genetic subdivision (Fst = 0.596 as well as of inbreeding within populations (Fis = 0.640. However, there was only a moderate level of genetic differentiation (Fst = 0.181 between the insular group of populations and the continental group.A variação eletroforética de proteínas codificadas por 14 loci foi analisada em oito populações (5 continentais e 3 insulares da rã leptodactilídea chilena Batrachyla leptopus. A proporção geral de loci polimórficos foi estimada como sendo de 18,7% e o número médio de alelos por loco, 1,2, enquanto que as heterozigosidades observada e esperada foram 1,7 e 5,1%, respectivamente. O coeficiente esperado de identidade genética foi 0,940; o número correspondente para a distância genética foi 0,063. A análise estatística F mostrou um coeficiente de endogamia total (Fit de 0,855 e altos níveis de subdivisão genética (Fst = 0,596, assim como de endogamia dentro das populações (Fis = 0,640. Contudo, houve apenas um nível moderado de diferenciação genética (Fst = 0,181 entre o grupo insular de populações e o grupo continental.
Adrian P Mundt
Full Text Available OBJECTIVE: High rates of mental disorders have been reported for prison populations worldwide, particularly in low- and middle-income countries (LMICs. The present study aimed to establish prevalence rates of mental disorders in Chilean prisoners. METHOD: A nationwide random sample of 1008 prisoners was assessed in 7 penal institutions throughout Chile. Twelve-month prevalence rates were established using the Composite International Diagnostic Interview (CIDI and compared to the prevalence rates previously published for the general population. RESULTS: Prevalence rates were 12.2% (95% CI, 10.2-14.1 for any substance use disorder, 8.3% (6.6-10.0 for anxiety disorders, 8.1% (6.5-9.8 for affective disorders, 5.7% (4.4-7.1 for intermittent explosive disorders, 2.2% (1.4-3.2 for ADHD of the adult, and 0.8% (0.3-1.3 for non-affective psychoses. Significantly higher prevalence rates among prisoners as compared to the general population in Chile were seen for major depression (6.1% vs. 3.7% males, Z=2.58, p<0.05 and illicit drug use (3.3% vs. 0.6% males with drug abuse, Z=2.04, p<0.05; 2.6% vs. 0.1% females with drug abuse, Z=5.36, p<0.001; 3.4% vs. 1.1% males with drug dependence, Z=3.70; p<0.001. Dysthymia (6.5% vs. 15.6%, Z=-2.39, p<0.05, simple (3.3% vs. 11.5%, Z=-3.13, p<0.001 and social phobias (3.9% vs. 9.7%, Z=2.38, p<0.05 were significantly less frequent in the female prison population than in the general population. One-year prevalence rates of alcohol abuse (2.3% vs. 3.9%; Z=-2.04; p<0.05 and dependence (2.7% vs. 8.2%; Z=-5.24; p<0.001 were less prevalent in the male prison population than in the general population. CONCLUSIONS: Service provision for prison populations in Chile should acknowledge high rates of depression and illicit drug use. Overall prevalence rates are lower than reported in other LMICs. Previous research in prison populations in LMICs might have overestimated prevalence rates of mental disorders.
Full Text Available Extreme sensitivity of soil organic carbon (SOC to climate and land use change warrants further research in different terrestrial ecosystems. The aim of this study was to investigate the link between aggregate and SOC dynamics in a chronosequence of three different land uses of a south Chilean Andisol: a second growth Nothofagus obliqua forest (SGFOR, a grassland (GRASS and a Pinus radiata plantation (PINUS. Total carbon content of the 0-10cm soil layer was higher for GRASS (6.7 kg C m-2 than for PINUS (4.3 kg C m-2, while TC content of SGFOR (5.8 kg C m-2 was not significantly different from either one. High extractable oxalate and pyrophosphate Al concentrations (varying from 20.3-24.4 g kg-1, and 3.9-11.1 g kg-1, respectively were found in all sites. In this study, SOC and aggregate dynamics were studied using size and density fractionation experiments of the SOC, δ13C and total carbon analysis of the different SOC fractions, and C mineralization experiments. The results showed that electrostatic sorption between and among amorphous Al components and clay minerals is mainly responsible for the formation of metal-humus-clay complexes and the stabilization of soil aggregates. The process of ligand exchange between SOC and Al would be of minor importance resulting in the absence of aggregate hierarchy in this soil type. Whole soil C mineralization rate constants were highest for SGFOR and PINUS, followed by GRASS (respectively 0.495, 0.266 and 0.196 g CO2-Cm-2d-1 for the top soil layer. In contrast, incubation experiments of isolated macro organic matter fractions gave opposite results, showing that the recalcitrance of the SOC decreased in another order: PINUS>SGFOR>GRASS. We deduced that electrostatic sorption processes and physical protection of SOC in soil aggregates were the main processes determining SOC stabilization. As a result, high aggregate carbon concentrations, varying from 148 till 48 g kg-1, were encountered for all land use
Full Text Available The presence and load of species of LAB at the end of the malolactic fermentation (MLF were investigated in 16 wineries from the different Chilean valleys (Limarí, Casablanca, Maipo, Rapel, and Maule Valleys during 2012 and 2013, using PCR-RFLP and qPCR. Oenococcus oeni was observed in 80% of the samples collected. Dominance of O. oeni was reflected in the bacterial load (O. oeni/total bacteria measured by qPCR, corresponding to >85% in most of the samples. A total of 178 LAB isolates were identified after sequencing molecular markers, 95 of them corresponded to O. oeni. Further genetic analyses were performed using MLST (7 genes including 10 commercial strains; the results indicated that commercial strains were grouped together, while autochthonous strains distributed among different genetic clusters. To pre-select some autochthonous O. oeni, these isolates were also characterized based on technological tests such as ethanol tolerance (12 and 15%, SO2 resistance (0 and 80 mg l−1, and pH (3.1 and 3.6 and malic acid transformation (1.5 and 4 g l−1. For comparison purposes, commercial strain VP41 was also tested. Based on their technological performance, only 3 isolates were selected for further examination (genome analysis and they were able to reduce malic acid concentration, to grow at low pH 3.1, 15% ethanol and 80 mg l−1 SO2. The genome analyses of three selected isolates were examined and compared to PSU-1 and VP41 strains to study their potential contribution to the organoleptic properties of the final product. The presence and homology of genes potentially related to aromatic profile were compared among those strains. The results indicated high conservation of malolactic enzyme (>99% and the absence of some genes related to odor such as phenolic acid decarboxylase, in autochthonous strains. Genomic analysis also revealed that these strains shared 470 genes with VP41 and PSU-1 and that autochthonous strains harbor an interesting
Henderson, Paul, Ed.; Francis, David, Ed.
This book contains 10 case studies of rural community development in England, Wales, Scotland, Ireland, and Catalonia, as seen from the perspective of community-work practitioners. Development projects encompassed such activities as promotion of tourism, establishment of community centers, vocational training for school dropouts, adult community…
Full Text Available This article reports Chilean and Finnish foreign-language (FL teachers’ perceptions of teaching and study realities in their own FL classrooms. Communicative language teaching (CLT is used as the teaching–studying–learning methodological framework of an international KIELO project (= the acronym for Finnish “kieltenopetus” meaning “language teaching”, whose online survey was used to collect data for this article. We aim at answering the following research question: What are the FL teachers’ main approaches to teaching and studying in Chilean and Finnish FL classrooms and what is the FL classroom teaching and study reality like in these two countries? The data were collected from 83 Chilean and 147 Finnish FL teachers through an online survey covering 15 key themes of CLT and including 115 Likert-scale statements and 8 open-ended questions. In the descriptive data analysis, both Chilean and Finnish FL teachers claim that they encourage their students to use the target language considerably and that they use communicative oral tasks. For both groups of participants, however, teacher-centeredness and use of textbook score relatively high. The two-cluster analysis revealed a context-dependent cluster and a context-independent cluster. Context-dependent teachers tended to favor communicative oral tasks, real-life tasks and their own language tasks, whereas context-independent teachers favored more non-communicative tasks. Context-dependent teachers proved more student-centered than context-independent teachers. For Chilean and Finnish research participants, the use of mother tongue in foreign language classrooms appears to be an issue despite the growing need of foreign language communication.
To avoid certain errors in practice, Charles Brenner offered an holistic substitute for the Freudian structural model of the mind. He used the term compromise formation ambiguously to refer to both actions and states, so as to render unnecessary what he considered artificial, judgmental attitudes embodied in images of psychic structures. He believed that a theory of conflicting structures transforms the phenomenological drama of the patient's actual life-world into an artificial drama of contending intrapsychic parties that may reflect the analyst's values. According to Brenner, the meaning of life, with its desires, fears, and regrets, is structured forever in the first articulation of the family drama, and that is all the structure a practitioner should have in mind. In principle, the ambiguity of the term compromise formation allows for observed continuities in human life, and might have inspired an ambitious theoretician to exploit that option for an account of character, but that aspect of theory moves in a direction opposite to Brenner's practical mission. For the same practical reason Brenner refused to acknowledge gradations of mental operation, such as differences in maturity, or style or level of thinking, so the theory cannot say how change can take place, analytic or otherwise. These lacunae in theory were unblinkingly (if implicitly) accepted in pursuit of Brenner's goal, which was not to polish up theory but to cleanse the analyst's mind of concepts that subtly interfere with the essential nondirectiveness of treatment. His theoretical minimalism and exclusive concern with practical consequences can be recognized as a peculiarly North American attitude to psychoanalysis.
Bellows, Jennifer Whitfield; Douglass, Katherine; Atilla, Ridvan; Smith, Jeffrey; Kapur, G Bobby
Background The specialty of Emergency Medicine has enjoyed recognition for nearly 20 years in Turkey. However, the majority of underserved and rural Turkish emergency departments are staffed by general practitioners who lack formal training in the specialty and have few opportunities to increase emergency medicine-specific knowledge and skills. Methods To address this ?practitioner gap,? the authors developed a four-phase comprehensive emergency medicine education and training program for gen...
Stockton, Rex; Morran, Keith
We offer comments regarding two articles in this issue, one titled "Bridging the Practitioner-Scientist Gap in Group Psychotherapy Research" and a complementary article providing the results of a survey, entitled "A Survey of Canadian Group Psychotherapist Association Members' Perceptions of Psychotherapy Research." We also make several recommendations for collaborative research between practitioners and scientists, such as the inclusion of clinicians on the research team, practice research networks, and improved approaches to communicating clinically relevant research findings. Also discussed are reflections and recommendations from the authors' experience as scientist-practitioners.
... State Guides Rural Data Visualizations Rural Data Explorer Chart Gallery Maps Case Studies & Conversations Rural Health Models & ... services provided by state Medicaid programs might include dental care, physical therapy, home and community-based services, ...
Cabieses, Baltica; Pickett, Kate; Tunstall, Helena
This study explored a range of sociodemographic factors associated with disability among international immigrants in Chile, and compared them to the Chilean-born. Secondary data analysis of the Chilean population-based survey CASEN-2006 was conducted (268,873 participants). Main health outcomes: any disability and six different types of disability: visual, hearing, learning, physical, psychiatric and speaking (binary outcomes). Sociodemographic variables: Demographic factors (age, sex, marita...
Erwin, Paul Campbell; Brownson, Ross C
The requisite capacities and capabilities of the public health practitioner of the future are being driven by multiple forces of change, including public health agency accreditation, climate change, health in all policies, social media and informatics, demographic transitions, globalized travel, and the repercussions of the Affordable Care Act. We describe five critical capacities and capabilities that public health practitioners can build on to successfully prepare for and respond to these forces of change: systems thinking and systems methods, communication capacities, an entrepreneurial orientation, transformational ethics, and policy analysis and response. Equipping the public health practitioner with the requisite capabilities and capacities will require new content and methods for those in public health academia, as well as a recommitment to lifelong learning on the part of the practitioner, within an increasingly uncertain and polarized political environment.
The committee of Teacher Education Policy (COTEP) considers the professional development of practitioners as one way to improve the quality of professional practice. An analysis of the literature on professional development in education ...
Heck, Daniel J.; Tarr, James E.; Hollebrands, Karen F.; Walker, Erica N.; Berry, Robert Q., III; Baltzley, Patricia C.; Rasmussen, Chris L.; King, Karen D.
The NCTM Research Committee developed this article to address a distinctly important activity that links research and practice: writing research-based articles for practitioner journals. Six guiding principles are described. (Contains 6 figures.)
the various security forces, policy reviews and the introduction of a human ...... Military legal practitioners must become experts in the land, air, maritime and cyber- ... private military companies, non-governmental organisations, transnational.
Practitioners do not read journals, and they do not even consider academic knowledge very ... disseminated to the discipline through research journals or academically oriented conferences. (AMA Task ..... European Journal of Marketing ...
Jones, J A; Humphreys, J S; Adena, M A
Private practitioners play a vital role in meeting the health needs of rural communities. However, the prospect of operating a private practice business in rural Australia seems to be increasingly unattractive, because many communities are forced to recruit salaried or overseas-trained doctors. This study focuses on rural practices as businesses whose viability influences their attractiveness for the recruitment and retention of practitioners. The specific objectives are to ascertain which factors contribute to or threaten practice viability in rural areas, and whether they vary according to the degree of rurality or geographical remoteness. This study is based on data collected from a national study into the viability of rural general practice undertaken jointly by the Rural Doctors Association of Australia and Monash University School of Rural Health Bendigo. The Rural Remote and Metropolitan Area (RRMA) classification was used as the indicator of rurality. The study surveyed all general practitioners practising in rural or remote regions of Australia (RRMAs 3 to 7). Only practitioners with some financial interest in the practice were selected for this analysis. Free-text responses to the two questions 'What are the key factors contributing to the viability of your practice?' and 'What factors would put the viability of your practice at risk?' were analysed using qualitative content analysis. Factors were derived iteratively through higher-level aggregation of responses. Chi-square tests were used to make comparisons across the RRMA categories. The national survey achieved a response rate of 35% of the entire population of GPs practising in RRMA 3 to 7 regions. Of these, 1050 respondents were relevant to this analysis. Seven major factors were identified by practitioners as the main contributors to practice viability. 'Practice characteristics' was nominated by 59% of respondents, followed by 'Income' (31%), 'Personal circumstances', 'Workforce' and 'Community
José M Bastías
Full Text Available The effect of four cooking methods was evaluated for proximate composition, fatty acid, calcium, iron, and zinc content in salmon and Chilean jack mackerel. The moisture content of steamed salmon decreased (64.94% compared to the control (68.05%; a significant decrease was observed in Chilean jack mackerel in all the treatments when compared to the control (75.37%. Protein content in both salmon and Chilean jack mackerel significantly increased under the different treatments while the most significant decrease in lipids was found in oven cooking and canning for salmon and microwaving for Chilean jack mackerel. Ash concentration in both salmon and Chilean jack mackerel did not reveal any significant differences. Iron and calcium content only had significant changes in steaming while zinc did not undergo any significant changes in the different treatments. Finally, no drastic changes were observed in the fatty acid profile in both salmon and Chilean jack mackerel.
Balladares, Pamela; Acuña, Sergio; Quevedo, Roberto; Muñoz, Ociel
The effect of four cooking methods was evaluated for proximate composition, fatty acid, calcium, iron, and zinc content in salmon and Chilean jack mackerel. The moisture content of steamed salmon decreased (64.94%) compared to the control (68.05%); a significant decrease was observed in Chilean jack mackerel in all the treatments when compared to the control (75.37%). Protein content in both salmon and Chilean jack mackerel significantly increased under the different treatments while the most significant decrease in lipids was found in oven cooking and canning for salmon and microwaving for Chilean jack mackerel. Ash concentration in both salmon and Chilean jack mackerel did not reveal any significant differences. Iron and calcium content only had significant changes in steaming while zinc did not undergo any significant changes in the different treatments. Finally, no drastic changes were observed in the fatty acid profile in both salmon and Chilean jack mackerel. PMID:28686742
This article illuminates why Nicolás Palacios's 1904 monograph, Raza chilena: Libro escrito por un Chileno i para los Chilenos [Chilean Race: A Book Written by a Chilean for Chileans], is central to the creation of a myth of Chilean racial homogeneity at the turn of the twentieth century. Placing Palacios in the context of Latin American eugenic discourse, it demonstrates how he selected a specific racial origin story in order to accommodate his belief in racial hierarchy while also depicting race mixing in a positive light. Specifically, the article highlights how the myth of Chilean racial homogeneity elided the difference between the term "mestizo," which was applied to people of mixed racial heritage, and "white." I contend that Palacios sought to differentiate Chileans from other Latin Americans by emphasizing their racial distinctiveness. The article therefore highlights that Latin American eugenics was concerned with the creation of national narratives that historicized particular racial mixtures in order to reify and affirm national differences. As such, it connects to literature regarding the history of eugenics, race, nation, and the creation of whiteness.
Farmer, Jane; Kilpatrick, Sue
Social entrepreneurs formally or informally generate community associations and networking that produces social outcomes. Social entrepreneurship is a relatively new and poorly understood concept. Policy promotes generating community activity, particularly in rural areas, for health and social benefits and 'community resilience'. Rural health professionals might be well placed to generate community activity due to their status and networks. This exploratory study, conducted in rural Tasmania and the Highlands and Islands of Scotland considered whether rural health professionals act as social entrepreneurs. We investigated activities generated and processes of production. Thirty-eight interviews were conducted with general practitioners, community nurses, primary healthcare managers and allied health professionals living and working rurally. Interviewees were self-selecting responders to an invitation for rural health professionals who were 'formally or informally generating community associations or networking that produced social outcomes'. We found that rural health professionals initiated many community activities with social outcomes, most related to health. Their identification of opportunities related to knowledge of health needs and examples of initiatives seen elsewhere. Health professionals described ready access to useful people and financial resources. In building activities, health professionals could simultaneously utilise skills and knowledge from professional, community member and personal dimensions. Outcomes included social and health benefits, personal 'buzz' and community capacity. Health professionals' actions could be described as social entrepreneurship: identifying opportunities, utilising resources and making 'deals'. They also align with community development. Health professionals use contextual knowledge to envisage and grow activities, indicating that, as social entrepreneurs, they do not explicitly choose a social mission, rather they
Claudio D. Miranda
Full Text Available The Chilean salmon industry has undergone a rapid development making the country the world’s second largest producer of farmed salmon, but this growth has been accompanied by an intensive use of antibiotics. This overuse has become so significant that Chilean salmon aquaculture currently has one of the highest rates of antibiotic consumption per ton of harvested fish in the world. This review has focused on discussing use of antibiotics and current status of scientific knowledge regarding to incidence of antimicrobial resistance and associated genes in the Chilean salmonid farms. Over recent years there has been a consistent increase in the amount of antimicrobials used by Chilean salmonid farms, from 143.2 tons in 2010 to 382.5 tons in 2016. During 2016, Chilean companies utilized approximately 0.53 kg of antibiotics per ton of harvested salmon, 363.4 tons (95% were used in marine farms, and 19.1 tons (5% in freshwater farms dedicated to smolt production. Florfenicol and oxytetracycline were by far the most frequently used antibiotics during 2016 (82.5 and 16.8%, respectively, mainly being used to treat Piscirickettsia salmonis, currently considered the main bacterial threat to this industry. However, the increasing development of this industry in Chile, as well as the intensive use of antimicrobials, has not been accompanied by the necessary scientific research needed to understand the impact of the intensive use of antibiotics in this industry. Over the last two decades several studies assessing antimicrobial resistance and the resistome in the freshwater and marine environment impacted by salmon farming have been conducted, but information on the ecological and environmental consequences of antibiotic use in fish farming is still scarce. In addition, studies reporting the antimicrobial susceptibility of bacterial pathogens, mainly P. salmonis, have been developed, but a high number of these studies were aimed at setting their
Cvetkovski, Biljana; Armour, Carol; Bosnic-Anticevich, Sinthia
To investigate the perceptions and attitudes towards asthma management of general practitioners, pharmacists and people with asthma in a rural area. Qualitative semistructured interviews. Small rural centre in New South Wales. General practitioners, pharmacists and people with asthma in a rural area. General practitioners perceived that the patient provided a barrier to the implementation of optimal asthma services. They were aware that other health care professionals had a role in asthma management but were not aware of the details, particularly in relation to that of the pharmacist and would like to improve communication methods. Pharmacists also perceived the patient to be a barrier to the delivery of optimal asthma management services and would like to improve communication with the general practitioner. The impact of the rural environment for the health care professionals included workforce shortages, availability of support services and access to continuing education. People with asthma were satisfied with their asthma management and the service provided by the health care professionals and described the involvement of family members and ambulance officers in their overall asthma management. The rural environment was an issue with regards to distance to the hospital during an emergency. General practitioners and pharmacists confirmed their existing roles in asthma management while expressing a desire to improve communication between the two professions to help overcome barriers and optimise the asthma service delivered to the patient. The patient described minimal barriers to optimising asthma management, which might suggest that they might not have great expectations of asthma care.
Full Text Available Essential elements of the process of rural renovation programme are: stimulating activity of local communities, cooperation for development, while preserving social identity, cultural heritage and natural environment. Implementing a rural revival programme in Poland: Sectoral Operational Programme “The Restructuring and Modernisation of the Food Sector and the Development of Rural Areas in 2004-2006” (action 2.3 “Rural renovation and protection and preservation of cultural heritage” evokes criticism. A wide discussion is carried amongst researchers, politicians, social activists, and local government practitioners. The main question remains: “is rural renovation process in Poland conducted in accordance with the rules in European countries or it is only a new formula of rural modernisation with the use of European funds?” The authors are joining the discussion and in the second part of the article they are presenting the assumption of sociological research. The aim of the analysis is to grasp the essence of revitalization of rural areas located in Łódzkie voivodeship, and analyse the question of specificity of rural Revival Programmes. What is the scope and manner of use of local capital? If so, are the results obtained from implementing a rural revival programme in 2004-2006 within the scope of sustainable development? What activities are predominant in the process of project implementation? Is it rural modernisation, revitalization of the rural areas, barrier removal and change in Infrastructure, or creation of social capital and subjectivity of the local community? Has the process of rural renovation in Łódzkie voivodeship got the so called “social face” and if so, to what extent? The major assumption is that rural renovation programme in Łódzkie voivodeship relates more to revitalization material aspects than “spirituality”.
Full Text Available We analyze the effect of two types of corporate diversification (business diversification and ownership diversification on the market value of the Chilean firms. For a sample of 83 nonfinancial firms listed on the Santiago Stock Market from 2005 to 2013, we find a discount for both business and ownership diversification, which is consistent with that reported for other economic or institutional settings. Second, we find that the business diversification discount is related to the ownership structure and is due to the excess of the largest shareholders’ control rights. Third, we find that the ownership diversification discount becomes a premium when the ownership diversification enables the control of the affiliated firms. This effect can be explained by the improvement of internal capital markets that allows overcoming the limitations of Chilean external capital markets.
Núñez, Paulina F; Torres, Adrián C; Armas, Rodolfo M
In Chile, 80 diseases were included in a health care system called Health Care Guarantees (GES) and clinical guidelines were elaborated for their management. To assess the scientific background of guidelines and if they were based on research financed by the Chilean National Commission for Science and Technology. The references of the 82 guidelines developed for 80 diseases were reviewed, registering their number, authors, country of origin and funding source. The guidelines had a total of 6,604 references. Of these, only 185 were Chilean (2.8%) and five (0.08%) originated from research financed by the National Commission for Science and Technology. The contribution of research funded by national agencies to the formulation of clinical guidelines is minimal.
Maritza Fernanda Ortega
Full Text Available The present paper reports the implementation of syllabus innovations in EFL teacher education in Chile after diagnosing a lack of language achievement standards common to all EFL teacher training programs offered in public and private universities alike. The aim of this study is to collect linguistic data in natural and artificial social contexts – EFL trainees’ intermediate status between their native language (Spanish and the target language (English – in order to create the first Chilean corpus of spoken English as a foreign language, in the interest of analyzing the errors that are most likely to be made and fossilized by native speakers of Chilean Spanish. Once the results of this exercise are available, EFL trainers, professors, and SLA researchers will be able to design a newly sequenced syllabus based on the Content-based Approach and tailored to students’ needs so as to enhance oral performance in L2 English.
Guerra Vio, Cristóbal; Castro Arancibia, Lorena; Vargas Castro, Judith
The School Social Climate Questionnaire (CECSCE) was adapted and applied. Subsequently, its psychometric proprieties were analyzed. The 1075 Chilean students who participated were assessed with the CECSCE and the School Violence Scale. The results showed that the CECSCE has a bifactorial structure, although there was also the possibility of a unifactorial structure. The CECSCE achieved satisfactory reliability and homogeneity indexes. The CECSCES scores were inversely related to the school violence rate. Lastly, differences by gender and educational level were analyzed. Given that there are differences in school climate perceptions in favor of girls, Chilean standards are presented in percentiles by gender. It can therefore be concluded that the CECSCE is sufficiently valid and reliable to be applied in Chile.
Full Text Available Alexithymia can be defined as inability to identify and describe emotions in the self. Has shown to be related to several psychological and pathological processes that can result in unsatisfactory interpersonal relationships and decreased social adjustment. Advances in research of alexithymia require the development and validation of assessment instruments, and its application to different population. With this aim, we studied the psychometric properties of the Twenty-Item Toronto Alexithymia Scale (TAS-20 in Chilean population using various modeling procedures (e.g., CFA, ESEM in different structures (i.e., Correlated, Unidimensional, Hierarchical or Wording factors. Among the 10 models tested, the four-dimensional structure offered the best fit but with item-loading problems in the last factor (Pragmatic Thinking. We suggest that the studied version of the scale needs improvement (theoretical and empirical to ensure optimal indices of validation for Chilean population.
Marín, Juan C; Saucedo, Cristian E; Corti, Paulo; González, Benito A
Guanaco (Lama guanicoe) is a protected and widely distributed ungulate in South America. A poacher, after killing guanacos in Valle Chacabuco, Chilean Patagonia, transported and stored the meat. Samples were retrieved by local police but the suspect argued that the meat was from a horse. Mitochondrial cytochrome b gene (774 pb), 15 loci microsatellites, and SRY gene were used to identify the species, number of animals and their population origin, and the sex of the animals, respectively. Analysis revealed that the samples came from a female (absence of SRY gene) Patagonian guanaco (assignment probability between 0.0075 and 0.0282), and clearly distinguishing it from sympatric ungulates (E-value = 0). Based on the evidence obtained in the field in addition to forensic data, the suspect was convicted of poaching and illegally carrying fire arms. This is the first report of molecular tools being used in forensic investigations of Chilean wildlife indicating its promising future application in guanaco management and conservation.
Hidalgo-Rasmussen, Carlos; Molina, Temístocles; Molina, Ramiro; Sepúlveda, Rodrigo; Martínez, Vania; Montaño, Rosa; González, Electra; George, Myriam
Bullying has a negative impact on the perception of adolescents of their quality of life. To analyze the association between being bullied and health related quality of life in Chilean adolescents. The bullying module of the KIDSCREEN 52 survey and the KIDSCREEN 10 survey to assess health related quality of life were applied to 7737 students aged 10 to 18 years. Social and demographic data, information about disability and type of school were also gathered. Fifteen percent of surveyed students were bullied. A lower quality of life perception increased by a factor of 2.6 among bullied students. It also increased by a factor of 4.4 among students with a low self-esteem, by a factor of 3.1 among those who perceived their health status as regular or bad and by a factor of 1.4 among women. Bullying is associated with a lower quality of life perception among Chilean students.
Miller, Amber Dawn
A measurement of the angular spectrum of the Cosmic Microwave Background (CMB) between l = 50 and l = 400 is described. Data were obtained using HEMT radiometers at 30 and 40 GHz with angular resolutions of ≈1 deg and ≈0.7 deg respectively and with SIS based receivers at 144 GHz with angular resolution of ≈0.2 deg. Observations were made from Cerro Toco in the Chilean altiplano at an altitude of 17,000 feet in the Northern Chilean Andes. We find that the angular spectrum rises from l = 50 to a peak at l ≈ 200 and falls off at higher angular scales. A peak in the angular spectrum with amplitude, deltaTl ≈ 85muK is thus located for the first time with a single instrument at l ≈ 200. In addition, we find that the detected anisotropy has the spectrum of the CMB. Cosmological implications of this result are discussed.
Langerhuus, Alice Thoft; Niggemann, Jutta; Lomstein, Bente Aagaard
ORGANIC MATTER DEGRADATION IN CHILEAN SEDIMENTS – FOLLOWING NATURE’S OWN DEGRADATION EXPERIMENT Degradation of sedimentary organic matter was studied at two stations from the shelf of the Chilean upwelling region. Sediment cores were taken at 1200 m and 800 m water depth and were 4.5 m and 7.5 m...... in length, respectively. The objective of this study was to assess the degradability of the organic matter from the sediment surface to the deep sediments. This was done by analysing amino acids (both L- and D-isomers) and amino sugars in the sediment cores, covering a timescale of 15.000 years. Diagenetic...... indicators (percentage of carbon and nitrogen present as amino acid carbon and nitrogen, the ratio between a protein precursor and its non-protein degradation product and the percentage of D-amino acids) revealed ongoing degradation in these sediments, indicating that microorganisms were still active in 15...
Molinos-Senante, María; Donoso, Guillermo; Sala-Garrido, Ramon; Villegas, Andrés
Benchmarking the efficiency of water companies is essential to set water tariffs and to promote their sustainability. In doing so, most of the previous studies have applied conventional data envelopment analysis (DEA) models. However, it is a deterministic method that does not allow to identify environmental factors influencing efficiency scores. To overcome this limitation, this paper evaluates the efficiency of a sample of Chilean water and sewerage companies applying a double-bootstrap DEA model. Results evidenced that the ranking of water and sewerage companies changes notably whether efficiency scores are computed applying conventional or double-bootstrap DEA models. Moreover, it was found that the percentage of non-revenue water and customer density are factors influencing the efficiency of Chilean water and sewerage companies. This paper illustrates the importance of using a robust and reliable method to increase the relevance of benchmarking tools.
Full Text Available The paper deals with bilateral relations between Argentina and Chile in recent decades, highlighting the potential of their new border relations. It assumes that the wide range of governmental actors, subnational and local entities linking each other have given this a unique dynamic border and are considered spaces of cooperation. The article is descriptive-reflective and is organized around a series of questions about the continued search for Argentine-Chilean border integration since the nineties and the construction of top-down and bottom-up institutional agreements. Within the variety of links, some remarkable examples are selected for the article like the "Integration Committees", the settlement of the Central West of South America Integration Zone (Zicosur and the Argentine-Chilean cooperation in Antarctica. It stresses the integrationist Maipú Treaty (2009 and institutions that charge different instances of bilateral dialogue.
Campbell, Alison M; Brown, James; Simon, David R; Young, Sari; Kinsman, Leigh
To understand the factors influencing the decisions of rural general practitioners and GP registrars to practise obstetrics, and to understand the impact on these decisions of an innovative obstetric training and support program in the Gippsland region of Victoria. Qualitative approach using semistructured interviews conducted in July and August 2013 and inductive content analysis. Participants were identified from training records over the previous 5 years for the Gippsland GP obstetric training and support program. Two questions were posed during interviews: What challenges face rural GPs in practising obstetrics? What impact has the Gippsland GP obstetric program had on GP obstetric career decisions? Of 60 people invited to participate, 22 agreed. Interviews ranged in duration from 40 to 90 minutes. The major themes that emerged on the challenges facing rural GPs in practising obstetrics were isolation, work-life balance and safety. The major themes that emerged on the impact of the Gippsland GP obstetric program were professional support, structured training and effective leadership. Rural GP obstetricians are challenged by isolation, the impact of their job on work-life balance, and safety. The support, training and leadership offered by the Gippsland expanded obstetric training program helped doctors to deal with these challenges. The Gippsland model of training offers a template for GP obstetric procedural training programs for other rural settings.
Miranda, Marcelo; Bustamante, M Leonor; Mena, Francisco; Lees, Andrew
Manganism has captured the imagination of neurologists for more than a century because of its similarities to Parkinson disease and its indirect but seminal role in the "l-dopa miracle." We present unpublished footage of the original case series reported in Neurology® in 1967 by Mena and Cotzias depicting the typical neurologic signs of manganism in 4 Chilean miners and their response to high doses of l-dopa. © 2015 American Academy of Neurology.
This paper analyzes econometrically the determinants of ownership concentration in the Chilean stock market, with particular attention to the e¤ects of the Tender Offer Law (OPA law). Even though the central pourpose of OPAs Law is achieved, the tender offer mechanism increases the ownership concentration. The main reason for this effect has to do with the "residual OPA" obligation considered by the law.
Full Text Available It is generally believed that students from low-income families are less successful at school, as indicated by theories of social reproduction. This article focuses on Chilean students that, in spite of their social background, have performed well in the Programme for International Student Assessment (PISA 2009. Using logistic regression analysis we identify factors associated with academic achievement in reading. Results show that student variables have a greater explanatory value than family and school variables.
Felipe López Pérez
the Western notion of State, Nation and Citizenship in the Chilean laws on immigration issues. this review is provided in the context of modernity and late capitalism, theoretical and conceptual references that are subsumed under this regulation. The absence of grand narratives and identities defined reread forces in the legal code, the migratory insertion of human capital in the country. From this point off the charges and cultural processes that entails.
The paper explores the effects of the social security system over retirement and labor supply decision of individuals aged 55 to 65 in Chile. We use the 1998 CASEN survey elaborated by the Chilean government. Due to regulations established by the current social security law, two social security systems coexist on 1998: the .Pay-as-you-go. and the individual account system. This property of the dataset, allows us to disentangle the effects of those two systems over retirement and labor supply....
Ortega Pérez, Maritza Fernanda
The present paper reports the implementation of syllabus innovations in EFL teacher education in Chile after diagnosing a lack of language achievement standards common to all EFL teacher training programs offered in public and private universities alike. The aim of this study is to collect linguistic data in natural and artificial social contexts - EFL trainees' intermediate status between their native language (Spanish) and the target language (English) - in order to create the first Chilean...
Maritza Fernanda Ortega
The present paper reports the implementation of syllabus innovations in EFL teacher education in Chile after diagnosing a lack of language achievement standards common to all EFL teacher training programs offered in public and private universities alike. The aim of this study is to collect linguistic data in natural and artificial social contexts – EFL trainees’ intermediate status between their native language (Spanish) and the target language (English) – in order to create the first Chilean...
Shigeru Watanabe; Katharina Braun; Maria Mensch; Henning Scheich
Most nonhuman animals do not show selective preference for types of music, but researchers have typically employed only Western classical music in such studies. Thus, there has been bias in music choice. Degus (Octodon degus), originally from the mountain areas of Chile, have highly developed vocal communication. Here, we examined music preference of degus using not only Western classical music (music composed by Bach and Stravinsky), but also South American folk music (Chilean and Peruvian)....
University in Washington, DC, and at George Mason University in Fairfax, VA. He is the author and editor of several award-winning books , notably Ships and...expertise, material, and labor. British shipbuilders, with full order- books , did not view this as harmful competition, but rather saw increased...Chilean navy has been almost entirely composed of foreign-built and secondhand vessels. Indeed, during Chile’s war for independence from Spain in
Martine Pellerin; Fraño Ivo Paukner Nogués
This article discusses the outcomes of a case study that engaged Chilean in-service teachers in systematic action research (AR) as a means of improving their pedagogical practice and effecting changes in their educational context. The study involved six in-service teachers from a region of Chile and two university researchers. The findings show that knowledge of systematic AR provided the teachers with the necessary means to engage in a critical reflection and inquiry process regarding their ...
Gonzalo Aguilar Cavallo
Full Text Available In this brief analysis we will review the difficulties faced in establishing responsibility for human rights violation to companies as well as the Inter-American Court of Human Rights’ case law in the field. We will analyze the international standards established in corporate responsibility. Finally, we will examine if the Chilean national courts incorporate the standards set by the Inter-American Court of Human Rights, especially concerning private companies.
Bascur B., Gabriel; Tay U., Juan
Recently performed studies on the type of seed protein present from several origins and their morphological traits have shown that the common bean (Phaseolus vulgaris L.) is native to America, being a species without a specific center of origin and with two areas of domestication: Central America and South America. In this last center, three strains were determined, one of them is called "the Chilean strain", which as noted is a sub-center of genetic diversity for this species. With the purpo...
Petitpierre, Eduard; Elgueta, Mario
Abstract Four species of Chilean leaf beetles in the subfamily Chrysomelinae have been cytogenetically analyzed, Blaptea elguetai Petitpierre, 2011, Henicotherus porteri Br?thes, 1929 and Jolivetia obscura (Philippi, 1864) show 2n = 28 chromosomes and a 13 + Xyp male meioformula, and Pataya nitida (Philippi, 1864) has the highest number of 2n = 38 chromosomes. The karyotype of Henicotherus porteri is made of mostly small meta/submetacentric chromosomes, and that of Jolivetia obscura displays ...
María Angélica Franken Osorio
The following paper explores the recent Chilean narrative which recalls childhood during the dictatorship, the so-called “literatura de los hijos” (literature of sons and daughters), establishing an aesthetic and discoursive link between shared memory and the development imaginaries of those who were children during the dictatorial past and that are writers in the post-dictatorial present. The affective continuity of a conflict, between a present state of memory and a past of childhood learn...
Villegas, Natalia; Santisteban, Daniel; Cianelli, Rosina; Ferrer, Lilian; Ambrosia, Todd; Peragallo, Nilda; Lara, Loreto
Purpose The incidence of sexually transmitted infections (STIs) and human immunodeficiency virus (HIV) is high among young Chilean women, and there are no STI or HIV prevention interventions available to them that incorporate technology. The purpose of this study was to investigate the preliminary efficacy of an Internet-based STI and HIV prevention intervention (I-STIPI) for Chilean young women on measures of STI- and HIV-related information, motivation, behavioral skills, and preventive behaviors. Design This is a pretest-posttest study. Forty young Chilean women between 18 and 24 years of age participated in an investigation of the I-STIPI’s preliminary efficacy on STI and HIV prevention-related outcomes between baseline and a postintervention assessment. The intervention consisted of four online modules. Data collection was conducted in Santiago, Chile. Paired-samples t test analysis was used to determine whether there were significant differences in each of the outcome variables. Findings After receiving I-STIPI, women reported a significant increase in levels of STI- and HIV-related knowledge, attitudes toward the use of condoms and perceived self-efficacy, and a reduction of risky sexual behaviors with uncommitted partners. Conclusions The I-STIPI showed promise as an Internet-based intervention that can reduce barriers to accessing preventive interventions and increase STI and HIV preventive behaviors in young Chilean women. Clinical Relevance The study provided important information about the ability of an Internet-based intervention to reduce young women’s risk factors and to provide positive preliminary efficacy on STI- and HIV-related outcomes. Internet-based interventions can eliminate many barriers to receiving prevention interventions and may prove to be cost effective. PMID:25410132
Diego MONTALTI et al
Monomorphic birds cannot be sexed visually and discriminant functions on the basis of external morphological variations are frequently used. Our objective was to evaluate the reliability of sex classification functions created from structural measurements of Chilean flamingos Phoenicopterus chilensis museum skins for the gender assignment of live birds. Five measurements were used to develop four discriminant functions: culmen, bill height and width, tarsus length and middle toe claw. The fun...
Bankoski, Andrea J; Jacobsen, Kathryn H; Pawloski, Lisa R; Moore, Jean Burley; Gaffney, Kathleen F; Jaimovich, Sonia; Campos, Cecilia
The objective of this study was to examine agreement between parental preferences and self-reported food intake in Chilean children. In 2008,152 pairs, of 8 to 13 year old schoolchildren and their parents in Santiago were surveyed. Children self-reported their frequency of consumption of foods from various food groups. Parents reported how often they preferred their children to consume foods from these same food groups. Children reported consuming more sweets, high-calorie snacks, and fruit, ...
Irene Depetris Chauvin
Full Text Available The article examines the high school students’ protest against the neoliberal conception of education during the first period of President Michelle Bachelet government. Specifically, I analyze how the new generation of young Chileans critically uses and produces pop culture — photoblogs, posters, and stencils — in order to express disagreement with the mercantilist approach to education and the very concept of neoliberal freedom and equality.
US Department of Agriculture, 2016
Many people have definitions for the term rural, but seldom are these rural definitions in agreement. For some, rural is a subjective state of mind. For others, rural is an objective quantitative measure. In this brief report the United States Department of Agriculture presents the following information along with helpful links for the reader: (1)…
Karla A. Bascuñán
Full Text Available Chilean diets are characterized by a low supply of n-3 polyunsaturated fatty acids (n-3 PUFA, which are critical nutrients during pregnancy and lactation, because of their role in brain and visual development. DHA is the most relevant n-3 PUFA in this period. We evaluated the dietary n-3 PUFA intake and erythrocyte phospholipids n-3 PUFA in Chilean pregnant women. Eighty healthy pregnant women (20–36 years old in the 3rd–6th month of pregnancy were included in the study. Dietary assessment was done applying a food frequency questionnaire, and data were analyzed through the Food Processor SQL® software. Fatty acids of erythrocyte phospholipids were assessed by gas-liquid chromatography. Diet composition was high in saturated fat, low in mono- and PUFA, high in n-6 PUFA (linoleic acid and low in n-3 PUFA (alpha-linolenic acid and DHA, with imbalance in the n-6/n-3 PUFA ratio. Similar results were observed for fatty acids from erythrocyte phospholipids. The sample of Chilean pregnant women showed high consumption of saturated fat and low consumption of n-3 PUFA, which is reflected in the low DHA content of erythrocyte phospholipids. Imbalance between n-6/n-3 PUFA could negatively affect fetal development. New strategies are necessary to improve n-3 PUFA intake throughout pregnancy and breast feeding periods. Furthermore, it is necessary to develop dietary interventions to improve the quality of consumed foods with particular emphasis on n-3 PUFA.
Full Text Available ABSTRACT OBJECTIVE To validate a Spanish version of the Test of Gross Motor Development (TGMD-2 for the Chilean population. METHODS Descriptive, transversal, non-experimental validity and reliability study. Four translators, three experts and 92 Chilean children, from five to 10 years, students from a primary school in Santiago, Chile, have participated. The Committee of Experts has carried out translation, back-translation and revision processes to determine the translinguistic equivalence and content validity of the test, using the content validity index in 2013. In addition, a pilot implementation was achieved to determine test reliability in Spanish, by using the intraclass correlation coefficient and Bland-Altman method. We evaluated whether the results presented significant differences by replacing the bat with a racket, using T-test. RESULTS We obtained a content validity index higher than 0.80 for language clarity and relevance of the TGMD-2 for children. There were significant differences in the object control subtest when comparing the results with bat and racket. The intraclass correlation coefficient for reliability inter-rater, intra-rater and test-retest reliability was greater than 0.80 in all cases. CONCLUSIONS The TGMD-2 has appropriate content validity to be applied in the Chilean population. The reliability of this test is within the appropriate parameters and its use could be recommended in this population after the establishment of normative data, setting a further precedent for the validation in other Latin American countries.
Salas, Sofía P; Besio, Mauricio; Bórquez Estefó, Gladys; Salinas, Rodrigo A; Valenzuela, Carlos Y; Micolich, Constanza; Novoa Sotta, Fernando; Bernier Villarroel, Lioniel; Montt M, Julio; Misseroni Raddatz, Adelio
The Chilean bill that regulates abortion for three cases (Bulletin Nº 9895-11) includes the possibility that health professionals may manifest their conscientious objection (CO) to perform this procedure. Due to the broad impact that the issue of C O had, the Ethics Department of the Chilean College of Physicians considered important to review this concept and its ethical and legal basis, especially in the field of sexual and reproductive health. In the present document, we define the practical limit s of CO, both for the proper fulfillment of the medical profession obligations, and for the due respect and non-discrimination that the professional objector deserves. We analyze the denial of some health institutions to perform abortions if it is legalize d, and we end with recommendations adjusted to the Chilean reality. Specifically, we recognize the right to conscientious objection that all physicians who directly participate in a professional act have. But we a lso recognize that physicians have ineludib le obligations towards their patients, including the obligation to inform about the existence of this service, how to access to it and -as set out in our code of ethics- to ensure that another colleague will continue attending the patient.
Full Text Available Most nonhuman animals do not show selective preference for types of music, but researchers have typically employed only Western classical music in such studies. Thus, there has been bias in music choice. Degus (Octodon degus, originally from the mountain areas of Chile, have highly developed vocal communication. Here, we examined music preference of degus using not only Western classical music (music composed by Bach and Stravinsky, but also South American folk music (Chilean and Peruvian. The degus preferred the South American music to the Western classical music but did not show selective preference between the two Western classical music choices. Furthermore, the degus preferred the Chilean to the Peruvian music to some extent. In the second experiment, we examined preference for music vs. silence. Degus overall showed a preference for Chilean music over silence, but preferred silence over Western music. The present results indicate that the previous negative data for musical preference in nonhuman animals may be due to biased music selection (Krause, 2012. Our results suggest the possibility that the soundscape of an environment influences folk music created by native peoples living there and the auditory preference of other resident animals there.
Lyu, Fei; Huang, Rui-Ji; Liu, Lin; Zhou, Xuxia; Ding, Yu-Ting
The main objective of this study was to assess the influence of slaughter methods on the quality of Chilean jack mackerel (Trachurus murphyi) during refrigerated storage on board. Fishes were slaughtered by asphyxia in air (AA), asphyxia in ice water (AI) or stunning fish heads (SH), and the rigor mortis, pH, total volatile basic nitrogen (TVB-N), trimethylamine (TMA), 2-thiobarbituric acid reactive substances (TBARS) and sensory properties for the fishes were analyzed. On day 0, Chilean jack mackerel samples of AI group displayed higher pH values than those of AA and SH groups. TVB-N, TMA and TBARS values of all samples increased with the storage time, and these values of AI had a lower increase than AA and SH. Moreover, samples of AI had a better sensory score than AA and SH during storage. It can be concluded that slaughter method of asphyxia in ice water for Chilean jack mackerel exhibit the better efficiency on maintaining the fish quality during refrigerated storage on board.
Bascuñán, Karla A; Valenzuela, Rodrigo; Chamorro, Rodrigo; Valencia, Alejandra; Barrera, Cynthia; Puigrredon, Claudia; Sandoval, Jorge; Valenzuela, Alfonso
Chilean diets are characterized by a low supply of n-3 polyunsaturated fatty acids (n-3 PUFA), which are critical nutrients during pregnancy and lactation, because of their role in brain and visual development. DHA is the most relevant n-3 PUFA in this period. We evaluated the dietary n-3 PUFA intake and erythrocyte phospholipids n-3 PUFA in Chilean pregnant women. Eighty healthy pregnant women (20-36 years old) in the 3rd-6th month of pregnancy were included in the study. Dietary assessment was done applying a food frequency questionnaire, and data were analyzed through the Food Processor SQL® software. Fatty acids of erythrocyte phospholipids were assessed by gas-liquid chromatography. Diet composition was high in saturated fat, low in mono- and PUFA, high in n-6 PUFA (linoleic acid) and low in n-3 PUFA (alpha-linolenic acid and DHA), with imbalance in the n-6/n-3 PUFA ratio. Similar results were observed for fatty acids from erythrocyte phospholipids. The sample of Chilean pregnant women showed high consumption of saturated fat and low consumption of n-3 PUFA, which is reflected in the low DHA content of erythrocyte phospholipids. Imbalance between n-6/n-3 PUFA could negatively affect fetal development. New strategies are necessary to improve n-3 PUFA intake throughout pregnancy and breast feeding periods. Furthermore, it is necessary to develop dietary interventions to improve the quality of consumed foods with particular emphasis on n-3 PUFA.
Martinez, Suzanna M; Blanco, Estela; Delva, Jorge; Burrows, Raquel; Reyes, Marcela; Lozoff, Betsy; Gahagan, Sheila
Purpose Studies report an association between neighborhood risk and both obesity and cardiometabolic risk factors (CMR) among adolescents. Here we describe the effect of perceived neighborhood risk on adiposity and CMR among Chilean adolescents. Methods Participants were 523 low- to middle-income Chilean adolescents. We assessed neighborhood risk in early adolescence, adiposity in childhood and in early and later adolescence, and blood pressure and fasting glucose in later adolescence. Neighborhood risk profiles were estimated using latent profile analysis (LPA) and based on reported perceptions of crime and drug sales/use. Using linear and logistic regression, we examined the effect of neighborhood risk on adiposity and CMR. Results Mean age in early and later adolescence was 14 and 17 years, respectively. Participants were 52% male, with a mean BMI z-score of 0.67, and 8% met criteria for the metabolic syndrome. LPA identified two neighborhood profiles: 61% low risk and 39% high risk. In later adolescence, being in the high risk profile predicted a higher BMI z-score, waist-to-height ratio, and fat mass index (p-values Chilean neighborhoods with high crime and drugs, targeted public health interventions and policies for youth could be beneficial. PMID:24411818
Full Text Available Introduction: Knowledge about the size and proportion of upper anterior teeth allows dental rehabilitation taking into consideration the local parameters of a population. The aim of this research is to determine the width, length and the relationship between width and length of central incisor, lateral incisor and canine teeth in both sexes in young Chilean population. Methodology: A cross-sectional study was performed. Study subjects included 187 dentistry students from two Chilean cities (mean age 21.35±2.7 years, 52.9% men. The teeth width and height were measured and the width/height ratio was calculated. Differences in measurements according to sex was analyzed (p<0.05; STATA v.10.0. Results: The width and height of the teeth were statistically and proportionally larger in men (p<0.05. The width/height ratio of lateral and canine incisors was significantly higher in women (p<0.05. Conclusion: In a sample of young Chileans, upper anterior teeth were longer and wider in men. However, the width/height ratio of teeth was found to be significantly higher in women.
J. Enrique Hinostroza
Full Text Available This paper presents the results of the analysis of the data from a national survey of the Chilean educational ICT infrastructure and its use in schools implemented by the Centre for Technology and Education of the Chilean Ministry of Education in 2004. Results show that the context of ICT use in Chilean schools can be characterized as relatively good, insofar as there are no first-order barriers for implementing ICT pedagogy. In this context, students’ ICT use can be categorized based on four factors: communication, productivity, recreation, and communication with teachers. On the other hand, teachers’ ICT use can be categorized using three factors: communication, teaching, and technical. Based on these factors and considering the availability and use of ICT in schools, the question remains how to make this time most effective for improving students’ learning. Additionally, results show that students, on their own, spend a considerable amount of time developing activities described as communication. The question that arises from this finding is how to take advantage of these activities in order to meet teaching and learning aims. Regarding teachers, results open possibilities for redesigning professional development courses by taking advantage of what they already do with ICT.
Aravena, Pedro Christian; Schulz, Karen; Parra, Annemarie; Perez-Rojas, Francisco; Rosas, Cristian; Cartes-Velásquez, Ricardo
Electronic textbooks have become available in recent decades as replacements or alternatives for print versions. The aim of this descriptive cross-sectional study was to evaluate the use of electronic versus print textbooks by Chilean dental students. The target population was students from 14 Chilean dental schools. The questionnaire was adapted and translated to Spanish from a previous survey used in a similar study. It consisted of the following variables: preferred type, type used, frequency of use, source, electronic devices used to read, and disposal after use. The use of textbooks was analyzed and compared by gender and course (p≤0.05). The final sample consisted of 3,256 students (21.38±2.5 years of age, 50.8% women). Most of the participants reported using both types of texts, with most (63.9%) preferring print over electronic texts, including significantly more women (pelectronic books on a daily basis (47.3%) or at least twice a week (30.7%). The main source of electronic textbooks was the Internet (43.8%). A personal computer was the most widely used device for reading electronic texts (95.0%), followed by a cell phone (46.4%) and a tablet (24.5%). Overall, these Chilean dental students preferred print over electronic textbooks, despite having available electronic devices.
Robert N. Gwynne
Full Text Available This paper argues that the favourable export trajectories for Chilean wine to global markets in general and the UK market in particular are partly due to the nature of the insertion of wine producing firms into global value chains. Much of the data in this paper comes from a two-year British Academy research project (2005-07 which examined the impacts of globalization on export-oriented wine firms in Chile’s Colchagua Valley and the record of collaboration between these firms and key purchasing companies within the UK market. The paper examines the political economy of value chains in agro-industry, retail concentration in core economy markets and the relevance of convention theory to value chains in the wine sector. The paper then analyses how value chains give context to the nature of upgrading within the Chilean wine sector by focusing on: the strategic example of the lead firm; firm upgrading as a response to the demands of and knowledge flows from retailers; and firm upgrading through the flying winemaker model. The paper will conclude by assessing the relevance of the Chilean experience for other countries wishing to rapidly expand their wine exports, such as those in S. E. Europe.
Full Text Available Introduction: The low levels of maximum oxygen consumption (VO2max evaluated in Chilean schoolchildren suggest the startup of trainings that improve the aerobic capacity. Objective: To analyze the effect of a High-intensity Interval Training method on maximum oxygen consumption in Chilean schoolchildren. Materials and methods: Thirty-two high school students from the eighth grade, who were divided into two groups, were part of the study (experimental group = 16 students and control group = 16 students. The main analyzed variable was the maximum oxygen consumption through the Course Navette Test. A High-intensity Interval training method was applied based on the maximum aerobic speed obtained through the Test. A mixed ANOVA was used for statistical analysis. Results: The experimental group showed a significant increase in the Maximum Oxygen Consumption between the pretest and posttest when compared with the control group (p < 0.0001. Conclusion: The results of the study showed a positive effect of the High-intensity Interval Training on the maximum consumption of oxygen. At the end of the study, it is concluded that High-intensity Interval Training is a good stimulation methodology for Chilean schoolchildren.
Inger Sally Padilla
Full Text Available To study the frequency of metabolic syndrome, its components and its relationship with physical activity in Chilean immigrants living in Río Gallegos, Santa Cruz, Argentina.314 Chilean immigrants (165 women and 149 men were interviewed in Rio Gallegos in 2010, with healthy status in medical records (2000. Anthropometry, blood pressure control, blood test to measure glucose, triglycerides and HDL cholesterol were determined. Metabolic syndrome was established by criteria of the NCEPATPIII.The metabolic syndrome had an overall prevalence of 28.9% (95%CI: 23.9 to 34. Metabolic syndrome prevalence was larger in women (32.1% than in men (25.5%. The prevalence of its components were: abdominal obesity 56%, low levels of HDL cholesterol 48.3%, high levels of triglycerides 68.1%, hypertension 46.1% and high levels of glucose 72.5%. Inadequate physical activity was 66.2% (95%CI: 60.1 to 71.5. Immigrants had more likelihood of metabolic syndrome living in Río Gallegos for 15 years or more(β: 5.74,95%CI:2,81-11,73, p=0.000 and with inadequate physical activity (β: 3.36, 95%CI: 1.57to7.21,p=0.002. The prevalence of metabolic syndrome in Chilean immigrants living in Río Gallegos is higher than that reported in Argentina and Chile
Full Text Available Objective: This study was carried out to investigate knowledge levels of general practitioners and their thoughts about circumcision in Middle Anatolia.Materials and Methods: This descriptive and cross-sectional study was carried out with 247 general practitioners working in Sivas. A questionnaire was prepared by the authors using previous reports. Questionnaires were sent to subjects by post. One hundred and seventy eight general practitioners (57 women, 121 men responded and were included in the study. For statistical analysis, Chi-square test was used and p<0.05 value was accepted as significant.Results: 42.1% of subjects believed that circumcision should be performed between 2 and 6 years of age. 2.2% of subjects declared that circumcision could be done at home and 7.3% believed that the location of the operation is not important. 9.6% of subjects believed that the person who performs the circumcision does not have to be a doctor. 21.3% of subjects believed that circumcision could be performed without anesthesia during the newborn period because of undeveloped pain sensation. Conclusion: This study demonstrated that general practitioners, who are the most easily accessible health staff for information about health, do not have updated information about the way to perform circumcision and its necessity. Therefore, it is concluded that education programs about circumcision for general practitioners must be continued and updated.
Lochmiller, Chad R.; Lester, Jessica Nina
In this conceptual article, we draw upon recent literature to describe the theoretical, epistemological, and methodological anchors that can inform a working conception of practitioner-scholarship. We position practitioner-scholarship at the intersection of an individual's work as a practitioner and researcher, wherein a practitioner focuses on…
Kane, R; Dean, M; Solomon, M
Reviews the state of the art of rural health research and evaluation in the U.S. with particular emphasis on the questions of access, health personnel, and financing. The current state of knowledge both in the published and unpublished literature in each area is summarized and a series of unresolved issues is proposed. A strategy for further research to include the various types of rural health care programs is described. Major findings suggest that, although rural populations do have somewhat less access to care than do urban populations, our ability to quantify precisely the extent and importance of this discrepancy is underdeveloped. Despite a substantial investment in a variety of rural health care programs there is inadequate information as to their effectiveness. Programs designed to increase the supply of health personnel to rural areas have met with mixed success. Sites staffed by National Health Service Corps personnel show consistently lower productivity than do sites under other sponsorship. Nonphysician personnel (physician assistants and nurse practitioners) offer a promising source of primary care for rural areas: recent legislation that reimburses such care should increase their utilization. A persistent problem is the expectation (often a mandate) incorporated into many rural health care demonstration efforts that the programs become financially self-sufficient in a finite period of time. Self-sufficiency is a function of utilization, productivity, and the ability to recover charges for services. In many instances stringent enforcement of the self-sufficiency requirement may mean those who need services most will be least likely to receive them.
Fisher, Carole; Adams, Jon; Frawley, Jane; Hickman, Louise; Sibbritt, David
To explore the prevalence with which Australian Western herbalists treat menstrual problems and their related treatment, experiences, perceptions, and interreferral practices with other health practitioners. Members of the Practitioner Research and Collaboration Initiative practice-based research network identifying as Western Herbalists (WHs) completed a specifically developed, online questionnaire. Western Herbalists regularly treat menstrual problems, perceiving high, though differential, levels of effectiveness. For menstrual problems, WHs predominantly prescribe individualised formulas including core herbs, such as Vitex agnus-castus, and problem-specific herbs. Estimated clients' weekly cost (median = $25.00) and treatment duration (median = 4-6 months) covering this Western herbal medicine treatment appears relatively low. Urban-based women are more likely than those rurally based to have used conventional treatment for their menstrual problems before consulting WHs (p = .001). Only 19% of WHs indicated direct contact by conventional medical practitioners regarding treatment of clients' menstrual problems despite 42% indicating clients' conventional practitioners recommended consultation with WH. Western herbal medicine may be a substantially prevalent, cost-effective treatment option amongst women with menstrual problems. A detailed examination of the behaviour of women with menstrual problems who seek and use Western herbal medicine warrants attention to ensure this healthcare option is safe, effective, and appropriately co-ordinated within women's wider healthcare use. Copyright © 2017 John Wiley & Sons, Ltd.
Scotts, H; Carter, M
This article discusses some of the issues raised in the Interim Report of the current Review of Registration of Health Practitioners being conducted for the Victorian Health Department. The Report attempts to develop the framework in which the registration Boards will operate as part of a cohesive registration system. It proposed a mechanism and criteria for the registration of new groups as well as principles which can be applied to the ongoing review of each existing Board. The Review takes the perspective that registration of health practitioners carries with it both advantages and disadvantages for the general community. Under the proposed new system the controls exercised over health care providers by Registration Boards would be evaluated on the basis of to what extent the benefits to the public outweighed the potential costs. It is in this context that the Report addresses issues such as consumer complaints handling, registration of individual practitioners and controls over professional advertising and other business practices.
Full Text Available This paper examines the perceptions of practitioners of the new directions taken by NZICA with respect to its academic and professional programme requirements to obtain CA Institute membership. The “future viability of any professional body is dependent on continuously attracting new members, ideally the best and the brightest new tertiary graduates”, and this is “undoubtedly the case for New Zealand’s professional accounting body, the New Zealand Institute of Chartered Accountants (NZICA” (Malthus & Fowler 2009, p. 26. In this study, the concurrent triangulation approach to mixed methods described by Creswell (2009 was used to collect data. This approach enabled the results of the two quantitative and qualitative databases to be integrated and compared. It was found that accounting practitioners felt the changes made by NZICA may devalue the brand, while the reduction in liberal papers would result in a narrower degree. Overall, accounting practitioners agreed that three to four years of tertiary accounting education was adequate, a broader four-year course would result in a better-rounded graduates. The reduction in the length of the tertiary programme caused concern that future graduates would be less mature. Accounting practitioners also felt that the changes would harm the credibility of NZICA internationally. However, some accounting practitioners did welcome the fact that the NZICA membership requirements will be more aligned with Institute of Chartered Accountants Australia. Accounting practitioners felt that the new technical modules would offer more flexibility. They believed that the four technical modules should repeat the material taught at university, as long as a balance was maintained between technical and practical skills. They also believed that the changes would result in an increased onus on the employer. Additionally, accounting practitioners agreed that on-the-job training should not replace a tertiary
Carpenter, Lindsey M; Hubbard, Grace B
The purpose of this article is to inform and educate psychiatric nurse practitioners about the pervasiveness of the rapidly increasing problem of cyberbullying. As more children and adolescents obtain access to the Internet, mobile devices, and social networking sites, the exposure to bullying in the virtual format increases. Cyberbullying is a growing public health concern and can affect mental health and school performance. Cyberbullying often results in a range of psychiatric symptoms and has been linked to suicide attempts and completions. The psychiatric nurse practitioner is uniquely prepared to provide a range of interventions for patients, families, and communities who have experienced cyberbullying. © 2014 Wiley Periodicals, Inc.
Groenier Klaas H
Full Text Available Abstract Background Patients with severe mental illness (SMI experience distress and disabilities in several aspects of life, and they have a higher risk of somatic co-morbidity. Both patients and their family members need the support of an easily accessible primary care system. The willingness of general practitioners and the impeding factors for them to participate in providing care for patients with severe mental illness in the acute and the chronic or residual phase were explored. Methods A questionnaire survey of a sample of Dutch general practitioners spread over the Netherlands was carried out. This comprised 20 questions on the GP's 'Opinion and Task Perspective', 19 questions on 'Treatment and Experiences', and 27 questions on 'Characteristics of the General Practitioner and the Practice Organisation'. Results 186 general practitioners distributed over urban areas (49%, urbanised rural areas (38% and rural areas (15% of the Netherlands participated. The findings were as follows: GPs currently considered themselves as the first contact in the acute psychotic phase. In the chronic or residual phase GPs saw their core task as to diagnose and treat somatic co-morbidity. A majority would be willing to monitor the general health of these patients as well. It appeared that GP trainers and GPs with a smaller practice setting made follow-up appointments and were willing to monitor the self-care of patients with SMI more often than GPs with larger practices. GPs also saw their role as giving support and information to the patient's family. However, they felt a need for recognition of their competencies when working with mental health care specialists. Conclusion GPs were willing to participate in providing care for patients with SMI. They considered themselves responsible for psychotic emergency cases, for monitoring physical health in the chronic phase, and for supporting the relatives of psychotic patients.
Oud, Marian J T; Schuling, Jan; Slooff, Cees J; Groenier, Klaas H; Dekker, Janny H; Meyboom-de Jong, Betty
Patients with severe mental illness (SMI) experience distress and disabilities in several aspects of life, and they have a higher risk of somatic co-morbidity. Both patients and their family members need the support of an easily accessible primary care system. The willingness of general practitioners and the impeding factors for them to participate in providing care for patients with severe mental illness in the acute and the chronic or residual phase were explored. A questionnaire survey of a sample of Dutch general practitioners spread over the Netherlands was carried out. This comprised 20 questions on the GP's 'Opinion and Task Perspective', 19 questions on 'Treatment and Experiences', and 27 questions on 'Characteristics of the General Practitioner and the Practice Organisation'. 186 general practitioners distributed over urban areas (49%), urbanised rural areas (38%) and rural areas (15%) of the Netherlands participated. The findings were as follows: GPs currently considered themselves as the first contact in the acute psychotic phase. In the chronic or residual phase GPs saw their core task as to diagnose and treat somatic co-morbidity. A majority would be willing to monitor the general health of these patients as well. It appeared that GP trainers and GPs with a smaller practice setting made follow-up appointments and were willing to monitor the self-care of patients with SMI more often than GPs with larger practices.GPs also saw their role as giving support and information to the patient's family.However, they felt a need for recognition of their competencies when working with mental health care specialists. GPs were willing to participate in providing care for patients with SMI. They considered themselves responsible for psychotic emergency cases, for monitoring physical health in the chronic phase, and for supporting the relatives of psychotic patients.
Garcia, V; Rona, R J; Chinn, S
To determine the level of agreement between the American (Chilean) and British food composition tables in estimating intakes of macronutrients and antioxidants. Information based on a food-frequency questionnaire with emphasis on antioxidants was collected from 95 Chileans aged 24-28 years. Nutritional composition was analysed using the British table of food composition and the American table of food composition modified by Chilean food items. Mean differences and limits of agreement (LOAs) of estimated intake were assessed. Mean differences between the two tables of food composition ranged from 5.3% to 8.9% higher estimates when using the American (Chilean) table for macronutrients. For micronutrients, a bias towards a higher mean was observed for vitamin E, iron and magnesium when the American (Chilean) table was used, but the opposite was observed for vitamin A and selenium. The intra-class correlation coefficient (ICC) ranged from 0.86 (95% confidence interval (CI) 0.81-0.91) to 0.998 (95% CI 0.995-1.00), indicating high to excellent agreement. LOAs for macronutrients and vitamins A and C were satisfactory, as they were sufficiently narrow. There was more uncertainty for other micronutrients. The American table gives relative overestimates of macronutrients in comparison to the British table, but the relative biases for micronutrients are inconsistent. Estimates of agreement between the two food composition tables provide reassurance that results are interchangeable for the majority of nutrients.
According to a 1981 survey, advertising practitioners place more importance on the accreditation of college advertising programs when it comes to evaluating a graduate of such a program than do the educators who must earn the accreditation. Only directors of advertising education programs in the communication-journalism area that are currently…
Shams, Marie-Lise Antoun
This study was designed to identify core journals for the nurse practitioner specialty and to determine the extent of their indexing in bibliographic databases. As part of a larger project for mapping the literature of nursing, this study followed a common methodology based on citation analysis. Four journals designated by nurse practitioners as sources for their practice information were selected. All cited references were analyzed to determine format types and publication years. Bradford's Law of Scattering was applied to identify core journals. Nine bibliographic databases were searched to estimate the index coverage of the core titles. The findings indicate that nurse practitioners rely primarily on journals (72.0%) followed by books (20.4%) for their professional knowledge. The majority of the identified core journals belong to non-nursing disciplines. This is reflected in the indexing coverage results: PubMed/MEDLINE more comprehensively indexes the core titles than CINAHL does. Nurse practitioners, as primary care providers, consult medical as well as nursing sources for their information. The implications of the citation analysis findings are significant for collection development librarians and indexing services.
Keith, Novella Zett
How can we support campus-based practitioners of civic and community engagement in moving from normalized engagement toward practices that engage others democratically and respectfully across borders created by social race, class, gender, status, and other markers of difference? The article presents a framework derived from practice theory, a…
This reflective essay presents a personal account of experiences and models that have shaped the development of the author as a leader in tertiary education. It is presented from the perspective of a practitioner whose career has led her through academic and administrative roles in Australian and UK institutions into her current position as…
This podcast discusses bullying as a public health problem, and provides information and resources for public health practitioners. Created: 1/19/2012 by National Center for Injury Prevention and Control (NCIPC). Date Released: 1/19/2012.
Information risk management (IRM) is about identifying, assessing and prioritising risks to keep information secure and available. This accessible book provides practical guidance to the principles and development of a strategic approach to an IRM programme. The only textbook for the BCS Practitioner Certificate in Information Risk Management.
Rose, Patricia B.; Miller, Debra A.
Finds little or no difference in the interest of small market advertising and public relations practitioners in professional courses. Lends support to the idea of a common curriculum (an Integrated Marketing Communications program) to fulfill the educational needs of both groups. (SR)
Background: General Practitioners have limited means to compete. As quality is hard to observe by patients, GPs have incentives to signal quality by using instruments patients perceive as quality. Objectives: We investigate whether GPs exhibit different prescribing behavior (volume and value of
Background General Practitioners (GP) have limited means to compete. As quality is hard to observe by patients, GPs have incentives to signal quality by using instruments patients perceive as quality. Objectives I investigate whether GPs prescribe more units when confronted with more competition. As
Feuerstein, Julie L.; Olswang, Lesley B.; Greenslade, Kathryn J.; Dowden, Patricia; Pinder, Gay Lloyd; Madden, Jodi
Purpose: This research explores practitioners' perspectives during the implementation of triadic gaze intervention (TGI), an evidence-based protocol for assessing and planning treatment targeting gaze as an early signal of intentional communication for young children with physical disabilities. Method: Using qualitative methods, 7 practitioners…
Age and puberty have been found to contribute to malaria resistance. It is expected that knowledge of natural resistance to malaria may aid in developing Vaccines against this deadly disease. Keywords: malaria resistance, puberty, malaria economy, malaria vaccine. Nigerian Medical Practitioner Vol. 49(5) 2006: 133-142 ...
Spaan, Nadia Roos; Dekker, Anne R. J.; van der Velden, Alike W.; de Groot, Esther
Purpose: The purpose of this study is to understand the influence of formal learning from a web-based training and informal (workplace) learning afterwards on the behaviour of general practitioners (GPs) with respect to prescription of antibiotics. Design/methodology/approach: To obtain insight in various learning processes, semi-structured…
Spaan, Nadia Roos; Dekker, Anne R. J.; van der Velden, Alike W.; de Groot, Esther
Purpose The purpose of this study is to understand the influence of formal learning from a web-based training and informal (workplace) learning afterwards on the behaviour of general practitioners (GPs) with respect to prescription of antibiotics. Design/methodology/approach To obtain insight in
Sweeney, Thomas J.
Written with the practitioner in mind, this overview of the theory and practice of Alfred Adler's Individual Psychology explains the dimensions and uses of natural and logical consequences--the twin bases of Adlerian/Individual Psychology. The text takes a practical approach to the topic, and covers a variety of settings (school, home, community,…
... not share the password or other knowledge factor, or biometric information, with any other person. The... the same responsibilities when issuing prescriptions for controlled substances via electronic means as when issuing a paper or oral prescription. Nothing in this subpart relieves a practitioner of his...
Ngan, Peter W; Kao, Elizabeth C; Wei, Stephen H
The principle of early treatment through well-planned extraction of primary teeth followed by removal of permanent teeth has stood the test of time. The objective of this article is to develop some simple guidelines for general dental practitioners to perform 'guidance of eruption' in malocclusion with severe crowding.
Aydin, Berna; Kartal, Mehtap; Midik, Ozlem; Buyukakkus, Alper
We aimed to determine the violence against general practitioners (GPs) through their suggestions on its cause and prevention. This is a descriptive cross-sectional study based on self-administered questionnaire answered by a convenience study population consisting of 522 GPs between November and December 2006. Of the participating GPs, 82.8%…
Judith, D. de; Groenewegen, Peter P.; Westert, Gert P.
The aim of this study was to find out whether or not general practitioners (GPs) within the same partnership show more similarities in attitudes and behaviour than GPs in different partnerships, and what the causes of these similarities might be. Knowledge of the causes of patterns of similarities
Farmer, Jane; Hinds, Kerstin; Richards, Helen; Godden, David
To compare satisfaction with, and expectations of, health care of people in rural and urban areas of Scotland. Questions were included in the 2002 Scottish Social Attitudes Survey (SSAS). The Scottish House-hold Survey urban-rural classification was used to categorize locations. A random sample of 2707 people was contacted to participate in a face-to-face interview and a self-completion questionnaire survey. SPSS (v.10) was used to analyse the data. Relationships between location category and responses were explored using logistic regression analysis. In all, 1665 (61.5%) interviews were conducted and 1507 (56.0%) respondents returned self-completion questionnaires. Satisfaction with local doctors and hospital services was higher in rural locations. While around 40% of those living in remote areas thought A&E services too distant, this did not rank as a top priority for health service improvement. This could be due to expectations that general practitioners would assist in out-of-hours emergencies. Most Scots thought services should be good in rural areas even if this was costly, and that older people should not be discouraged from moving to rural areas because of their likely health care needs. In all, 79% of respondents thought that care should be as good in rural as urban areas. Responses to many questions were independently significantly affected by rural/urban location. Most Scots want rural health care to continue to be good, but the new UK National Health Service (NHS) general practitioner contract and service redesign will impact on provision. Current high satisfaction, likely to be due to access and expectations about local help, could be affected. This study provides baseline data on attitudes and expectations before potential service redesign, which should be monitored at intervals in future.
Bart M. Demaerschalk
Full Text Available Objective. The objective was to define and evaluate a role for the Vascular Neurology-Nurse Practitioner (VN-NP in the delivery of telemedicine consultations in partnership with a vascular neurologist. Methods. Prospective stroke alert patients at participating hospitals underwent a two-way audio video telemedicine consultation with a VN-NP at a remotely located stroke center in partnership with a vascular neurologist. Demographic information, National Institutes of Health Stroke Scale (NIHSS scores, diagnoses, CT contraindications to thrombolysis, thrombolysis eligibility, and time interval data were collected. The inter-rater agreement between VN-NP and vascular neurologist assessments was calculated. Results. Ten patients were evaluated. Four were determined to have ischemic stroke, one had a transient ischemic attack, two had intracerebral hemorrhages, and three were stroke mimics. Overall, three patients received thrombolysis. The inter-rater agreement between VN-NP and vascular neurologist assessments were excellent, ranging from 0.9 to 1.0. The duration of VN-NP consultation was 53.2±9.0 minutes, which included the vascular neurologist supervisory evaluation time of 12.0±9.6 minutes. Conclusion. This study illustrated that a stroke center VN-NP, in partnership with a vascular neurologist, could deliver timely telemedicine consultations, accurate diagnoses, and correct treatments in acute stroke patients who presented to remotely located rural emergency departments within a hub and spoke network. VN-NPs may fulfill the role of a telestroke provider.
Demaerschalk, Bart M; Kiernan, Terri-Ellen J; Investigators, Starr
Objective. The objective was to define and evaluate a role for the Vascular Neurology-Nurse Practitioner (VN-NP) in the delivery of telemedicine consultations in partnership with a vascular neurologist. Methods. Prospective stroke alert patients at participating hospitals underwent a two-way audio video telemedicine consultation with a VN-NP at a remotely located stroke center in partnership with a vascular neurologist. Demographic information, National Institutes of Health Stroke Scale (NIHSS) scores, diagnoses, CT contraindications to thrombolysis, thrombolysis eligibility, and time interval data were collected. The inter-rater agreement between VN-NP and vascular neurologist assessments was calculated. Results. Ten patients were evaluated. Four were determined to have ischemic stroke, one had a transient ischemic attack, two had intracerebral hemorrhages, and three were stroke mimics. Overall, three patients received thrombolysis. The inter-rater agreement between VN-NP and vascular neurologist assessments were excellent, ranging from 0.9 to 1.0. The duration of VN-NP consultation was 53.2 +/- 9.0 minutes, which included the vascular neurologist supervisory evaluation time of 12.0 +/- 9.6 minutes. Conclusion. This study illustrated that a stroke center VN-NP, in partnership with a vascular neurologist, could deliver timely telemedicine consultations, accurate diagnoses, and correct treatments in acute stroke patients who presented to remotely located rural emergency departments within a hub and spoke network. VN-NPs may fulfill the role of a telestroke provider.
Full Text Available Purpose: In order to train more high-level general practitioners (GPs to work in primary care institutions, China launched the 5+3 model in 2015 as a way to educate GPs nationwide. In this study, we investigated the awareness of the 5+3 model, career choices after graduation, and influences on GP career choice of undergraduate medical students from Zhengzhou University. Methods: The study population consisted of 288 undergraduate medical students from Zhengzhou University. We explored the students׳ awareness of the 5+3 model, career choices after graduation, influences on general practitioner career choice and mental status by using a self-report questionnaire and the Chinese version of the 21-item Depression Anxiety Stress Scale. Results: We found 34.2% of students did not understand the new policy. Only 23.2% of students would choose to work as a GP after graduation, and those tended to be female, to have a monthly family income less than 4000 ¥, or to be from rural areas. Only 10% of undergraduate medical students expressed a preference to work at primary care institutions. The participants showed higher anxiety and stress scores than did a previously published group of Chinese college students, and those who chose to pursue higher education had more anxiety and stress than those who decided to become general practitioners. Discussion: More efforts should be made to popularize the 5+3 model and mental intervention among medical students. More efforts should be tried to increase the income/welfare benefits and strengthen the infrastructure of primary care institutions to attract more medical students. Keywords: 5+3 model, General practitioner, Health care reform, Hierarchical medical system
Full Text Available Carolyn M Rutledge,1 Karen Kott,2 Patty A Schweickert,3 Rebecca Poston,1 Christianne Fowler,1 Tina S Haney1 1College of Health Sciences, School of Nursing, 2College of Health Sciences, School of Physical Therapy, Old Dominion University, Norfolk, 3Department of Neuroradiology, University of Virginia, Charlottesville, VA, USA Abstract: Telehealth is becoming a vital process for providing access to cost-effective quality care to patients at a distance. As such, it is important for nurse practitioners, often the primary providers for rural and disadvantaged populations, to develop the knowledge, skills, and attitudes needed to utilize telehealth technologies in practice. In reviewing the literature, very little information was found on programs that addressed nurse practitioner training in telehealth. This article provides an overview of both the topics and the techniques that have been utilized for training nurse practitioners and nurse practitioner students in the delivery of care utilizing telehealth. Specifically, this article focuses on topics including 1 defining telehealth, 2 telehealth etiquette, 3 interprofessional collaboration, 4 regulations, 5 reimbursement, 6 security/Health Insurance Portability and Accountability Act (HIPAA, 7 ethical practice in telehealth, and 8 satisfaction of patients and providers. A multimodal approach based on a review of the literature is presented for providing the training: 1 didactics, 2 simulations including standardized patient encounters, 3 practice immersions, and 4 telehealth projects. Studies found that training using the multimodal approach allowed the students to develop comfort, knowledge, and skills needed to embrace the utilization of telehealth in health care. Keywords: telehealth, nurse practitioner education, telemedicine, simulation, health care
K. P. Mashige
Full Text Available This paper presents findings of a survey of optometric practices and practitioners in the KwaZulu-Natal (KZN province. Questions on demographics of practitioners, equipment, clinical practice andbusiness profile were included in the questionnaire. Also, issues that have the potential to impact on optometric practices were contained in the questionnaire and these include medical aid, advertising, continuous professional development (CPD and emigration. Of the 117 completed questionnaires, 55% were from females and 45% were from male practitioners. The respondents included 55% Indians, 27% Whites, 17% Blacks and 1% Coloureds. The majority of practices were located in urban areas (90% and rural areas (10%, and were mostly independent (67% and franchises (33%. Only a minority of the practices had major diagnostic equipment such as visual field analysers (33% and corneal topographers (7%. A significant proportion of the practitioners reported not routinely performing non-contact tonometry (45% and slit lamp examination (41% respectively. The majority (95% rated patient’s needs as a very important factor in their decision to prescribe an optical device. A significant proportion (38% of the practices had annual patient bases of above 33 000, with 35% having an average of 51-100 new patients per month. A few (5% practices reported gross monthly turnovers of above R400 000, and 27% reported turnovers of less than R60 000. Many (89% derived 41% and above of their total revenue from spectacle lens sales and 11% derived 41% and above from contact lens sales. The majority (92% of practices were contracted to over 60% of the medical aid schemes. Many (68% reported that they were not negatively affected by medical aid fraud committed by their colleagues, however, a significant proportion (32% reported the converse. More than half (54% of the practitioners reported that they used the print media
Melvin, Cathy L; Corbie-Smith, Giselle; Kumanyika, Shiriki K; Pratt, Charlotte A; Nelson, Cheryl; Walker, Evelyn R; Ammerman, Alice; Ayala, Guadalupe X; Best, Lyle G; Cherrington, Andrea L; Economos, Christina D; Green, Lawrence W; Harman, Jane; Hooker, Steven P; Murray, David M; Perri, Michael G; Ricketts, Thomas C
The National Institutes of Health convened a workshop to engage researchers and practitioners in dialogue on research issues viewed as either unique or of particular relevance to rural areas, key content areas needed to inform policy and practice in rural settings, and ways rural contexts may influence study design, implementation, assessment of outcomes, and dissemination. Our purpose was to develop a research agenda to address the disproportionate burden of cardiovascular disease (CVD) and related risk factors among populations living in rural areas. Complementary presentations used theoretical and methodological principles to describe research and practice examples from rural settings. Participants created a comprehensive CVD research agenda that identified themes and challenges, and provided 21 recommendations to guide research, practice, and programs in rural areas.
People in rural areas face some different health issues than people who live in towns and cities. Getting health care can ... long distances to get routine checkups and screenings. Rural areas often have fewer doctors and dentists, and ...
... community has a significant impact on the local economy. In rural areas, Medicare reimbursement is a critical source of that healthcare spending, particularly since the higher percentage of elderly population in rural areas mean that Medicare accounts for ...
Araya, A X; Norr, K F; Pérez, C M; Levy, J A; Park, C G; Kim, M J
Identifying both Human immunodeficiency virus (HIV)-related and co-morbid symptoms experienced by people living with HIV (PLWH) who are receiving antiretroviral therapy (ART) treatment is a major challenge for healthcare providers globally. Yet, little research to date has examined the symptoms of illness experienced by PLWH including patients living in Central and South American. To address this gap, this study was designed to identify symptoms of HIV by socio-demographic and/or clinical characteristics among Chilean patients living with the virus. A convenience sample of 209 Chilean PLWH was recruited from an outpatient clinic in Santiago, Chile. A structured interview was used to elicit socio-demographic information and HIV symptoms status. Additional clinical information was obtained through a review of the participants' medical records. Results show that patients' most commonly reported HIV-related symptoms were fear/worries (66%), anxiety (52%), gas/bloating (50%), and thirst (50%). Multivariate analysis revealed a positive association between the number of reported HIV-related symptoms and number of years living with HIV. Having completed college was negatively associated with number of symptoms. Latent class analysis indicated that PLWH in the sample who had completed college were two times more likely to experience a mild intensity of HIV-related symptoms than their lesser educated counterparts. Similarly, logistic regression revealed that college-educated PLWH were twice as likely to be classified in the subgroup reporting mild intensity of symptoms than those who lacked a college degree. Overall, the study's results reveal that many Chilean PLWH, even those with high CD4 counts and low or undetectable viral loads, are not symptom free. The findings point to the need for clinicians to tailor a plan of care for individuals living with HIV that is based on their symptomatology.
Full Text Available OBJETIVO: Explorar el financiamiento del sistema de salud chileno sobre la base de los datos más recientes disponibles. MATERIAL Y MÉTODOS: Se utiliza el marco teórico de los sistemas de salud del informe de salud del mundo del año 2000 de la Organización Mundial de la Salud (OMS para analizar el financiamiento del sistema de salud chileno, con especial énfasis en los esquemas de aseguramiento existentes. RESULTADOS: En el sistema de salud chileno hay una gran proporción de personas cubiertas por los seguros de salud existentes (alrededor de 88%; sin embargo, se presenta una tendencia importante hacia la segmentación de la población, sea por riesgo o por ingreso. Se observan esfuerzos, en especial por parte del Fondo Nacional de Salud (FONASA, orientados a realizar una compra estratégica de servicios de salud. CONCLUSIONES: Existe aún mucho espacio para mejorar el financiamiento del sistema de salud chileno, sobre todo en cuanto a pooling y compra estratégica.OBJECTIVE: To explore the Chilean health system financing based on the most recent available data. MATERIAL AND METHODS: Using the WHO World Health Report 2000 framework, this paper analyzes the Chilean health system financing, with special emphasis on insurance schemes. RESULTS: The analysis shows that a great proportion of people is covered by the existing health insurance schemes (about 88%. However, there is a tendency towards segmentation of the population in terms of risk and income. Additionally, efforts have been made, especially by FONASA (National Health Fund, to perform a strategic purchasing of healthcare. CONCLUSIONS: There still is a need for improving the Chilean health system financing in terms of pooling and strategic purchasing.
Huneeus, Andrea; Schilling, Andrea; Fernandez, Mario I
To determine the prevalence of Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis infection in sexually active Chilean adolescents and young adults. A comparative analysis was performed between genders to identify demographic, clinical, and sexual behavior characteristics to predict the occurrence of C trachomatis. Analytical observational study. Santiago, Chile. Two hundred eighty-six sexually active volunteers aged 24 years or younger (171 female and 115 male); 82.9% (237/286) of them were classified as having high socioeconomic status. Confidential survey and self-collected samples (urine for men and vaginal swabs for women). Prevalence, demographic characteristics, symptoms, and sexual behavior characteristics. The prevalence rate of C trachomatis was 8.7% (10/115) in men and 8.8% (15/171) in women (P = .58). N gonorrhoeae was detected in 1 subject, whereas no T vaginalis cases were detected. In multivariate analysis, having some college education was protective (odds ratio [OR], 0.28; 95% confidence interval [CI], 0.09-0.89), whereas having a higher number of sexual partners was a risk factor (OR, 1.19; 95% CI, 1.1-1.3) for C trachomatis infection. The latter was also predicted by postcoital bleeding (OR, 4.6; 95% CI, 1.30-16.23) in the female model. C trachomatis infection rates were similar between both genders. Protective characteristics for the occurrence of this infection were having some college education, lower number of sexual partners, and if female, the absence of postcoital bleeding. This study highlights the importance of C trachomatis screening among the Chilean affluent population younger than 25 years. However, further studies are needed in a more diverse and representative sample to recommend universal screening in Chilean adolescents and young adults. Copyright © 2018 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.
Full Text Available Dental disorders are common in horses. The objetive of the study was determined the frequency of dental problems in Chilean Rodeo Horses and described the most common dental treatments used in Chile. Oral examinations were performed on 456 Chilean rodeo horses and the disorders were observed as follows: Oral soft tissues, 259 horses (56% presented lacerations and/or ulcers. Regarding the first premolar, it was present in 32% of the horses, all maxillary positioned. In canines, 245 (54% were present and overlong tooth. Disorders found in incisors show supererupted (Tooth overlong in 147 (32%; ventral curvature in 116 (25%, nevertheless 102 (22% horses showed no abnormalities. About the diseases found in cheek teeth (premolars and molars, the more prevalent ones was enamel points in 426 (93%, rostral or caudal hooks in 354 (78%, and ramps in 231 (51%. Confidence intervals between all dental diseases found in the study showed no statistical significance when was analyzed for age or gender. When age groups were made, statistical significance appear X² Pearson (p=0,01, were mostly malocclusion type I was the more common in young, mature and geriatric horses. Other disorders such as problems at the time of eruption, development and periodontal disease are statiscally similar X² (p=0,07. About the treatments it is important to mention that in 453 (99% horses received odontoplasty and 147 (32% first premolar extraction. This study shows that Chilean rodeo horses have dental disorders similar to other horse breeds, except by small increase in soft tissue damage and incisors problems.
Quiñones, Luis; Sasso, Jaime; Tamayo, Evelyn; Catalán, Johanna; González, Juan Paplo; Escala, Mario; Varela, Nelson; León, Jorge; Cáceres, Dante Daniel; Saavedra, Iván
The aim of this study was to compare the pharmacokinetic parameters between two brands of pregabalin in healthy Chilean volunteers. A randomized, single-dose, two-period, two-sequence, crossover study design with a 2-week washout period was conducted in healthy Chilean males. Plasma samples were collected over a 12-hour period after administration of 150 mg pregabalin in each period. A validated ultra-performance liquid chromatography with positive ionization mass spectrometric detection method was used to analyze pregabalin concentration in plasma. Pharmacokinetic parameters were determined using a noncompartmental method. Bioequivalence between the test and reference products was determined when the ratio for the 90% confidence intervals (CIs) of the difference in the means of the log-transformed area under the curve (AUC)(0-t), AUC(0-∞), and maximum concentration (C(max)) of the two products were within 0.80 and 1.25. The study was carried out on 22 healthy Chilean volunteers. The mean (SD) C(max), AUC(0-t) and AUC(0-∞) of the test formulation (Pregobin™) of pregabalin were 2.10 (0.56) μg/ml, 10.35 (2.00) μgxh/ml and 13.92 (2.74) μgxh/ml, respectively. The mean (SD) C(max), AUC(0-t) and AUC(0-∞) of the reference formulation (Lyrica™) of pregabalin were 2.15 (0.52) μg/ml, 10.31 (1.85) μgxh/ml and 13.78 (2.25) μgxh/ml, respectively. The parametric 90% CIs for C(max), AUC(0-t), and AUC(0-∞) were 0.97-1.13, 1.01-1.04, and 0.98-1.02, respectively. These results suggest that both products are bioequivalent and can be used as interchangeable options in the clinical setting.
Binfa, Lorena; Pantoja, Loreto; Gonzalez, Hilda; Ransjö-Arvidson, Anna-Berit; Robertson, Eva
to determine Chilean midwives' views with regard to Chilean women's health-care needs in midlife. The aim was also to explore Chilean midwifery students' views on the clinical care provided to women in midlife. a qualitative study using focus group discussions and narratives which were analysed using thematic manifest and latent content analysis. 10 different primary health care (PHC) centres in Santiago, Chile. 22 midwives, working in PHC clinics and 13 (n = 13) midwifery students with PHC clinical experience, attending their fourth or fifth year of midwifery education at the School of Midwifery in Santiago. the midwives felt that women in midlife have special health-care service needs. They also considered themselves to be the most appropriate health staff to provide health care for women in midlife, but recognised that they lacked competence in attending psychological and social health-care needs of women in midlife such as violence, abuse and sexuality issues. The midwifery students remarked that many midwives focused their attention on fulfilling the biomedical requirements. Even if the midwives had knowledge about recent research on menopause, they had difficulties in approaching this issue and including it in their counselling. Some students also questioned the sometimes disrespectful attitude shown, especially towards Peruvian immigrants and women with psychosocial problems. the findings suggest that midwives need more education about women's health-care needs in midlife, and that more focus should be placed on the psychosocial aspects of midwifery. More reflections about the quality of the client-provider relationship in clinical practice are needed. Gender issues, the structure of power relationships, and empowerment should be incorporated and critically discussed during midwifery education and training, and also in clinics. Copyright © 2010 Elsevier Ltd. All rights reserved.
Holuby, Ronnie Scott; Pellegrin, Karen L; Barbato, Anna; Ciarleglio, Anita
The availability of rural healthcare is a growing concern in the United States as fewer healthcare providers choose to work in rural areas. Accessing quality continuing education (CE) for rural healthcare practitioners (HCPs) remains a challenge and may pose a barrier to quality care. To maximize attendance at a live, in-person, free CE program focusing on geriatric medication and issues specifically targeted to HCPs in rural areas, two methods were implemented sequentially. The first method used formal advertising implemented by a professional marketing service to promote CE events. The second method enlisted local healthcare organizations and physician groups to promote the CE event to their employees. Cost per attendee was calculated for comparison. Professional marketing services recruited 31 HCPs (March 2011) and resulted in a per-participant recruitment cost of US$428.62. Local healthcare organizations and physician groups' marketing recruited 48 HCPs (July-August 2011) and resulted in a per-participant recruitment cost of US$55.19. Providing free CE coordinated through local healthcare organizations and physician groups was the most cost-effective method of recruiting rural HCPs for CE. Formal advertising added cost without increasing the number of participants per event. Although this is the first study of the cost-effectiveness of recruitment methods targeting HCPs in rural areas, results are consistent with research on cost-effectiveness of outreach to rural lay community members.
Ronnie Scott Holuby
Full Text Available Introduction: The availability of rural healthcare is a growing concern in the United States as fewer healthcare providers choose to work in rural areas. Accessing quality continuing education (CE for rural healthcare practitioners (HCPs remains a challenge and may pose a barrier to quality care. Methods: To maximize attendance at a live, in-person, free CE program focusing on geriatric medication and issues specifically targeted to HCPs in rural areas, two methods were implemented sequentially. The first method used formal advertising implemented by a professional marketing service to promote CE events. The second method enlisted local healthcare organizations and physician groups to promote the CE event to their employees. Cost per attendee was calculated for comparison. Results: Professional marketing services recruited 31 HCPs (March 2011 and resulted in a per-participant recruitment cost of US$428.62. Local healthcare organizations and physician groups’ marketing recruited 48 HCPs (July–August 2011 and resulted in a per-participant recruitment cost of US$55.19. Discussion: Providing free CE coordinated through local healthcare organizations and physician groups was the most cost-effective method of recruiting rural HCPs for CE. Formal advertising added cost without increasing the number of participants per event. Although this is the first study of the cost-effectiveness of recruitment methods targeting HCPs in rural areas, results are consistent with research on cost-effectiveness of outreach to rural lay community members.
Full Text Available The construction industry is one of the key sectors that facilitate sustainable economic and social development in the region. Currently, community development mechanisms are adopted by many developed and developing nations, aimed at enhancing economic growth and quality of life along with social welfare of the local community. This study reviews the rural residents’ perception of public construction project delays and aims to explore economic and social challenges confronted by residents, especially in rural areas in Pakistan. A questionnaire with 26 factors identified from the literature was sent to rural educated residents. Through a questionnaire survey, the opinions of rural residents were sought and tested. Based on 366 (73% valid responses, this study examined the socio-economic influencing factors. The findings of the study revealed that problems faced while traveling, increase the price of consumer goods, high transportation costs, lack of educational opportunities, more expenditures on education, and barriers to primary healthcare access were the top most important factors. Research results confirmed that the delays in construction projects negatively affect the socio-economic conditions of the rural community, which directly influence the rural dwells’ sustainable life. The research findings suggest that the practitioners in public sector organization make sure to execute the project on time and within the quality. Otherwise, it has negative socio-economic implications for the rural community.
Ubeda, C; Callejón, R M; Troncoso, A M; Peña-Neira, A; Morales, M L
The volatile compositions of Charmat and traditional Chilean sparkling wines were studied for the first time. For this purpose, EG-Silicone and PDMS polymeric phases were compared and, afterwards, the most adequate was selected. The best extraction method turned out to be a sequential extraction in the headspace and by immersion using two PDMS twisters. A total of 130 compounds were determined. In traditional Chilean sparkling wines, ethyl esters were significantly higher, while acetic esters and ketones were predominant in the Charmat wines. PCA and LDA confirmed the differences in the volatile profiles between the production methods (traditional vs. Charmat). Copyright © 2016 Elsevier Ltd. All rights reserved.
Eades, Daniel C.; Hughes, David W.
Researchers and practitioners are aware of the importance of the skills of the local workforce in attracting and developing businesses in a regional economy. There has been, however, relatively little applied research concerning the identification of labor skill gaps in rural areas. We seek to address this issue through a case study of the Upper…
Introduction International evidence indicates consistently lower rates of access and use of healthcare by international immigrants. Factors associated with this phenomenon vary significantly depending on the context. Some research into the health of immigrants has been conducted in Latin America, mostly from a qualitative perspective. This population-based study is the first quantitative study to explore healthcare provision entitlement and use of healthcare services by immigrants in Chile and compare them to the Chilean-born. Methods Data come from the nationally representative CASEN (Socioeconomic characterization of the population in Chile) surveys, conducted in 2006 and 2009. Self-reported immigrants were compared to the Chilean-born, by demographic characteristics (age, sex, urban/rural, household composition, ethnicity), socioeconomic status (SES: education, household income, contractual status), healthcare provision entitlement (public, private, other, none), and use of primary services. Weighted descriptive, stratified and adjusted regression models were used to analyse factors associated with access to and use of healthcare. Results There was an increase in self-reported immigrant status and in household income inequality among immigrants between 2006 and 2009. Over time there was a decrease in the rate of immigrants reporting no healthcare provision and an increase in reporting of private healthcare provision entitlement. Compared to the Chilean-born, immigrants reported higher rates of use of antenatal and gynaecological care, lower use of well-baby care, and no difference in the use of Pap smears or the number of attentions received in the last three months. Immigrants in the bottom income quintile were four times more likely to report no healthcare provision than their equivalent Chilean-born group (with different health needs, i.e. vertical inequity). Disabled immigrants were more likely to have no healthcare provision compared to the disabled Chilean
Full Text Available Abstract Introduction International evidence indicates consistently lower rates of access and use of healthcare by international immigrants. Factors associated with this phenomenon vary significantly depending on the context. Some research into the health of immigrants has been conducted in Latin America, mostly from a qualitative perspective. This population-based study is the first quantitative study to explore healthcare provision entitlement and use of healthcare services by immigrants in Chile and compare them to the Chilean-born. Methods Data come from the nationally representative CASEN (Socioeconomic characterization of the population in Chile surveys, conducted in 2006 and 2009. Self-reported immigrants were compared to the Chilean-born, by demographic characteristics (age, sex, urban/rural, household composition, ethnicity, socioeconomic status (SES: education, household income, contractual status, healthcare provision entitlement (public, private, other, none, and use of primary services. Weighted descriptive, stratified and adjusted regression models were used to analyse factors associated with access to and use of healthcare. Results There was an increase in self-reported immigrant status and in household income inequality among immigrants between 2006 and 2009. Over time there was a decrease in the rate of immigrants reporting no healthcare provision and an increase in reporting of private healthcare provision entitlement. Compared to the Chilean-born, immigrants reported higher rates of use of antenatal and gynaecological care, lower use of well-baby care, and no difference in the use of Pap smears or the number of attentions received in the last three months. Immigrants in the bottom income quintile were four times more likely to report no healthcare provision than their equivalent Chilean-born group (with different health needs, i.e. vertical inequity. Disabled immigrants were more likely to have no healthcare provision compared
Playford, Denese; Ngo, Hanh; Gupta, Surabhi; Puddey, Ian B
To compare the influence of rural background, rural intent at medical school entry, and Rural Clinical School (RCS) participation on the likelihood of later participation in rural practice. Analysis of linked data from the Medical School Outcomes Database Commencing Medical Students Questionnaire (CMSQ), routinely collected demographic information, and the Australian Health Practitioner Regulation Agency database on practice location. University of Western Australia medical students who completed the CMSQ during 2006-2010 and were practising medicine in 2016. Medical practice in rural areas (ASGC-RAs 2-5) during postgraduate years 2-5. Full data were available for 508 eligible medical graduates. Rural background (OR, 3.91; 95% CI, 2.12-7.21; P practice in the multivariate analysis of all potential factors. When interactions between intention, origin, and RCS experience were included, RCS participation significantly increased the likelihood of graduates with an initial rural intention practising in a rural location (OR, 3.57; 95% CI, 1.25-10.2; P = 0.017). The effect of RCS participation was not significant if there was no pre-existing intention to practise rurally (OR, 1.38; 95% CI, 0.61-3.16; P = 0.44). For students who entered medical school with the intention to later work in a rural location, RCS experience was the deciding factor for realising this intention. Background, intent and RCS participation should all be considered if medical schools are to increase the proportion of graduates working rurally.
Robert N. Gwynne
This paper argues that the favourable export trajectories for Chilean wine to global markets in general and the UK market in particular are partly due to the nature of the insertion of wine producing firms into global value chains. Much of the data in this paper comes from a two-year British Academy research project (2005-07) which examined the impacts of globalization on export-oriented wine firms in Chile’s Colchagua Valley and the record of collaboration between these firms and key purchas...
Aguirre, I M; Fuentes, R; Celedón, M O
Llamas and alpacas are domesticated South American camelids (SACs) important to ancestral population in the Altiplano region, and to different communities worldwide where they have been introduced. These ungulates have shown to be susceptible to several livestock viral pathogens such as members of the Pestivirus genus, in particular Bovine Viral Diarrhea (BVDV), but there is little data available on Pestivirus infections in SACs. In this study we aimed to detect and identify Pestivirus genotypes and subgroups infecting SACs in both wild and confined environments. Samples were collected from 136 llamas and 30 alpacas from different areas in the Chilean Altiplano (wild animals), and from 22 llamas and 26 alpacas diagnosed as Pestivirus positive from the Metropolitana region in Chile (confined animals). Seroneutralization tests showed titers lower than 2 in all 166 samples from Chilean Altiplano. These samples were also negative to BVDV isolation, indicating that these animals have not been exposed to Pestivirus. After reactivation of positive samples from the Metropolitana region, the 5' non-codifying region (5'NCR) and E2 glycoprotein were amplified by RT-PCR from the Pestivirus genome. Viral sequences were pairwise compared and phylogenetic trees were constructed. The 5'NCR analysis showed that all 12 sequenced isolates belonged to BVDV-1. Of particular interest, isolates from eight llama and two alpaca were BVDV-1j and two alpacas were BVDV-1b. In agreement with these results, E2 phylogenetic analysis rendered a similar grouping indicating that all 16 isolates belong to BVDV-1. However, the lower availability of E2 sequences determines the creation of a smaller number of sub-groups than the 5'NCR sequences. Based on the E2 sequences, the 5'NCR BVDV 1j group consisting of all the llamas and 3 alpacas are completely included in the E2 BVDV 1e group. Due to the universal availability of the 5'NCR segment, we propose the classification of these Chilean llamas and
Herrera, C.; Cassidy, J. F.; Dosso, S. E.
The ground shaking assessment allows quantifying the hazards associated with the occurrence of earthquakes. Chile and western Canada are two areas that have experienced, and are susceptible to imminent large crustal, in-slab and megathrust earthquakes that can affect the population significantly. In this context, we compare the current GMPEs used in the 2015 National Building Code of Canada and the most recent GMPEs calculated for Chile, with observed accelerations generated by four recent Chilean megathrust earthquakes (MW ≥ 7.7) that have occurred during the past decade, which is essential to quantify how well current models predict observations of major events.We collected the 3-component waveform data of more than 90 stations from the Centro Sismologico Nacional and the Universidad de Chile, and processed them by removing the trend and applying a band-pass filter. Then, for each station, we obtained the Peak Ground Acceleration (PGA), and by using a damped response spectra, we calculated the Pseudo Spectral Acceleration (PSA). Finally, we compared those observations with the most recent Chilean and Canadian GMPEs. Given the lack of geotechnical information for most of the Chilean stations, we also used a new method to obtain the VS30 by inverting the H/V ratios using a trans-dimensional Bayesian inversion, which allows us to improve the correction of observations according to soil conditions.As expected, our results show a good fit between observations and the Chilean GMPEs, but we observe that although the shape of the Canadian GMPEs is coherent with the distribution of observations, in general they under predict the observations for PGA and PSA at shorter periods for most of the considered earthquakes. An example of this can be seen in the attached figure for the case of the 2014 Iquique earthquake.These results present important implications related to the hazards associated to large earthquakes, especially for western Canada, where the probability of a
Fujio-Vejar, Sayaka; Vasquez, Yessenia; Morales, Pamela; Magne, Fabien; Vera-Wolf, Patricia; Ugalde, Juan A.; Navarrete, Paola; Gotteland, Martin
The gut microbiota is currently recognized as an important factor regulating the homeostasis of the gastrointestinal tract and influencing the energetic metabolism of the host as well as its immune and central nervous systems. Determining the gut microbiota composition of healthy subjects is therefore necessary to establish a baseline allowing the detection of microbiota alterations in pathologic conditions. Accordingly, the aim of this study was to characterize the gut microbiota of healthy Chilean subjects using 16S rRNA gene sequencing. Fecal samples were collected from 41 young, asymptomatic, normal weight volunteers (age: 25 ± 4 years; ♀:48.8%; BMI: 22.5 ± 1.6 kg/m2) with low levels of plasma (IL6 and hsCRP) and colonic (fecal calprotectin) inflammatory markers. The V3-V4 region of the 16S rRNA gene of bacterial DNA was amplified and sequenced using MiSeq Illumina system. 109,180 ± 13,148 sequences/sample were obtained, with an α-diversity of 3.86 ± 0.37. The dominant phyla were Firmicutes (43.6 ± 9.2%) and Bacteroidetes (41.6 ± 13.1%), followed by Verrucomicrobia (8.5 ± 10.4%), Proteobacteria (2.8 ± 4.8%), Actinobacteria (1.8 ± 3.9%) and Euryarchaeota (1.4 ± 2.7%). The core microbiota representing the genera present in all the subjects included Bacteroides, Prevotella, Parabacteroides (phylum Bacteroidetes), Phascolarctobacterium, Faecalibacterium, Ruminococcus, Lachnospira, Oscillospira, Blautia, Dorea, Roseburia, Coprococcus, Clostridium, Streptococcus (phylum Firmicutes), Akkermansia (phylum Verrucomicrobia), and Collinsella (phylum Actinobacteria). Butyrate-producing genera including Faecalibacterium, Roseburia, Coprococcus, and Oscillospira were detected. The family Methanobacteriaceae was reported in 83% of the subjects and Desulfovibrio, the most representative sulfate-reducing genus, in 76%. The microbiota of the Chilean individuals significantly differed from those of Papua New Guinea and the Matses ethnic group and was closer to that of
Full Text Available The gut microbiota is currently recognized as an important factor regulating the homeostasis of the gastrointestinal tract and influencing the energetic metabolism of the host as well as its immune and central nervous systems. Determining the gut microbiota composition of healthy subjects is therefore necessary to establish a baseline allowing the detection of microbiota alterations in pathologic conditions. Accordingly, the aim of this study was to characterize the gut microbiota of healthy Chilean subjects using 16S rRNA gene sequencing. Fecal samples were collected from 41 young, asymptomatic, normal weight volunteers (age: 25 ± 4 years; ♀:48.8%; BMI: 22.5 ± 1.6 kg/m2 with low levels of plasma (IL6 and hsCRP and colonic (fecal calprotectin inflammatory markers. The V3-V4 region of the 16S rRNA gene of bacterial DNA was amplified and sequenced using MiSeq Illumina system. 109,180 ± 13,148 sequences/sample were obtained, with an α-diversity of 3.86 ± 0.37. The dominant phyla were Firmicutes (43.6 ± 9.2% and Bacteroidetes (41.6 ± 13.1%, followed by Verrucomicrobia (8.5 ± 10.4%, Proteobacteria (2.8 ± 4.8%, Actinobacteria (1.8 ± 3.9% and Euryarchaeota (1.4 ± 2.7%. The core microbiota representing the genera present in all the subjects included Bacteroides, Prevotella, Parabacteroides (phylum Bacteroidetes, Phascolarctobacterium, Faecalibacterium, Ruminococcus, Lachnospira, Oscillospira, Blautia, Dorea, Roseburia, Coprococcus, Clostridium, Streptococcus (phylum Firmicutes, Akkermansia (phylum Verrucomicrobia, and Collinsella (phylum Actinobacteria. Butyrate-producing genera including Faecalibacterium, Roseburia, Coprococcus, and Oscillospira were detected. The family Methanobacteriaceae was reported in 83% of the subjects and Desulfovibrio, the most representative sulfate-reducing genus, in 76%. The microbiota of the Chilean individuals significantly differed from those of Papua New Guinea and the Matses ethnic group and was closer to
Petitpierre, Eduard; Elgueta, Mario
Four species of Chilean leaf beetles in the subfamily Chrysomelinae have been cytogenetically analyzed, Blaptea elguetai Petitpierre, 2011, Henicotherus porteri Bréthes, 1929 and Jolivetia obscura (Philippi, 1864) show 2n = 28 chromosomes and a 13 + Xyp male meioformula, and Pataya nitida (Philippi, 1864) has the highest number of 2n = 38 chromosomes. The karyotype of Henicotherus porteri is made of mostly small meta/submetacentric chromosomes, and that of Jolivetia obscura displays striking procentric blocks of heterochromatin at pachytene autosomic bivalents using conventional staining. These findings are discussed in relation to previous cytogenetic data and current taxonomy of the subfamily.
Petitpierre, Eduard; Elgueta, Mario
Abstract Four species of Chilean leaf beetles in the subfamily Chrysomelinae have been cytogenetically analyzed, Blaptea elguetai Petitpierre, 2011, Henicotherus porteri Bréthes, 1929 and Jolivetia obscura (Philippi, 1864) show 2n = 28 chromosomes and a 13 + Xyp male meioformula, and Pataya nitida (Philippi, 1864) has the highest number of 2n = 38 chromosomes. The karyotype of Henicotherus porteri is made of mostly small meta/submetacentric chromosomes, and that of Jolivetia obscura displays striking procentric blocks of heterochromatin at pachytene autosomic bivalents using conventional staining. These findings are discussed in relation to previous cytogenetic data and current taxonomy of the subfamily. PMID:24260673
Luis Alberto Vivero Arriagada
Full Text Available Objective: To analyze and interpret the influence of neoliberalism in Chilean Social Work. Method: The points of view of users and benefactors of social programs are interpreted from a critical-hermeneutic perspective. All this articulated with the revision of historical data of Social Work. Results: It is seen that the profession is still influenced by conservative perspectives, expressed in a pragmatic/functional intervention having a weak theoretical framework. Conclusions: The need of strengthening the conceptual-theoretical formation, define theoretical paths in the undergraduate programs and a continuous link between the academy and the professional field of action are pointed out.
Full Text Available Four species of Chilean leaf beetles in the subfamily Chrysomelinae have been cytogenetically analyzed, Blaptea elguetai Petitpierre, 2011, Henicotherus porteri Bréthes, 1929 and Jolivetia obscura (Philippi, 1864 show 2n = 28 chromosomes and a 13 + Xyp male meioformula, and Pataya nitida (Philippi, 1864 has the highest number of 2n = 38 chromosomes. The karyotype of H. porteri is made of mostly small meta/submetacentric chromosomes, and that of Jolivetia obscura displays striking procentric blocks of heterochromatin at pachytene autosomic bivalents using conventional staining. These findings are discussed in relation to previous cytogenetic data and current taxonomy of the subfamily.
Lamorgese, A.R.; Linarello, A.; Warzynski, Frederic Michel Patrick
In this paper, we use detailed information about firms' product portfolio to study how trade liberalization affects prices, markups and productivity. We document these effects using firm product level data in Chilean manufacturing following two major trade agreements with the EU and the US....... The dataset provides information about the value and quantity of each good produced by the firm, as well as the amount of exports. One additional and unique characteristic of our dataset is that it provides a firm-product level measure of the unit average cost. We use this information to compute a firm...
Gloria Cortés Aliaga
Full Text Available The identification metaphors during the celebration of the independence centenary in Chile were defined by partisan discourses, access to modernity, and opposition to the political, cultural, and social system originated during the nineteenth century. On the one hand, this territorial definition gave place to a rhetoric of landscape according to a social critique containing the paradigms of time and space. On the other hand, it fostered the definition of spaces of power, where festivities, popular activities, and the erection of monuments delimit territorial politics and the symbolic construction of Chilean oligarchy. Reading these expressions would explain the position occupied by social subjects and their territorial affirmation after 1910.
Aguilera, P., E-mail: email@example.com; Romero-Barrientos, J. [Comisión Chilena de Energía Nuclear, Nueva Bilbao 12501, La Reina, Santiago (Chile); Universidad de Chile, Dpto. de Física, Facultad de Ciencias, Las Palmeras 3425, Nuñoa, Santiago (Chile); Molina, F. [Comisión Chilena de Energía Nuclear, Nueva Bilbao 12501, La Reina, Santiago (Chile)
Neutron activations experiments has been perform at the RECH-1 Chilean Nuclear Reactor to measure its neutron flux energy distribution. Samples of pure elements was activated to obtain the saturation activities for each reaction. Using - ray spectroscopy we identify and measure the activity of the reaction product nuclei, obtaining the saturation activities of 20 reactions. GEANT4 and MCNP was used to compute the self shielding factor to correct the cross section for each element. With the Expectation-Maximization algorithm (EM) we were able to unfold the neutron flux energy distribution at dry tube position, near the RECH-1 core. In this work, we present the unfolding results using the EM algorithm.
Medel, R; González-Browne, C; Fontúrbel, F E
We conducted a systematic review of the scientific literature published on plant-pollinator interactions, from both the plant and pollinator perspective, in the Chilean Mediterranean-type ecosystem (MTE hereafter). Our search identified 69 published papers on 235 native plant species from 62 families. Less than 7.9% of the flowering species inhabiting the Chilean Mediterranean have been studied, and most studies were restricted to only one locality and one reproductive season. The geographic location of the studies differed from a random pattern, showing two well-defined areas where most studies were conducted. Likewise, most studies in the Andes Range were performed above 2000 m a.s.l. The number of species of flower visitor per plant species was low (4.25 ± 0.22), which probably results from the historical and biogeographic isolation of Chile. This literature survey shows that studies relating floral traits with pollinator attraction and plant reproduction are the most frequent topics of research, reaching 37.6% of studies, followed by studies that examine pollination in relation to human impact (16.1%), micro- and macroevolution (14.0%), relationships between pollination and other ecological interactions (10.8%), community and network assessments (11.8%), and effects of abiotic variables on pollination interactions (9.7%). Our review highlights a lack of research on the effects of pollination for anthropogenic land use especially as agricultural practice is one of the most salient features of the Chilean MTE. Future directions to increase our understanding of the role of plant-pollinator relationships for biodiversity maintenance should include: to extend the taxonomic and geographic scope of research, to increase the number of spatial and temporal replicates, to increase the number of studies on pollination networks as they provide estimates of community complexity and putative stability, to develop studies that estimate the importance of pollination for
Cristian Ovando Santana
Full Text Available The following article draws the priorities of border public policy that define the Chilean foreign policy. Through a theoretical framework from the rational–reflective approach of International Relations, we argue that despite of the increasing openness, internationalization of the country, and the emergence of new actors and subnational initiatives; the views and options between the actors of this new area and the definitions of foreign policy not always match. We propose the need to establish mechanisms that settle the positions among regional social–political actors, intermediate agencies and the central level.
Full Text Available This article is an inventory and analysis of Chilean Poetry in the seventies, written in Chileand abroad, emphasizing the "exilio" and "insilio" concept. Apart from focusing on the "exilio-insilio" problem, its development and subsequent integration, this work analyzes the relationships between poets and their enviroment by means of subjective representations in different situations and places (especially urban. The cities of Chile, as well as foreign cities in the countries of exile, acquire repressive connotations, which influence the problems of the divided subject in this poetry.
Almandoz, M G
"This article deals with [the] settlement of immigrants from Chile and Bolivia in a town in the province of Buenos Aires [Argentina], far away from the borders and from the metropolitan area. Although underrepresented when compared with the overall percentage of immigrants from those two countries in Argentina, the interest of this case lies in the possibility of understanding settlement of new immigrants in dynamic areas of the country. Chilean immigrants live in Tandil in greater number than Bolivian immigrants, but are also older. Though a certain mobility is not unknown, they usually hold low skilled jobs and are only by exception granted social security and medical insurance." (EXCERPT)
Khandker, Shahidur R.; Samad, Hussain A.; Badruddoza, Syed
Simultaneity of borrowing, withdrawal of savings, and loan defaults due to the pronounced seasonality of agriculture often leads to investment failure of rural financial institutions. Lack of borrowing leads to lack of in-come- and consumption-smoothing, and in turn, causes inefficient resource allocation by rural households. Financial institutions that are active in rural areas take diffe...
Full Text Available Abstract Background While attraction of doctors to rural settings is increasing in Mali, there is concern for their retention. An orientation course for young practicing rural doctors was set up in 2003 by a professional association and a NGO. The underlying assumption was that rurally relevant training would strengthen doctors' competences and self-confidence, improve job satisfaction, and consequently contribute to retention. Methods Programme evaluation distinguished trainees' opinions, competences and behaviour. Data were collected through participant observation, group discussions, satisfaction questionnaires, a monitoring tool of learning progress, and follow up visits. Retention was assessed for all 65 trainees between 2003 and 2007. Results and discussion The programme consisted of four classroom modules – clinical skills, community health, practice management and communication skills – and a practicum supervised by an experienced rural doctor. Out of the 65 trained doctors between 2003 and 2007, 55 were still engaged in rural practice end of 2007, suggesting high retention for the Malian context. Participants viewed the training as crucial to face technical and social problems related to rural practice. Discussing professional experience with senior rural doctors contributed to socialisation to novel professional roles. Mechanisms underlying training effects on retention include increased self confidence, self esteem as rural doctor, and sense of belonging to a professional group sharing a common professional identity. Retention can however not be attributed solely to the training intervention, as rural doctors benefit from other incentives and support mechanisms (follow up visits, continuing training, mentoring... affecting job satisfaction. Conclusion Training increasing self confidence and self esteem of rural practitioners may contribute to retention of skilled professionals in rural areas. While reorientations of curricula in
Van Dormael, Monique; Dugas, Sylvie; Kone, Yacouba; Coulibaly, Seydou; Sy, Mansour; Marchal, Bruno; Desplats, Dominique
While attraction of doctors to rural settings is increasing in Mali, there is concern for their retention. An orientation course for young practicing rural doctors was set up in 2003 by a professional association and a NGO. The underlying assumption was that rurally relevant training would strengthen doctors' competences and self-confidence, improve job satisfaction, and consequently contribute to retention. Programme evaluation distinguished trainees' opinions, competences and behaviour. Data were collected through participant observation, group discussions, satisfaction questionnaires, a monitoring tool of learning progress, and follow up visits. Retention was assessed for all 65 trainees between 2003 and 2007. The programme consisted of four classroom modules--clinical skills, community health, practice management and communication skills--and a practicum supervised by an experienced rural doctor. Out of the 65 trained doctors between 2003 and 2007, 55 were still engaged in rural practice end of 2007, suggesting high retention for the Malian context. Participants viewed the training as crucial to face technical and social problems related to rural practice. Discussing professional experience with senior rural doctors contributed to socialisation to novel professional roles. Mechanisms underlying training effects on retention include increased self confidence, self esteem as rural doctor, and sense of belonging to a professional group sharing a common professional identity. Retention can however not be attributed solely to the training intervention, as rural doctors benefit from other incentives and support mechanisms (follow up visits, continuing training, mentoring...) affecting job satisfaction. Training increasing self confidence and self esteem of rural practitioners may contribute to retention of skilled professionals in rural areas. While reorientations of curricula in training institutions are necessary, other types of professional support are needed
Yarnell, Eric; Abascal, Kathy; Greenfield, Russell Howard; Romm, Aviva; Sudberg, Sidney
This article discusses how practitioners, regardless of other professional licenses they may hold, could be credentialed in botanical medicine. The article reviews the field of clinical botanical medicine and the history and modern status of botanical medicine, as well as organizations currently involved in botanical medicine credentialing. Many different types of professionals prescribe botanical medicines, and the potential for collaboration among them is great. The current trend treats botanical medicine as a narrow subdivision of allopathic medicine and does not acknowledge the breadth, depth, and diversity of botanical medicine and ultimately will not provide maximum benefits for patients. An alternative approach that instead credentials practitioners skilled in the use of a wide variety of botanical medicines in a responsible, scientific fashion is presented.
Papalexakis, Evangelos E; Faloutsos, Christos
Multiaspect data are ubiquitous in modern Big Data applications. For instance, different aspects of a social network are the different types of communication between people, the time stamp of each interaction, and the location associated to each individual. How can we jointly model all those aspects and leverage the additional information that they introduce to our analysis? Tensors, which are multidimensional extensions of matrices, are a principled and mathematically sound way of modeling such multiaspect data. In this article, our goal is to popularize tensors and tensor decompositions to Big Data practitioners by demonstrating their effectiveness, outlining challenges that pertain to their application in Big Data scenarios, and presenting our recent work that tackles those challenges. We view this work as a step toward a fully automated, unsupervised tensor mining tool that can be easily and broadly adopted by practitioners in academia and industry.
Fontenot, Holly B; Hawkins, Joellen W; Weiss, Josie A
The purpose of this study was to explicate the concept of cognitive dissonance as experienced and reported by nurse practitioner (NP) faculty members. Responses from NP faculty members to an online survey about their experiences with cognitive dissonance. The respondents detailed their experiences with cognitive dissonance, citing differences between expectations for which they are rewarded and those for which they are paid. Expecting all faculty members to excel in practice, research, teaching, and service may create unrealistic workloads for NP faculty members. Examining expectations and considering creation of a clinical track for faculty who practice may be options administrators of NP programs might explore. ©2012 The Author(s) Journal compilation ©2012 American Academy of Nurse Practitioners.
Grierson, Lawrence; Dubrowski, Adam; So, Steph; Kistner, Nicole; Carnahan, Heather
Technical and communicative skills are both important features for one's perception of practitioner competence. This research examines how trainees' perceptions of practitioner competence change as they view health care practitioners who vary in their technical and communicative skill proficiencies. Occupational therapy students watched standardized encounters of a practitioner performing a patient transfer in combinations of low and high technical and communicative proficiency and then reported their perceptions of practitioner competence. The reports indicate that technical and communicative skills have independently identifiable impacts on the perceptions of practitioner competency, but technical proficiency has a special impact on the students' perceptions of practitioner communicative competence. The results are discussed with respect to the way in which students may evaluate their own competence on the basis of either technical or communicative skill. The issue of how this may lead trainees to dedicate their independent learning efforts to an incomplete set of features needed for the development of practitioner competency is raised.
Md. Nasir Ahmed
Full Text Available Schizophrenia is a subtle disorder of brain development and plasticity; it affects the most basic human processes of perception, emotion, and judgment. In Bangladesh the traditional medical practitioners of rural and remote areas characterized the schizophrenia as an insanity or a mental problem due to possession by ghosts or evil spirits and they have used various plant species’ to treat such symptoms. The aim of the present study was to conduct an ethnomedicinal plant survey and documentation of the formulations of different plant parts used by the traditional medical practitioners of Rangamati district of Bangladesh for the treatment of schizophrenia like psychosis. It was observed that the traditional medical practitioners used a total of 15 plant species to make 14 formulations. The plants were divided into 13 families, used for treatment of schizophrenia and accompanying symptoms like hallucination, depression, oversleeping or insomnia, deterioration of personal hygiene, forgetfulness, and fear due to evil spirits like genies or ghost. A search of the relevant scientific literatures showed that a number of plants used by the medicinal practitioners have been scientifically validated in their uses and traditional medicinal knowledge has been a means towards the discovery of many modern medicines. Moreover, the antipsychotic drug reserpine, isolated from the dried root of Rauvolfia serpentina species, revolutionized the treatment of schizophrenia. So it is very much possible that formulations of the practitioner, when examined scientifically in their entireties, can form discovery of lead compounds which can be used as safe and effective antipsychotic drug to treat schizophrenia.
Ahmed, Md Nasir; Kabidul Azam, Md Nur
Schizophrenia is a subtle disorder of brain development and plasticity; it affects the most basic human processes of perception, emotion, and judgment. In Bangladesh the traditional medical practitioners of rural and remote areas characterized the schizophrenia as an insanity or a mental problem due to possession by ghosts or evil spirits and they have used various plant species' to treat such symptoms. The aim of the present study was to conduct an ethnomedicinal plant survey and documentation of the formulations of different plant parts used by the traditional medical practitioners of Rangamati district of Bangladesh for the treatment of schizophrenia like psychosis. It was observed that the traditional medical practitioners used a total of 15 plant species to make 14 formulations. The plants were divided into 13 families, used for treatment of schizophrenia and accompanying symptoms like hallucination, depression, oversleeping or insomnia, deterioration of personal hygiene, forgetfulness, and fear due to evil spirits like genies or ghost. A search of the relevant scientific literatures showed that a number of plants used by the medicinal practitioners have been scientifically validated in their uses and traditional medicinal knowledge has been a means towards the discovery of many modern medicines. Moreover, the antipsychotic drug reserpine, isolated from the dried root of Rauvolfia serpentina species, revolutionized the treatment of schizophrenia. So it is very much possible that formulations of the practitioner, when examined scientifically in their entireties, can form discovery of lead compounds which can be used as safe and effective antipsychotic drug to treat schizophrenia.
Krein, S L
To examine the response of rural hospitals to various market and organizational signals by determining the factors that influence whether or not they establish a provider-based rural health clinic (RHC) (a joint Medicare/Medicaid program). Several secondary sources for 1989-1995: the AHA Annual Survey, the PPS Minimum Data Set and a list of RHCs from HCFA, the Area Resource File, and professional associations. The analysis includes all general medical/surgical rural hospitals operating in the United States during the study period. A longitudinal design and pooled cross-sectional data were used, with the rural hospital as the unit of analysis. Key variables were examined as sets and include measures of competitive pressures (e.g., hospital market share), physician resources, nurse practitioner/physician assistant (NP/PA) practice regulation, hospital performance pressures (e.g., operating margin), innovativeness, and institutional pressure (i.e., the cumulative force of adoption). Adoption of provider-based RHCs by rural hospitals appears to be motivated less as an adaptive response to observable economic or internal organizational signals than as a reaction to bandwagon pressures. Rural hospitals with limited resources may resort to imitating others because of uncertainty or a limited ability to fully evaluate strategic activities. This can result in actions or behaviors that are not consistent with policy objectives and the perceived need for policy changes. Such activity in turn could have a negative effect on some providers and some rural residents.
The non-technical skills of situational awareness and the formation of effective interpersonal relationships are essential to enhance surgical outcomes. However, most scrub practitioners demonstrate only tacit awareness of these skills and develop such qualities on an informal basis. Application of non-technical skills may be assessed formally, using a structured framework, to transform normative behaviour and to strengthen barriers against the latent threats that may result from fallible humans working in inadequate organisational systems.
Service development and service improvement are complex concepts, but this should not prevent practitioners engaging in, or initiating, them. There is no set blueprint for service development so this article examines the process, describes the skills required, lists some change management tools and offers a guide to the stages involved. The article aims to demystify service development for those considering embarking on the process for the first time.
This Portfolio of Exploration outlines the course of learning by a practitioner on a personal leadership journey. It constructs a functional examination of ideas around leadership. It explores the belief system which underpins leadership practice and it also explores to what extent the increased participation of women can lead to a qualitatively different type of leadership. Different models of leadership are explored to find the model which can best fit with the author’s perception of leader...
As a practitioner, I have to rely on outside clinical laboratories and affiliated hospitals to perform laboratory tests. In this abstract, I describe specific problems I have encountered with third-party laboratories, and propose solutions for these problems to optimize use of laboratory tests. BLOOD TESTS: The most frequent problem in ordering blood tests is the lack of detailed information regarding sampling conditions. I often have to call laboratories to check whether the sample should be serum or plasma, what volume is needed, whether the sample should be cooled, etc. I propose that clinical laboratories should provide practitioners' manuals that describe specific sampling information. Most laboratories do not keep the data from ultrasonographic tests. The lack of these is most problematic when test results are interpreted differently by laboratories and by practitioners. Retaining the data would also help private laboratories improve the quality of the test by enabling them to compare their interpretations with others'. ANNUAL MEDICAL SCREENING: Even if an abnormal finding is detected at medical screening clinics, the final diagnosis is usually not sent back to the screening facilities. This is highly recommended to establish an official system that mediates the feedback to screening centers. MRI: Due to miscommunication between practitioners and radiologists, the test is sometimes performed inappropriately. A thorough consultation should occur before the test to clarify specific goals for each patient. PATHOLOGICAL TESTS: Interpretation of results is often inconsistent among laboratories. Independent clinical laboratories tend to report results without indicating sample problems, while pathology departments at affiliated hospitals tend to emphasize sample problems instead of diagnosis or suggesting ways to improve sample quality. Mutual communication among laboratories would help standardize the quality of pathological tests.
Kianmehr, Nahid; Haghighi, Anousheh; Bidari, Ali; Sharafian Ardekani, Yaser; Karimi, Mohammad Ali
Fibromyalgia syndrome (FMS) is a common rheumatologic disorder characterized by easy fatigability, widespread musculoskeletal pain and sleep disorder. In spite of its high prevalence, general practitioners, as primary care providers, seem to have inadequate knowledge about FMS. This study aimed to assess Iranian general practitioners' knowledge about FMS and its treatment. A detailed questionnaire (including items on signs and symptoms, diagnostic criteria and treatment) was completed by 190 general practitioners (54.7% male; mean age: 41 years). Data analysis was performed with SPSS for Windows 15.0 and awareness about all aspects of FMS was reported as percentages. About one-third (30%) of the participants had seen at least one case of FMS during their practice. Most subjects (62.7%) claimed to know 1-6 tender points. Only 3.2% knew 16-18 points. The common proposed symptoms of FMS were widespread pain (72.6%), excessive fatigue (72.6%), weakness (60.5%), sleep disorder (36.3%), anxiety (34.7%) and depression (34.2%). Wrong symptoms including elevated erythrocyte sedimentation rate and C-reactive protein, arthritis, joint swelling, weight loss and abnormal radiologic findings were selected by 27.9%, 18.9%, 14.7%, 12.6% and 2.1% of the physicians, respectively. Moreover, selective serotonin reuptake inhibitors, tricyclic antidepressant and pregabalin were identified as treatment options for FMS by, respectively, 45.8%, 22.1% and 15.3% of the participants. Finally, 52.1% and 23.7% of the subjects incorrectly considered nonsteroidal anti-inflammatory drugs and corticosteroids as treatment modalities for FMS. Iranian general practitioners are not well informed about FMS. Therefore, FMS should be specifically integrated in continuing medical education programs and undergraduate medical training curriculum. © 2015 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.
ALINA BEATTRICE VLADU
This paper reports the results of a survey designed to explore if accounting practitioners are using as a reference point in their daily activities the opinions of academia. Since accounting research comprises various trends of research the earnings management research field is used as illustrative case. Among our respondents were accounting professional, members of professional bodies as the Chamber of Financial Auditors or Romania and also Body of Expert and Licensed Accountants...
Edmond, Gary; Towler, Alice; Growns, Bethany; Ribeiro, Gianni; Found, Bryan; White, David; Ballantyne, Kaye; Searston, Rachel A; Thompson, Matthew B; Tangen, Jason M; Kemp, Richard I; Martire, Kristy
Human factors and their implications for forensic science have attracted increasing levels of interest across criminal justice communities in recent years. Initial interest centred on cognitive biases, but has since expanded such that knowledge from psychology and cognitive science is slowly infiltrating forensic practices more broadly. This article highlights a series of important findings and insights of relevance to forensic practitioners. These include research on human perception, memory, context information, expertise, decision-making, communication, experience, verification, confidence, and feedback. The aim of this article is to sensitise forensic practitioners (and lawyers and judges) to a range of potentially significant issues, and encourage them to engage with research in these domains so that they may adapt procedures to improve performance, mitigate risks and reduce errors. Doing so will reduce the divide between forensic practitioners and research scientists as well as improve the value and utility of forensic science evidence. Copyright © 2016 The Chartered Society of Forensic Sciences. Published by Elsevier B.V. All rights reserved.
Auerbach, K G; Walburn, J
The authors conducted an anonymous survey of 220 Nebraska family and general practitioners' attitudes and practice recommendations for infant feeding. Most practitioners' attitudes reflect published American Academy of Pediatrics (AAP) guidelines regarding using commercial formula for bottle-feeding babies rather than evaporated milk-based formulations. Ninety-two per cent agreed with recommendations relating to the need for fluoride supplementation when fluoride was unavailable in the water supply and 93% agreed that whole cow's milk was inappropriate in the infant's first year. Another 68% felt similarly about evaporated milk formulas. However, 32% of board certified and 53% of nonboard certified physicians continue to believe that early solid foods will reduce night waking. In 80% of the cases, practice recommendations disagreed with AAP guidelines by prescribing vitamin supplements for bottle-feeding babies receiving proprietary infant formulas. Additionally, two-thirds of the practitioners recommended unnecessary water complements and 62% suggested formula supplementation for breastfeeding babies. Solid foods and whole cow's milk for both breastfeeding and bottle-feeding babies often were recommended earlier than the second half of the first year.
Greene, Jessica; El-Banna, Majeda M; Briggs, Linda A; Park, Jeongyoung
While male nurses have been shown to earn considerably more than female nurses, there is less evidence on gender disparities in salary among nurse practitioners (NPs). This study examines whether the gender gap in NP salaries persists after controlling for differences in work setting and demographic factors. We analyzed the relationship between gender and salary (2011 pretax earnings) among 6591 NPs working as NPs at least 35 h per week, using the 2012 National Sample Survey of Nurse Practitioners. We first conducted bivariate regression analyses examining the relationship between gender and earnings, and then developed a multivariate model that controlled for individual differences in demographic and work characteristics. Male NPs earned $12,859 more than female NPs, after adjusting for individual differences in demographics and work characteristics. The gender gap was $7405 for recent NP graduates, and grew over time. Male NPs earned significantly more than female NPs across all clinical specialty areas. The gender disparities in NP salaries documented here regardless of professional seniority or clinical area should spark healthcare organizations to conduct pay equity assessments of their employees' salaries to identify and ameliorate pay inequality. ©2017 American Association of Nurse Practitioners.
Mills, P D; Newbury, J
In order to review anaesthetic morbidity in our remote rural hospital, a retrospective audit of all anaesthetic records was undertaken for a five-year period between 2006 and 2010. Eight hundred and eighty-nine anaesthetic records were reviewed. The patients were all American Society of Anaesthesiologists physical status I to III. Ninety-eight percent of the anaesthetics were performed by general practitioner (non-specialist) anaesthetists. There were no anaesthetic deaths or serious adverse outcomes reported over this period. Sixteen intraoperative and seven postoperative problems were documented, but all were resolved uneventfully. The most common problems documented were difficult intubation (n=9) and respiratory depression (n=3). Within the limitations of this retrospective audit, these findings indicate that general practitioner anaesthetists provided safe anaesthesia in a remote rural hospital. It is our opinion that the case selection, prior experience of anaesthetic and theatre staff, stable nursing workforce and the use of protocols were important factors in determining the low rate of adverse events. However, we caution against over-interpretation of the data, given its retrospective nature, relatively small sample size, reliance on case records and the absence of agreed definitions for adverse events. We would also like to encourage all anaesthetic services, however remote, to audit their results as part of ongoing quality assurance.
... 45 Public Welfare 1 2010-10-01 2010-10-01 false The National Practitioner Data Bank. 60.1 Section 60.1 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION NATIONAL PRACTITIONER DATA BANK FOR ADVERSE INFORMATION ON PHYSICIANS AND OTHER HEALTH CARE PRACTITIONERS General...
Shook, LaVerne; Roth, Gene
Purpose: This paper seeks to provide perspectives of HR practitioners based on their experiences with mergers, acquisitions, and/or downsizings. Design/methodology/approach: This qualitative study utilized interviews with 13 HR practitioners. Data were analyzed using a constant comparative method. Findings: HR practitioners were not involved in…
The journey from VET practitioner to academic researcher is not an easy one, especially for VET teachers whose educational research training in action and ethnographic research have been inculcated through years of practice. This paper discusses the highlights of the journey from practitioner to practitioner researcher including a discussion of…
... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Veterinary practitioners and animal... FROM PREPARATION PURSUANT TO AN UNSUSPENDED AND UNREVOKED LICENSE § 107.1 Veterinary practitioners and...)(1) Products prepared by a veterinary practitioner (veterinarian) solely for administration to...
Zumbado, Jennifer Rochlis
The NASA/SP-2015-3709, Human Systems Integration (HSI) Practitioner's Guide, also known as the "HSIPG," provides a tool for implementing HSI activities within the NASA systems engineering framework. The HSIPG is written to aid the HSI practitioner engaged in a program or project (P/P), and serves as a knowledge base to allow the practitioner to step into an HSI lead or team member role for NASA missions. Additionally, this HSIPG is written to address the role of HSI in the P/P management and systems engineering communities and aid their understanding of the value added by incorporating good HSI practices into their programs and projects. Through helping to build a community of knowledgeable HSI practitioners, this document also hopes to build advocacy across the Agency for establishing strong, consistent HSI policies and practices. Human Systems Integration (HSI) has been successfully adopted (and adapted) by several federal agencies-most notably the U.S. Department of Defense (DoD) and the Nuclear Regulatory Commission (NRC)-as a methodology for reducing system life cycle costs (LCCs). These cost savings manifest themselves due to reductions in required numbers of personnel, the practice of human-centered design, decreased reliance on specialized skills for operations, shortened training time, efficient logistics and maintenance, and fewer safety-related risks and mishaps due to unintended human/system interactions. The HSI process for NASA establishes how cost savings and mission success can be realized through systems engineering. Every program or project has unique attributes. This HSIPG is not intended to provide one-size-fits-all recommendations for HSI implementation. Rather, HSI processes should be tailored to the size, scope, and goals of individual situations. The instructions and processes identified here are best used as a starting point for implementing human-centered system concepts and designs across programs and projects of varying types, including
Papke, J; Freier, W
Levels of experience and competence in palliative medicine vary considerably among physicians. The aim of the study was to collect information from specially interested general practitioners on education, pivotal lectures and experience regarding the delivery of palliative care. 92 general practitioners (41 women and 22 men) attending a basic course in palliative medicine were asked to fill in a standardized questionnaire relating to their knowledge and experience of palliative medicine. 63 responded (68%), 54 in general private practice, nine worked in a hospital. The same number worked in urban and in rural health care facilities. The majority of those questioned (53%) gained their first experience in palliative medicine as junior hospital doctors about a quarter (26%) only after starting in private practice. Many of the doctors (31%) admitted to taking more interest in palliative medicine only after having made mistakes, a significant percentage (20%) after the death of a relative. 28% expressed the view that practical courses were an important part in learning about palliative medicine. The implementation of practice-based c tuition of medical students and of continuing education of established general practitioners and hospital physicians in palliative medicine is indispensable.
Longstaff, Fran; Gervis, Misia
This study examined how practitioners who provide sport psychology support use counselling principles and skills to develop practitioner-athlete relationships. Semi-structured interviews were conducted with thirteen competent practitioners (Mean age = 41.2 ± 10.9 years old, five men, eight women). Thematic analysis revealed that the participants used a range of counselling principles to develop practitioner-athlete relationships including: the facilitative conditions, self-disclosure, counsel...
Solminihac, Hernan De; Salsilli, R.; Bengoa, E.; Kohler, E.
Serviceability is an indicator that represents the level of service a pavement provides to the users. This subjective opinion is closely related to objective aspects, which can be measured on the pavement's surface. This research aims specifically at relating serviceability results obtained by a 9-member evaluation panel, representing general public as closely as possible to parameters (particularly of roughness) measured within instruments on 30, 25 and 11 road sections of asphalt concrete, Portland cement concrete and asphalt overlay respectively. Results show that prediction of serviceability is quite accurate based on roughness evaluation, while also revealing that, by comparison to studies in more developed countries, Chileans are seemingly more tolerant, in that they assign a somewhat high rating to ride quality. Furthermore, visible distress does not have a significant influence on serviceability values for Chilean users. A ratio between International Roughness Index (IRI) and Serviceability, as defined by AASHTO, was developed and may be used in this design method. Results for the final pavement condition of urban pavements were obtained (IRI-asphalt final=5.9, IRI-concrete final=8.1). (author)
Durán Agüero, Samuel; Arroyo Jofre, Patricio; Varas Standen, Camila; Herrera-Valenzuela, Tomas; Moya Cantillana, Cristobal; Pereira Robledo, Rodolfo; Valdés-Badilla, Pablo
the sleep takes part in diverse biological and physiological functions, associating his restriction, with minor performance in the sport, nevertheless the quantity and quality of sleep is not known in paralympic athletes. to determine the sleep quality, insomnia and excessive daytime sleepiness in Chilean paralympic athletes. descriptive transverse Study, the sample included 33 paralympic athletes (24.2% women), those who were practicing swimming, tennis of table, football 5, powerlifting and tennis chair. The studied variables measured up across two surveys of dream: the Questionnaire of Insomnia and the Pittsburgh Sleep Quality Index. the paralympic athletes sleep were 6.9 } 1.4 hours, 27.7% presents daytime sleepiness, 69.6 % insomnia (Survey of insomnia =7), whereas 78.7 % exhibits a bad sleep quality. The age showed a positive correlation with latency to the sleep (r=0.417 *), the insomnia with latency to the sleep (r=0.462 **), the Pittsburg score was correlated negatively by the sleep duration (r =-0.323) and latency to the sleep is correlated positively by the Pittsburgh score (r=0.603 **). the chilean paralympic athletes, present a low sleep quality, insomnia and excessive daytime sleepiness, situation that might influence negatively the sports performance. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.
Oñate, Esteban; Meyer, Felipe; Espinoza, Jorge
The range of sizes used in Chile for clothing comes from criteria developed in continental Europe, mainly the EN 13402 standard. Any standard adopted by a country should consider the anthropometric dimensions of the user population, particularly to discern the ratio of garments for different size. Consequently, the purpose of this study was to propose standards for the size of clothing based on anthropometric characteristics of a sample of Chilean miners. The study was conducted in 447 male workers. The age and body weight were measured in each workers as well as their percentage of body fat. Anthropometric measurements for garments were made according to the criteria of the European Community (EN 13402-1) and ISO (8559- 1989). Body dimensions for the design of gloves, shoes, helmets and caps, clothes that cover the upper part of the body and clothes that cover the lower part were measured. The results obtained made it possible to establish the percentage of workers falling within the range of sizes that manufacturers consider as reference. One of the main conclusions of the study is the need to carefully consider a set of complementary anthropometric measures, which can help to improve the comfort of costumes, to the extent that the providers adapt their designs to the characteristics of Chilean workers.
Full Text Available Objective: To determine the accuracy of two international Body Mass Index (BMI cut-offs for classifying obesity compared to the percentage of fat mass (%FM assessed by Dual-Energy X-ray Absorptiometry (DXA in a Chilean sample of children and adolescents; Material and Methods: The subjects studied included 280 children and adolescents (125 girls and 155 boys aged 8 to 17 years. Weight and height were measured. The BMI was calculated. Two international references (IOFT and WHO were used as cut-off points. The %FM was assessed by DXA. The receiver operating characteristic (ROC curve was used to assess the performance of BMI in detecting obesity on the basis of %FM; Results: A high correlation was observed between the %FM measured by the DXA and the Z-scores of IOTF and WHO scores in the Chilean adolescents separated by sex (r = 0.78–0.80. Differences occurred in both references (IOFT and WHO in relation to the criteria (p < 0.001. Both references demonstrated a good ability to predict sensitivity (between 84% and 93% and specificity (between 83% and 88% in both sexes of children and adolescents; Conclusions: A high correlation was observed between the Z-score of the BMI with the percentage of fat determined by the DXA. Despite this, the classifications using the different BMI cut-off points showed discrepancies. This suggests that the cut-off points selected to predict obesity in this sample should be viewed with caution.
Carvajal, Bielka; Stuardo, Valeria; Manríquez, José Manuel; Belmar, Julieta; Folch, Cinta
To adapt a behavioural questionnaire for second-generation HIV/AIDS surveillance in female sex workers (FSWs) in the Metropolitan Region, Chile. Qualitative study of instruments validation. A Spanish instrument adapted in Catalonia was validated through a translation and back-translation of the original version. The content validity was determined through a modified Delphi method, via FSW and HIV experts representing community, political and institutional levels. Applicability aspects were determined by the application of the questionnaire to FSW in the Metropolitan Region. The questionnaire, drafted in Spain, was successfully adapted to Chilean Spanish. The content validity process enabled sections to be created that address HIV in FSWs. The adapted questionnaire takes less than 15minutes to complete, which makes it usable in fieldwork. The 61 women surveyed came from different countries (all were Latin Americans) and had different educational levels; all this enabled potential applicability problems to be detected. The adapted questionnaire for Chile contains all the UNAIDS indicators for FSWs, as well as the recommended indicators of Family Health International for bio-behavioural surveillance. Said questionnaire serves as a tool for second-generation HIV/other STD surveillance and further contributes to preventive policies in Chilean FSWs. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.
Figueroa, Guillermo; Troncoso, Miriam; López, Cristián; Rivas, Patricia; Toro, Magaly
Thermotolerant Campylobacter is among the more prevalent bacterial pathogens that cause foodborne diseases. This study aimed at evaluating the occurrence of thermotolerant Campylobacter contamination in chicken carcasses and processing plant stations (chilling water, scalding water, defeathering machinery, evisceration machine, and transport crates) in two of the Chilean main slaughterhouses. In addition, the isolation rates of thermotolerant Campylobacter during evisceration and following chiller processing were compared. The overall slaughterhouse contamination with thermotolerant Campylobacter was 54%. Differences were evident when the results from each plant were compared (plant A and plant B was 72% and 36%, respectively). The sampling points with the greatest contamination rates in both plants were after evisceration (90% and 54%, for plants A and B respectively). The decrease of thermotolerant Campylobacter contamination after chilling was significant (2 and 1.6 logs for plant A and B respectively P < 0.05). Our findings indicate that chilling process has a limited effect in the final products Campylobacter contamination because poultry enter the slaughter processing with high counts of contamination. This may represent a health risk to consumers, if proper cooking practices are not employed. The levels and frequencies of Campylobacter found during the processing of Chilean poultry appear to be similar to those reported elsewhere in the world.
Full Text Available Abstract Background Thermotolerant Campylobacter is among the more prevalent bacterial pathogens that cause foodborne diseases. This study aimed at evaluating the occurrence of thermotolerant Campylobacter contamination in chicken carcasses and processing plant stations (chilling water, scalding water, defeathering machinery, evisceration machine, and transport crates in two of the Chilean main slaughterhouses. In addition, the isolation rates of thermotolerant Campylobacter during evisceration and following chiller processing were compared. Results The overall slaughterhouse contamination with thermotolerant Campylobacter was 54%. Differences were evident when the results from each plant were compared (plant A and plant B was 72% and 36%, respectively. The sampling points with the greatest contamination rates in both plants were after evisceration (90% and 54%, for plants A and B respectively. The decrease of thermotolerant Campylobacter contamination after chilling was significant (2 and 1.6 logs for plant A and B respectively P Conclusion Our findings indicate that chilling process has a limited effect in the final products Campylobacter contamination because poultry enter the slaughter processing with high counts of contamination. This may represent a health risk to consumers, if proper cooking practices are not employed. The levels and frequencies of Campylobacter found during the processing of Chilean poultry appear to be similar to those reported elsewhere in the world.
Jiménez-Aspee, Felipe; Thomas-Valdés, Samanta; Schulz, Ayla; Ladio, Ana; Theoduloz, Cristina; Schmeda-Hirschmann, Guillermo
The Patagonian currant Ribes magellanicum is highly valued due to its pleasant flavor and sweet taste. The aim of this study was to characterize its constituents and to assess their antioxidant and cytoprotective properties. For the fruit phenolic-enriched extract (PEE), total phenolics (TP), total flavonoids (TF), and antioxidant activity (DPPH, Ferric reducing antioxidant power (FRAP), and Trolox equivalent antioxidant activity (TEAC)) were determined. Argentinean samples presented better activity in the DPPH and FRAP assays. Best cytoprotection against oxidative stress induced by H2O2 in AGS cells was found in one Argentinean sample at 500 μg mL(-1) (65.7%). HPLC MS/MS analysis allowed the tentative identification of 59 constituents, including eight anthocyanins, 11 conjugates of caffeic-, ferulic-, and coumaric acid, and 38 flavonoids, most of them quercetin and kaempferol derivatives. Argentinean samples showed a more complex pattern of anthocyanins, hydroxycinnamic acids (HCA), and flavonoids. Cyanidin rhamnoside hexoside and cyanidin hexoside were the main anthocyanins, accounting for 35 and 55% for the Argentinean and 60 and 27% for the ripe Chilean fruits. HCA content was about three times higher in Argentinean samples. The phenolic profiles of Chilean and Argentinean Ribes magellanicum show remarkable differences in chemical composition with higher HCA and flavonoid content in Argentinean samples.
Full Text Available Objective. To determine the prevalence of anemia and iron status among Chilean women of childbearing age between 1981 and 2010. Materials and methods. Calculation of the prevalence of anemia and iron status was based on multiple cross-sectional iron absorption studies performed in 888 women during this period of time. All studies included measurements of hemoglobin, mean corpuscular volume, zinc protoporphyrin, percentage of transferrin saturation and serum ferritin. Data were grouped by decade (1981-1990,1991-2000, and 2001-2010. Results. Prevalence of anemia for these decades was 9, 6 and 10%, respectively (p=NS. Iron deficiency anemia was the main cause of anemia in all periods (55, 85 and 75%, respectively; p=NS. A high prevalence of women with normal iron status was observed for all periods (64, 69, and 67, respectively; p=NS. Prevalence of iron deficiency without anemia in 1981-1990, 1991-2000 and 2001-2010 was 7, 20 and 12%, respectively (p menor que 0.05. Finally, prevalence of iron depleted stores was 20, 6 and 10%, respectively (p menor que 0.05. Conclusions. Prevalence of iron deficiency anemia in Chilean women of childbearing age was mild between 1981 and 2010. More than 60% of childbearing age women presented normal iron status in all periods. However, prevalence of iron depleted stores was moderate during 1981-1990, and was mild during 1991-2000 and 2001-2010.
Olivares, S; Kain, J; Lera, L; Pizarro, F; Vio, F; Morón, C
To assess the nutritional status, food consumption and physical activity (PA) habits of Chilean school children, as a baseline for developing an educational intervention. Cross-sectional study. A total of 1701 children from 3rd to 7th grade in nine schools located in three geographical regions. We determined body mass index, food consumption (quantified FFQ which we categorised into five groups), PA in terms of TV viewing and frequency of after school PA. The data were analysed according to age, nutritional status and gender. A logistic regression analysis was performed using obesity as outcome. Obesity was higher among boys; younger children presented higher prevalence in both genders. Daily intake of dairy products varied between 240 and 308 g, fruits/vegetables, between 197 and 271 g, energy-dense foods between 343 and 460 g. In all, 22.3 and 47% of the children watched over 3 h of TV during the week and weekend, respectively. Older children watched significantly more TV during the week, while on weekends all children increased this time significantly. Boys were more active than girls after school. The logistic regression analysis showed a significant association between obesity and low intake of dairy products. Prevalence of obesity among Chilean children is high. Although TV time, intake of energy dense foods and fruits/vegetables appeared as risk factors for obesity, only dairy consumption was significantly associated with obesity. FAO Copyright 2004 Nature Publishing Group
Florenzano U, Ramón; Valdés C, Macarena; Cáceres C, Eugenio; Santander R, Sylvia; Aspillaga H, Carolina; Musalem A, Claudia
In Chile, there has been an increase in suicide rates from 1.1 to 2.6 per 100,000 among adolescents aged 10 to 14 years and from 4.4 to 8.9 per 100,000 among those aged 15 to 19 years To identify protective factors for suicidal ideation according to parenting styles, as described by Barber et al. The relation between suicidal ideation and parenting styles was assessed in a random sample of 2,346 Chilean school attending adolescents aged 13 to 20 years old (59% women) from three cities: Antofagasta (Northern Chile, II Region), Santiago (Central, Metropolitan Region) and Concepción (Southern, VIII Region). Participants were tested with the Chilean adaptation of the Cross National Adolescents Program (CNAP) Plus questionnaire developed by Barber et al. The relation between suicidal ideation and parenting styles was assessed using regression analyses. Correlations between suicidal ideation and parenting styles were mostly significant, yet weak. High odds ratios were observed among parents who had a strong psychological control, inconsistent control, lack of expression of affection and covered marital hostility. High adolescent self-esteem, a good relationship with parents, psychological parental autonomy, expression of physical affection, social support and paternal monitoring were protective factors against suicidal ideation.
González-Guarda, Erwin; Domingo, Laura; Tornero, Carlos; Pino, Mario; Hernández Fernández, Manuel; Sevilla, Paloma; Villavicencio, Natalia; Agustí, Jordi
Stable isotope analyses have been performed on the bioapatite (δ13C; δ18O) and collagen (δ13C; δ15N) of four late Pleistocene South American megafaunal taxa (Notiomastodon platensis, Equus andium, cf. Hemiauchenia paradoxa and Xenarthra indet.) to evaluate paleoclimatic and paleoenvironmental conditions as well as paleoecological features of this time period. The analyzed megafauna was found at several locations in the northwestern Chilean Patagonia (38°-42°S, 74°-71°W). The bioapatite δ13C values indicated the presence of C3 vegetation ranging from forestal to woodland areas. The collagen δ15N values pointed to temperate and humid ecosystems, and to the consumption of shrubs, trees, grasses and sedges. Mean annual temperatures estimated from bioapatite δ18OPO4 values show a similarity to modern temperatures and suggested that the megafauna under study may have lived during warm stages (interstadials) of the late Pleistocene. When comparing our results with those obtained from other South American regions, we find that the diet of this particular Chilean megafauna appears to have been more influenced by resource availability than by the potential dietary range of the taxa.
Tornquist, Susan J; Boeder, Lisa; Rios-Phillips, Carolina; Alarcon, Virgilio
Mycoplasma haemolamae is a hemotropic mycoplasma that affects red blood cells of llamas (Lama glama) and alpacas (Lama pacos). It is variably associated with anemia, and most infections are subclinical. Development of a polymerase chain reaction assay has facilitated detection of this infection in llamas and alpacas in the United States and other countries. Whether the infection occurs in camelids in South America has previously been unknown. The current study documents a 15.8% infection rate among 76 Peruvian llamas, a 19.3% infection rate among Peruvian alpacas at one site, and a 9.26% infection rate in 108 Chilean alpacas from selected herds. All of the camelids tested appeared to be clinically healthy. No gender or species predilection was found. Only 1 positive camelid younger than 18 months was found. Infection is not associated with anemia, and the mean packed cell volume (PCV) in positive Peruvian camelids was slightly higher than the mean PCV in negative Peruvian camelids. In the Chilean alpacas, the positive alpacas had a slightly lower PCV than the negative alpacas, although the mean PCV was not in the anemic range in any of the groups.
Otterlei, Alexander; Brevik, Øyvind J; Jensen, Daniel; Duesund, Henrik; Sommerset, Ingunn; Frost, Petter; Mendoza, Julio; McKenzie, Peter; Nylund, Are; Apablaza, Patricia
The study presents the phenotypic and genetic characterization of selected P. salmonis isolates from Atlantic salmon and rainbow trout suffering from SRS (salmonid rickettsial septicemia) in Chile and in Canada. The phenotypic characterization of the P. salmonis isolates were based on growth on different agar media (including a newly developed medium), different growth temperatures, antibiotics susceptibility and biochemical tests. This is the first study differentiating Chilean P. salmonis isolates into two separate genetic groups. Genotyping, based on 16S rRNA-ITS and concatenated housekeeping genes grouped the selected isolates into two clades, constituted by the Chilean strains, while the Canadian isolates form a branch in the phylogenetic tree. The latter consisted of two isolates that were different in both genetic and phenotypic characteristics. The phylogenies and the MLST do not reflect the origin of the isolates with respect to host species. The isolates included were heterogeneous in phenotypic tests. The genotyping methods developed in this study provided a tool for separation of P. salmonis isolates into distinct clades. The SRS outbreaks in Chile are caused by minimum two different genetic groups of P. salmonis. This heterogeneity should be considered in future development of vaccines against this bacterium in Chile. Two different strains of P. salmonis, in regards to genetic and phenotypic characteristics, can occur in the same contemporary outbreak of SRS.
Ortiz, Manuel; Ortiz, Eugenia
Treatment compliance among patients with type 1 diabetes mellitus, is low in 50% of diabetic teenagers, becoming a social and medical problem. To determine psycho-social factors associated to treatment compliance among Chilean diabetic type 1 teenagers. A non experimental study of 61 diabetic teenagers (age 14.9+/-1.9 years, 37 male). The number of blood glucose determinations, socioeconomic level and practice of sports was measured. Psychological tests were applied to analyze self-efficiency, motivation of achievement, self-esteem and knowledge of the illness and its treatment. As a measure of patient compliance, glycosilated hemoglobin (HB1Ac) was measured. Six patients had a good control of diabetes (HB1Ac <7%), 24 had HB1Ac values between 7 and 8.9, and 31 (51%) had values of 9% or more, considered as a poor diabetes control. The intensified insulin treatment scheme, the knowledge of the illness and its treatment and the sense of self-efficiency, were the factors associated with a better compliance with treatment. Teenagers of higher socio-economical levels had a better compliance with treatment. Fifty percent of Chilean diabetic teenagers in this sample had a poor control of the disease and the variable knowledge about the disease is the better predictor of patient compliance.
Alerte, Viller; Cortés A, Sandra; Díaz T, Janepsy; Vollaire Z, Jeannette; Espinoza M, M Eugenia; Solari G, Verónica; Cerda L, Jaime; Torres H, Marisa
Foodborne disease outbreaks are one of the main health problems all over the world, which have an extensive impact on human health. [corrected] To analyze the foodborne disease outbreaks occurred in Chilean urban area from 2005 to 2010. We made a descriptive epidemiologic study. First, criteria were defined and classified according to previous epidemiologic investigations, clinical and environment samples, then. Variables of space, time, place and person were also analyzed. Among 2,806 reported outbreaks, 2434 (86.7%) fulfilled the inclusion criteria. Incidence rate of the period (2005-2010) were 32 cases per 100 inhabitants. A total of 12,196 people were affected, with an average of 5 patients per outbreak. The households (36.2%), restaurants (16.3%), supermarkets (6.3%) free fair (4.4%) have been the most important outbreak areas. The foods involved were seafood (15.4%), fish (15.1%), and fast food (13.5%). The etiologic agents were Salmonella spp, Shigella spp, Vibrio parahaemolyticus. Outbreaks foodborne diseases are frequents in the Chilean urban area, which make vulnerable a lot of people. The largest numbers happened in the households and were due to bad handling and/or inappropriate storage of the foods.
Oda-Montecinos, Camila; Saldaña, Carmina; Andrés Valle, Ana
this research aimed to characterize the daily eating behavior in a sample of Chilean adults according to their Body Mass Index (BMI) and gender and to analyze the possible links between these variables and abnormal eating behaviors. 657 participants (437 women and 220 men, age range 18-64 years) were evaluated with a battery of self-administered questionnaires. Mean BMI was 25.50 kg/m2 (women 24.96 kg/m2, men 26.58 kg/m2), being significantly higher the mean of BMI in the men group, being the BMI mean of the total sample and that of the male group in the overweight range. participants with overweight (BMI ≥ 25 kg/m2), in contrast with normal-weight group, tended to do more frequently the following behaviors: skip meals, follow a diet, eat less homemade food, eat faster and in greater quantities, in addition to do a greater number of abnormal eating behaviors of various kinds and to rate significantly higher in clinical scales that evaluated eating restraint and overeating. Men showed significantly more eating behaviors linked with overeating, and women performed more behaviors related with eating restraint and emotional eating. the results suggest that, besides "what" people eat, "how" people eat, in terms of specific behaviors, may contribute to the rapid increase of overweight in Chilean population. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.
Full Text Available Global increases in the demand for energy are imposing strong pressures over the environment while compromising the capacity of emerging economies to achieve sustainable development. In this context, implementation of effective strategies to reduce consumption in residential buildings has become a priority concern for policy makers as minor changes at the household scale can result in major energy savings. This study aims to contribute to ongoing research on energy consumer profiling by exploring the forecasting capabilities of discrete socio-economic factors that are accessible through social housing allocation systems. Accordingly, survey data gathered by the Chilean Ministry of Social Development was used identify key characteristics that may predict firewood usage for space heating purposes among potential beneficiaries of the Chilean social housing program. The analyzed data evidences strong correlations between general household characteristics and space heating behavior in certain climatic zones, suggesting that personalized delivery of energy efficiency measures can potentially increase the effectiveness of initiatives aimed towards the reduction of current patterns of consumption.
Gaete, Ximena; García, Roberto; Riquelme, Joel; Codner, Ethel
A secular trend towards a younger age of puberty onset has been reported in Chilean girls. To evaluate the age of onset of puberty and prevalence of early puberty in Chilean boys. A pediatric endocrinologist examined 319 children attending schools in central Santiago. Pubertal development was assessed by testicular volume (TV) and genital inspection (GI) using Tanner graduation. Precocious and early puberty development was diagnosed if TV ≥ 4 ml or GI > stage 2 occurred in boys younger than 9 years and at 9-10 years of age, respectively. Pubertal onset occurred at 10.2 ± 1.5 years according to TV and at 11.1 ± 1.6 years according to GI (p puberty was observed in 23.8% of children according to TV and 9.5% according to GI. However, no child of less than 11 years old had a TV ≥ 4 ml, genital changes and pubic hair simultaneously. Late pubertal stages occurred at the same age according to both criteria used. Body mass index z score was not associated with the age of pubertal onset. Testicular enlargement occurs one year earlier than changes in genitalia according to inspection. Testicular growth, but not late stages of puberty, are occurring one year earlier than previously reported in Chile 10 years ago.
Full Text Available Objective: Dental students are particularly affected by stress, which can lead to ‘burnout syndrome’ by association with other psychological factors. The aim of this study was to analyse the effect of perceived stress, coping strategies, and vocational satisfaction on the severity of burnout in Chilean dental students in the clinical years. Method: The study population was comprised of clinical dental students of five Chilean dental schools. The following variables were considered: age, gender, year of study, burnout, coping strategies, perceived stress, and vocational satisfaction. Statistical analysis included descriptive measures, correlation tests, and stepwise multiple regression analysis. Results: The final sample included 244 students. Three (1.23% students did not have burnout in any of its factors and 38 (15.57% had severe levels in all three factors. There was a statistically significant greater ‘emotional exhaustion’ in 4th year students. There was a statistically significant correlation of the three factors of burnout with ‘social withdrawal’ coping strategy, high levels of perceived stress, and low levels of present and future vocational satisfaction. Conclusion: Most students presented moderate and high levels of burnout. This situation is associated with dysfunctional coping strategies, high levels of perceived stress, and low levels of present and future vocational satisfaction.
Dawson, Maria Teresa; Gifford, Sandra Margaret
Cultural beliefs, norms and values regarding sexuality and gender roles forge people's sexual behaviour and understanding of sexual health risk. Acknowledging a person's cultural background is a key challenge for the promotion of sexual health programs and strategies for the prevention of sexually transmitted diseases (STDs) and HIV/AIDS. This challenge acquires larger dimensions when health promotion programs are directed towards migrant communities. This article examines narratives about past and present life experiences of Chilean women living in Australia and Chilean women in Chile. We inquire about social changes and exposure to education women experienced in their own country and in Australia and the ways in which migrant women define and articulate their experiences in relation to sexual health prevention. In comparing these experiences, we raise a number of questions about sexual health promotion and programs, including the prevention of STDs and HIV/AIDS targeted to specific migrant communities in Australia. Very few sexual health policies and strategies in Australia take into account the impact that the social and cultural background of migrants, social changes and the 'settlement process' has on the cultural construction of gender identity of migrants in the new country. We propose that these cultural constructs are key in the formulation of migrants' beliefs and attitudes towards sexuality and sexual health. We suggest that there is a need to build effective and culturally appropriate sexual health promotion and prevention strategies that build upon the social and cultural background and the present and past life experiences of migrant women and men.
Valladares, Macarena; Obregón, Ana María; Weisstaub, Gerardo; Burrows, Raquel; Patiño, Ana; Ho-Urriola, Judith; Santos, José Luis
Leptin (LEP) is mainly produced in adipose tissue and acts in the hypothalamus to regulate energy intake. Mutations in the LEP gene or its receptor (LEPR) that produce monogenic obesity are infrequent. However, LEP and LEPR polymorphisms have been associated with obesity multifactorial, due to the association found with body weight and eating behavior. Measure the association between LEP and LEPR polymorphisms with childhood obesity and eating behavior. 221 Chilean obese children (BMI above the 95th percentile) were recruited. Parents of 134 of these children were also recruited to determine the association between LEP and LEPR polymorphisms with obesity in a case study-parent trio. Eating behavior was measured through the questionnaire of three factors progenitors' version (TFEQ-P19) and eating behavior in children (CEBQ). No significant difference between the studied polymorphisms and childhood obesity, after correction for multiple comparisons, was observed. The dimensions; "Slow eating", "emotional eating", "enjoyment of food" and "uncontrolling eating" were significant associated with certain polymorphisms of LEP and LEPR. There would be an association between polymorphisms of the LEP and LEPR genes with eating behavior in Chilean obese children. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.
Caamaño, José; Musante, Evangelina; Contreras, Margarita; Ulloa, Hernán; Reyes, Carolina; Inaipil, Verónica; Saavedra, Nicolás; Guzmán, Neftalí
Alloimmunization is an adverse effect of blood transfusions. In Chile, alloimmunization frequency is not established, and for this reason the aim of this study was to investigate the prevalence and specificity of red blood cell (RBC) alloantibodies in Chilean transfused subjects. Records from 4,716 multi-transfused patients were analyzed. In these patients, antibody screening was carried out prior to cross-matching with a commercially available two-cell panel by the microcolum gel test, and samples with a positive screen were analyzed for the specificity of the alloantibody with a 16-cell identification panel. The incidence of RBC alloimmunization in transfused patients was 1.02% (48/4,716) with a higher prevalence in women (40/48). We detected 52 antibodies, the most frequent specificities identified were anti-E (30.8%), anti-K (26.9%), anti-D (7.7%), and anti-Fy(a) (5.8%). The highest incidence of alloantibodies was observed in cancer and gastroenterology patients. The data demonstrated a low alloimmunization frequency in Chilean transfused patients, principally associated with antibodies anti-E, anti-K, anti-D, and anti-Fy(a).
Cossio-Bolaños, Marco; Vilchez-Avaca, Catalina; Contreras-Mellado, Victor; Andruske, Cynthia Lee; Gómez-Campos, Rossana
Studies based on Body Mass Index (BMI) and waist circumference (WC) are generally used to examine the prevalence and tendency of overweight and obesity. These studies help determine the socioeconomic development of a country and improve public health policies. Therefore, the goal of this research was to determine the trend of change in abdominal obesity of Chilean university students according to the Body Mass Index (BMI) measured in intervals of three and six years. For this study, a total of 1598 students of both sexes ranging in age from 18 to 26 from a Chilean university were evaluated. Students were assessed commencing in 2007 (372 males and 315 females), 2010 (250 males and 330 females), and ending in 2013 (153 males and 178 females). During the three transversal assessments, weight, height, and waist circumference were evaluated. BMI was calculated for both sexes. No significant differences were found in age and BMI during the three years evaluated (2007, 2010, and 2013). In 2013, waist circumference (WC) increased significantly (p obese), the university students showed significant increases in WC (Females: p = 0.004; Males: p = 0.035) whereas in 2007 and 2010, the values remained relatively stable. BMI remained constant during 2007, 2010, and 2013. However, the university students of both sexes showed greater risk of abdominal obesity as a result of increased WC in 2013.
Olivares, Pedro R; García-Rubio, Javier
To analyze the associations between different components of fitness and fatness with academic performance, adjusting the analysis by sex, age, socio-economic status, region and school type in a Chilean sample. Data of fitness, fatness and academic performance was obtained from the Chilean System for the Assessment of Educational Quality test for eighth grade in 2011 and includes a sample of 18,746 subjects (49% females). Partial correlations adjusted by confounders were done to explore association between fitness and fatness components, and between the academic scores. Three unadjusted and adjusted linear regression models were done in order to analyze the associations of variables. Fatness has a negative association with academic performance when Body Mass Index (BMI) and Waist to Height Ratio (WHR) are assessed independently. When BMI and WHR are assessed jointly and adjusted by cofounders, WHR is more associated with academic performance than BMI, and only the association of WHR is positive. For fitness components, strength was the variable most associated with the academic performance. Cardiorespiratory capacity was not associated with academic performance if fatness and other fitness components are included in the model. Fitness and fatness are associated with academic performance. WHR and strength are more related with academic performance than BMI and cardiorespiratory capacity.
Urrutia, Maria-Teresa; Hall, Rosemary
The purpose of this study was to develop and validate a questionnaire to examine women's beliefs about cervical cancer and the Pap test in Chilean women. The questionnaire, developed following the guidelines by Robert de Vellis, is based on the Health Belief Model. The content validity index was 0.93 upon review by 10 Chilean experts. A cross-sectional design was implemented to validate the questionnaire. The sample included 333 women recruited from a women's healthcare center in Santiago, Chile. Exploratory factor analysis was used to evaluate validity and coefficient α to evaluate reliability. After six models were computed, the questionnaire was reduced from 53 to 28 items. The new questionnaire, CPC-28 (in Spanish, Creencias, Papanicolaou, Cancer -28), includes six domains: the barriers domain to take a Pap test, the cues to action domain, the severity domain, the need to have a Pap test domain, the susceptibility to cervical cancer domain, and the benefit domain. The unexpected salient factor "need to have a Pap test" was found as part of the susceptibility domain proposed in the initial questionnaire. This finding is an important topic for future research. The CPC-28 questionnaire explained 49% of the total variance, and the reliability was .735. It was concluded that the CPC-28 questionnaire will have important implications on research, education, and administration across disciplines. Nursing curricula and healthcare providers must stress the importance and reinforce the importance of prevention of cervical cancer and regular Pap test screenings. © 2013 Sigma Theta Tau International.
Hoyos-Bachiloglu, R; Ivanovic-Zuvic, D; Álvarez, J; Linn, K; Thöne, N; de los Ángeles Paul, M; Borzutzky, A
Food allergies (FAs) affect 2-4% of school-aged children in developed countries and strongly impact their quality of life. The prevalence of FA in Chile remains unknown. Cross-sectional survey study of 488 parents of school-aged children from Santiago who were asked to complete a FA screening questionnaire. Parents who reported symptoms suggestive of FA were contacted to answer a second in-depth questionnaire to determine immediate hypersensitivity FA prevalence and clinical characteristics of school-aged Chilean children. A total of 455 parents answered the screening questionnaire: 13% reported recurrent symptoms to a particular food and 6% reported FA. Forty-three screening questionnaires (9%) were found to be suggestive of FA. Parents of 40 children answered the second questionnaire; 25 were considered by authors to have FA. FA rate was 5.5% (95% CI: 3.6-7.9). Foods reported to frequently cause FA included walnut, peanut, egg, chocolate, avocado, and banana. Children with FA had more asthma (20% vs. 7%, Phistory compatible with anaphylaxis. Of 13 children who sought medical attention, 70% were diagnosed with FA; none were advised to acquire an epinephrine autoinjector. Up to 5.5% of school-aged Chilean children may suffer from FA, most frequently to walnut and peanut. It is critical to raise awareness in Chile regarding FA and recognition of anaphylaxis, and promote epinephrine autoinjectors in affected children. Copyright © 2013 SEICAP. Published by Elsevier Espana. All rights reserved.
Zimmerman, M; Bornstein, R; Martinsson, T
The aim of this study was to evaluate the effects of a simplified oral health programme on attitudes to and knowledge of preventive dentistry. The subjects were Chilean refugees and the programme was delivered at one or two sessions in the form of group information/discussion. Because of increasing immigration, Sweden has become a multicultural society. The number of non-Nordic immigrants has doubled in the past decade. The major refugee groups have come from Iran, Chile and Poland. The subjects comprised 193 Chilean refugees: 106 in a single-visit group and 87 in a two-visit group. The oral health programme was completed by 94 and 65 subjects respectively and was evaluated after 6 months. Positive effects were discernible in attitudes to and knowledge of preventive dentistry, particularly with respect to oral hygiene. A key to success may have been group discussion in which the refugees could relate oral health problems to their own ethnic group. This could have an important function in bridging cultural, linguistic and situational barriers. Different forms of outreach programmes for oral health via groups, organisations or authorities in close contact with refugees shortly after arrival in Sweden are proposed. This approach may be particularly effective in a multicultural society and also in the context of the turbulent conditions the newly-arrived refugee experiences.
Barrett, Elizabeth; Salem, Lesley; Wilson, Sue; O'Neill, Claire; Davis, Kathleen; Bagnulo, Sharif
Chronic kidney disease (CKD) is a significant health problem impacting Australia's Aboriginal and Torres Strait Islander population. After age adjustment, the prevalence of kidney disease is 3.7 times higher in Aboriginal people and 7.3 times higher for end-stage kidney disease compared with the wider population. Yet at an Aboriginal Community Controlled Health Service (ACCHS) with a significant patient population, fewer than expected numbers of Aboriginal patients were identified with CKD. The ACCHS engaged a nurse practitioner to lead a systematic approach to the identification and treatment of CKD. This nurse practitioner-led approach to CKD was developed and implemented at a rural NSW ACCHS, with the support of a partnership formed between the nurse practitioner, the ACCHS, a nephrologist from a referral hospital and a statewide NGO. The primary measure for improvement has been to identify and stage patients with CKD and establish management plans as appropriate. This nurse-led project was established to: (i) identify patients with CKD; (ii) provide access for CKD patients to appropriate services; (iii) commence pharmacological and non-pharmacological strategies that enable remission or regression of CKD; and (iv) educate practice GPs and other staff members on CKD clinical guidelines and best practice. The CKD project has improved access to essential health care for vulnerable and at-risk populations, with 187 patients to date having been identified with kidney disease and staged for its severity. The need for strong multi-disciplinary teamwork has been demonstrated with good communication strategies implemented. © 2015 National Rural Health Alliance Inc.
Korsgaard, Steffen; Müller, Sabine; Tanvig, Hanne Wittorff
Purpose: This article investigates how rural entrepreneurship engages with place and space. It explores the concept of “rural” in rural enterprise, and illustrates the importance of distinguishing between types of rural entrepreneurship. Design/methodology/approach: The constructs of “place” and ...... these processes are enabled and constrained by the immediate context or “place”. The paper weaves space and place in order to show the importance of context for entrepreneurship, which responds to the recent calls for contextualizing entrepreneurship research and theories....
Ruston, Francisco Contreras; Moreti, Felipe; Vivero, Martín; Malebran, Celina; Behlau, Mara
This research aims to accomplish the cross-cultural equivalence of the Chilean version of the VoiSS protocol through its cultural and linguistic adaptation. After the translation of the VoiSS protocol to Chilean Spanish by two bilingual speech therapists and its back translation to English, we compared the items of the original tool with the previous translated version. The existing discrepancies were modified by a consensus committee of five speech therapists and the translated version was entitled Escala de Sintomas Vocales - ESV, with 30 questions and five answers: "Never", "Occasionally", "Sometimes", "Most of the time", "Always". For cross-cultural equivalence, the protocol was applied to 15 individuals with vocal problems. In each question the option of "Not applicable" was added to the answer choices for identification of the questions not comprehended or not appropriate for the target population. Two individuals had difficulty answering two questions, which made it necessary to adapt the translation of only one of them. The modified ESV was applied to three individuals with vocal problems, and there were incomprehensible inappropriate questions for the Chilean culture. The ESV reflects the original English version, both in the number of questions and the limitations of the emotional and physical domains. There is now a cross-cultural equivalence of VoiSS in Chilean Spanish, titled ESV. The validation of the ESV for Chilean Spanish is ongoing. RESUMEN Este estudio tuvo como objetivo realizar la equivalencia cultural de la versión Chilena del protocolo Voice Symptom Scale - VoiSS por medio de su adaptación cultural y lingüística. Después de la traducción del VoiSS para el Español Chileno, por dos fonoaudiólogos bilingües, y de la retro traducción para el inglés, se realizó una comparación de los ítems del instrumento original con la versión traducida, surgiendo discrepancias; tales divergencias fueron resueltas por un comité compuesto por
Koljatic, Mladen; Silva, Monica
The article describes a test-blind admission initiative in a Chilean research university aimed at expanding the inclusion of talented, albeit educationally and socially disadvantaged, students. The outcomes of the test-blind admission cohort were compared with those of students admitted via the regular admission procedure to the same academic…
Besaury, L.; Marty, F.; Buquet, S.; Mesnage, V.; Muijzer, G.; Quillet, L.
Cultivation and molecular-based approaches were used to study microbial diversity in two Chilean marine sediments contaminated with high (835 ppm) and very high concentrations of copper (1,533 ppm). The diversity of cultivable bacteria resistant to copper was studied at oxic and anoxic conditions,
Full Text Available This article deals with the intellectual evolution and political activities of Carlos Keller Rueff between the early 1920s and the late 1930s. It discusses his development from a German nationalist to a Chilean fascist during the course of this eventful period. In the 1920s Keller, who started his career in the Deutsch-Chilenischer Bund, the umbrella organisation of the German-Chilean community, expressed German National positions. Only at the end of the decade he began to distance himself from his narrow, sectarian German sub-culture and took a broader, national view, a development that coincided with his move from Concepción to Santiago and the failure of his plan to revive the immigration of Germans to Chile. With the book La eterna crisis chilena, published in 1931, he finally emerged as a Chilean nationalist and gained the reputation of an intellectual. One year later, in April 1932, he was, together with Jorge González von Marées, one of the founding members of the Chilean Movimiento Nacional Socialista (MNS. Keller became the movement’s ideologue and its second most prominent leader. This career abruptly ended with the failed nacista coup of 5 September 1938 and the subsequent transformation of the MNS into the Vanguardia Popular Socialista
Holmgren, M.; Avilés, R.; Sierralta, L.; Segura, A.M.; Fuentes, E.R.
We show field and experimental evidence that introduced herbivores and soil degradation strongly influence the distribution of introduced herbs in the Chilean matorral. In the field, the relative abundance of introduced species was higher on sites grazed by livestock and on very poor soils. Two
Hervé-Fernández, Pedro; Houlbrèque, Fanny; Boisson, Florence; Mulsow, Sandor; Teyssié, Jean-Louis; Oberhaënsli, François; Azemard, Sabine; Jeffree, Ross
The Chilean blue mussel (Mytilus chilensis, Hupe 1854) represents the most important bivalve exploited along the Chilean coast and is a major food source for the Chilean population. Unfortunately, local fish and shellfish farming face severe problems as a result of bioaccumulation of toxic trace metals into shellfishes. Blue mussels collected along the Chilean coasts contain levels of Cd above the regulatory limits for human consumption. In this study, we examined the bioaccumulation, depuration and organ distribution of Cd in the M. chilensis, from 109Cd-labelled bulk seawater and from feeding with 109Cd-labelled algae. The uptake of 109Cd via seawater displayed a simple exponential kinetic model suggesting that cadmium activity tends to reach an equilibrium value of 1.838+/-0.175 ng g(-1) (mean+/-asymptotic standard error, p food uptake was fast, reaching only 20% of retention in 10 days. This knowledge of the long half-life of cadmium accumulated via seawater as well as the non-negligible level of cadmium accumulated into the shells is relevant to the management of Cd levels in this species and the refinement of detoxification processes in order to comply with authorized Cd levels. 2010 Elsevier B.V. All rights reserved.
Nazar, Gabriela; van der Heijden, Beatrice
Social and economic conditions, as well as the dynamism of the Chilean labour market, place new demands on middle-aged workers who have to explore both internal and external opportunities to develop successful careers. We assumed that possible self and identity in future states are core organizing
Klerkx, L.W.A.; Villalobos, P.; Engler, A.
As in many sectors in emerging economies, the concept of corporate social responsibility (CSR) has become important for exporting agri-food firms in view of their integration in global supply chains. The purpose of this research was to assess the implementation by Chilean fruit exporters of CSR
Blanco, Gustavo; Arce, A.M.G.; Fisher, E.F.
This article examines transformations in the Chilean Patagonia, a region that has become a world leader in Salmon production for global markets. Employing ethnographic methods, this study examines the possibilities of considering inter-subjectivities in the processes of conforming important regions
Ross, S; Gillies, J C
To investigate the differences between the characteristics and career intentions of GP registrars in urban and rural areas, and to make recommendations to reduce a potential work force crisis in rural practice. Postal survey. All general practices in Scotland. In February 1996, 40/196 (20%) of urban and 45/150 (30%) of rural GP registrar places available in Scotland, were vacant (chi 2 = 4.22, df = 1, p = 0.02). Postal questionnaires were sent to all 261 GP registrars in post. Of 235 respondents (90%), the majority wished to remain in general practice (63% of urban and 53% of rural registrars), but only 22% of urban and 18% of rural registrars intended to apply for principal posts immediately after training. Fewer urban (8%) than rural registrars (21%) stated an intention to go abroad to work after training. Rural registrars tended to want to work in rural areas, and vice versa. Part-time and job-sharing were attractive employment options for both groups, and more flexible career structures were favoured by over 80%. Though much more attention has been paid to recruitment in inner cities, the findings from this study suggest that in Scotland difficulties in finding principals may occur first in rural areas. As general practitioners have an extended role in rural areas, including that of emergency care, shortages could have a serious impact on patient care.
Dexter, Franklin; Ahn, Hyun-Soo; Epstein, Richard H
When a practitioner in a preanesthesia evaluation clinic is not evaluating a patient because no patient is waiting to be seen, the practitioner often has other responsibilities such as reviewing charts of patients. When practitioners differ in how quickly they complete evaluations, multiple scenarios can be created wherein the slowest practitioner would only evaluate patients when the number of patients waiting exceeds a threshold (e.g., at least 2 patients are waiting). Review of operations research studies identified conditions for which such management of the queue can be beneficial (e.g., mean evaluation time of the fastest practitioner is less than half that of the slowest practitioner). These conditions were compared with the actual completion rates of certified registered nurse practitioners at a hospital's clinic. The 99.9% confidence intervals (CI) were calculated for ratios of mean evaluation times. The fastest practitioner was typically 1.23 times faster than the second fastest practitioner (CI 1.22-1.23) and 1.61 times faster than the slowest of three practitioners (1.59-1.61). These are significantly less than the 3 times and 2 times faster, respectively, that would be sufficiently large to warrant managing queue discipline. Practitioners with longer mean evaluation times had larger percentage utilizations of working time (Kendall τb = 0.56, P = 0.0001), inconsistent with preferential assignment of patients to the fastest practitioner(s) available. Practitioners' speeds in evaluating patients do not differ sufficiently for information systems to be used routinely to choose who evaluates the next patient (i.e., state-dependent assignment policy). Clinics aiming to reduce patient waiting should focus on reducing the overall mean evaluation time (e.g., by chart review ahead), appropriately scheduling patients, and having the right numbers of nursing assistants and practitioners.
Barr, Megan; Duncan, Jill; Dally, Kerry
Children in regional, rural and remote areas have less access to services than those living in urban areas. Practitioners serving children with a hearing loss have attempted to address this gap, however there are few studies investigating service access and experiences of non-metropolitan families and professionals. This systematic review…
Brendle, Janna; Tucker, Kathryn J.; Lock, Robin H.
Transition planning requires quality vocational and transition assessment tailored to the student's needs, strengths, preferences and interests. Limited research is currently available that addresses assessment types and use of results that rural practitioners utilize to aid in transition planning for students with intellectual disabilities (ID).…
In the rural environment, faced with people in situations of precarity, the nurse is an ideal partner for health professionals, as a general practitioner working in a centre for emergency housing and social reintegration explains. Copyright © 2018 Elsevier Masson SAS. All rights reserved.
Ghaida M.J. Al-Shoraian
Full Text Available Background: Job burnout is an important syndrome that can deplete the emotional health aspects of physicians. Its impacts are reflected both on the physicians and their patients through undermining the performance of physicians and degrading the quality of the administered medical care leading to dissatisfaction of the patients about the medical service. Objectives: This study is formulated to compare the prevalence of high burnout among family physicians and general practitioners and reveal the predictors of high grades of burnout among physicians. Subjects and methods: A cross sectional study was carried out. Out of 378 physicians working in two health regions in Kuwait, 200 physicians returned a filled questionnaire, of these 105 were family physicians and the rest were primary health care physicians. Maslach Burnout Inventory–Human Service Survey tool was used to estimate high degree of burnout on three domains, namely emotional exhaustion, depersonalization and personal accomplishment. Results: General practitioners were more likely to suffer from high grades of emotional exhaustion (63.2% than family physicians (19.0%. They also suffered from high grade of depersonalization (65.3% compared with family physicians (27.6%. Those suffering from high grades of personal accomplishment burnout (inverse score constituted 61.1% of primary health care physicians and 33.3% of family physicians. Those suffering from grades for the three burnout domain constituted more than one third of primary health care physicians (36.8% compared with only 5.7% of family physicians. Type of physician job and marital status proved to be significant predictors of high grades of burnout. Conclusion: Burnout is more common among primary care than family physicians. Searching for and eliminating all sources of stress in the primary health care centers in addition to training of these physicians on coping strategies to deal with stress at work seems to be an important
Colthart, Iain; McBride, Margot; Murray, Maria
Purpose: The aim of this study was to evaluate the experiences of diagnostic and therapeutic radiographers as they mentored trainee assistant practitioners undertaking an educational programme. The evaluation study describes the challenges and benefits the radiographers experienced as mentors as well as giving their insights into the introduction of assistant practitioners in their departments. Method: The mentors' opinions were sought by a questionnaire which formed part of the evaluation of the respective diagnostic imaging and therapeutic educational programmes run by two colleges. Results: The response rate was 54% (22/41). Mentors described personal and professional benefits for themselves from undertaking this role. Although mentoring had provided a number of challenges including an increase in workload, the experience had also enhanced their teaching and mentoring skills and contributed to their Continuing Professional Development (CPD). Whilst the role was more time consuming than initially expected this had not impacted generally on their ability to undertake CPD or deliver patient care. In relation to the wider impact of the programmes some negative impact was reported on the speed of service delivery but not on the quality of practice. Mentors felt that the programmes had a positive effect on teamworking and had been beneficial for patient care. Some difficulties were noted in balancing the mentoring of trainee assistant practitioners and radiography undergraduates. Conclusion: The mentors strongly endorsed the educational programmes and their roles and responsibilities in their delivery. Protected time to carry out mentoring duties and establishing good communication with the colleges providing the theoretical teaching were identified as means of further improving the mentoring process.
Tulinius, Charlotte; Hølge-Hazelton, Bibi
OBJECTIVES: The profession of medicine has long been characterised by virtues such as authorisation, specialisation, autonomy, self-regulation and adherence to an ethical code of practice, and its complexity has granted it the privilege of self-regulation. Studies have shown continuing professional...... development (CPD) for general practitioners (GPs) to be most effective when it is set up within a multi-method design. This paper reports a research-based evaluation of a 2-year educational CPD project for 21 GPs. METHODS: The project focused on the issue of 'children in need' and was delivered through group...
Morrison, Mark; Murphy, Tom; Nalder, Craig
This study focuses on segmenting the market for General Practitioner services in a regional setting. Using factor analysis, five main service attributes are identified. These are clear communication, ongoing doctor-patient relationship, same gender as the patient, provides advice to the patient, and empowers the patient to make his/her own decisions. These service attributes are used as a basis for market segmentation, using both socio-demographic variables and cluster analysis. Four distinct market segments are identified, with varying degrees of viability in terms of target marketing.
Dredge, Dianne; Benckendorff, Pierre; Day, Michele
the balance between higher order knowledge in liberal education and skills-based vocational education required by industry; and it builds upon the Philosophic Practitioner Education to conceptualise a curriculum space that is socially constructed, dynamic and flexible. The proposed framework incorporates......This chapter reviews contemporary debates about tourism and hospitality education to conceptualise a curriculum space framework that can be used to facilitate understanding and decision making. The chapter is conceptual and makes two key contributions: it draws together diverse discourses about...
Although virtualization is a widely accepted technology, there are few books dedicated to virtualization and security. Filling this need, Securing Cloud and Mobility: A Practitioner's Guide explains how to secure the multifaceted layers of private and public cloud deployments as well as mobility infrastructures. With comprehensive coverage that includes network, server, and endpoint security, it provides a strategic view of the security implications of virtualization and cloud computing. The book begins by deconstructing the terminology of cloud computing. It explains how to establish a secure
Videbæk, Solvej; Jensen, A V; Rasmussen, S
BACKGROUND: General Medical Practitioners (GMP) in Denmark perform clinical examinations of patients with musculoskeletal pain. However, the prevalence proportion of examinations caused by running-related injuries remains unknown. PURPOSE: The primary purpose of the present study was to estimate...... the prevalence proportion of consultations in general medical practice caused by running-related injuries. The secondary purpose was to estimate the prevalence proportion of injured runners, who consult their GMP, that are referred to additional examinations or treatments. STUDY DESIGN: A survey-based study...
... people with partial edentulism when compared to urban (Urban, 38.4%, High Poverty Rural 51.3%, Other Rural, 45%). Counties with high rates of full edentulism are also rural (Urban, 4.3%, High-Poverty Rural 10.5%, Other Rural, 8.2%). ( Mitchell, ...
Backman, Kenneth; And Others
This publication provides a variety of information on prevention and intervention programs for rural and urban children and adolescents. Drawing from a rural sociological perspective, the introductory paper defines "rural," discusses rural-urban economic and social differences, and lists indicators of risk for rural youth. It discusses the extent…
Delansorne, Fanny; Buis, Hélène; Robino, Stéphane; Tomas, Josiane; Huez, Jean-François; Fanello, Serge
The purpose of this study is to conduct a census of general practitioners in order to better understand their early withdrawal from primary care practice and to assess the impact of such withdrawal on current medical demography. The study covers the withdrawals from January 2000 to December 2005 in three western French counties. Data were collected through the district councils of the practitioners'guild, followed by a questionnaire filled in by 75 doctors. The participation rate was 60%. The study reveals that only 29% of these withdrawals are due to retirement. More than one in two doctors left to pursue another paid employment, and more than 25% chose to relocate their practice in a different area of the county. Two thirds of them were practicing in rural or semi-rural locations. Less than half, 47%, were replaced by a successor. General practitioners surveyed did not stop all professional medical care provision and service activities. Their careers are complex, and they are mobile professionals. The main reasons for suspending their activities in a given location were essentially related to the difficulties they had in dealing with their work loads and in maintaining a healthy work-life balance. They have noted that they will leave a range of possibilities open, either looking for private practice or not, exploring the possibility of primary care or not; the basis of their decision is whether a new position will correspond to their desire of mobility and meet their needs for more free.
Cook, A D; Copans, S A; Schetky, D H
Rural child and adolescent psychiatry offers many challenges, a varied and interesting practice, and the satisfaction of performing needed and important work in an environment in which one's presence is valued. The successful psychiatrist can expect to be an integrated and appreciated member of the community. The fit is not a good one for every practitioner, however. Not only are incomes lower, although the cost of living is low as well, but practitioners may find they have only exchanged urban stresses for rural pressures. The characteristics important for the child and adolescent psychiatrist are the same for rural and urban settings: flexibility, creativity and innovation, competence, self confidence, a good sense of boundaries, a good balance between personal and private life, supportive personal relationships, and a sense of humor. One must be a child advocate, have a willingness to give of one's self and one's time, and be down to earth, comfortable with oneself, and capable of self entertainment. Training programs with access to rural populations can introduce residents to rural child and adolescent psychiatry while supporting those who are already in practice. The authors hope that this article will promote a dialogue with psychiatrists considering relocation to a rural area and encourage training programs to prepare residents for rural practice.
Shannon, C Ken; Jackson, Jodie
The validity of medical student projection of, and predictors for, rural practice and the association of a measure of service orientation, projected practice accessibility to the indigent, were investigated. West Virginia (WV) medical student online pre- and postrural rotation questionnaire data were collected during the time period 2001-2009. Of the 1,517 respondent students, submissions by 1,271 met the time interval criterion for inclusion in analyses. Subsequent WV licensing data were available for 461 in 2013. These 2 databases were used to assess for validity of projection of rural practice, for predictors of rural practice, and for student projected accessibility of the future practice to indigent patients. There were statistically significant associations between both pre- and postrotation projections of rural practice and subsequent rural practice. The most significant independent predictors of rural practice were student rural background, reported primary care intent, prediction of rural practice and projection of greater accessibility of the future practice to indigent patients. For scoring of practice access, there were trends for higher scoring by rural students and rural practitioners, with greater pre-post increases for those with urban hometowns. This study demonstrates the utility of medical student questionnaires for projections of numbers of future rural physicians. It suggests that students with a rural background, rural practice intent, or greater service orientation are more likely to enter rural practice. It also suggests that students, particularly those with urban hometowns, are influenced by rural rotation experiences in forecasting greater practice accessibility and in entering rural practice. © 2015 National Rural Health Association.
A literature review for studies of job satisfaction among nurse practitioners (NPs) suggests that the true determinants of job satisfaction have not been discovered. The purpose of this study was to determine job satisfaction among adult health NPs (ANPs) practicing in Arizona. The Misener nurse practitioner job satisfaction scale was mailed to 329 Arizona ANPs who were certified by the Arizona State Board of Nursing (47% response rate). The mean overall satisfaction score was 4.69 out of a possible score of 6.0 for very satisfied. Differences in employer type, gender, annual income, membership in professional nursing organization, or full-time versus part-time employment status did not result in significantly different scores on the job satisfaction scale in this group. A deep and sustained nursing shortage, the exodus of experienced nurses from the profession, and a projected shortage of primary care providers have generated interest among professional groups, private and government healthcare commissions, and the healthcare industry in determining what factors may influence an individual to choose and remain active in nursing practice. Researchers, educators, employers, and the healthcare industry must look beyond well-worn assumptions about job satisfaction to explore what the individual NP finds satisfying about his or her role.
Freed, Gary L; Dunham, Kelly M; Martyn, Kristy; Martin, Jean; Moran, Lauren M; Spera, Laura
The demand for hiring pediatric nurse practitioners (PNPs) is strong. However, the number of newly educated PNPs has remained relatively flat during the past several years. Understanding the rationale and timing for the decision to pursue this profession is essential to having a positive impact on increasing the future workforce. A mail survey of all new PNPs certified between January 2009 and July 2011 (N = 1040) was conducted. The response rate was 79.9%. Nearly half of all respondents (45%, N = 314) reported that they work in outpatient general pediatrics, 26% (N = 184) in outpatient subspecialty pediatrics, and 22% (N = 152) in inpatient settings. More than one third (36%, N = 253) spend most of their time in a private practice. Forty percent (N = 307) reported that they decided to pursue education as an advanced practice nurse while in practice as a registered nurse (RN), and 38% (N = 289) made the decision before pursuing RN education. Efforts to increase the PNP pipeline will need to be directed both to students during their RN education and to creating opportunities for current RNs to pursue advanced practice nurse education that is focused on children. Copyright © 2014 National Association of Pediatric Nurse Practitioners. Published by Mosby, Inc. All rights reserved.
O'Rourke, Nancy C; Crawford, Sybil L; Morris, Nancy S; Pulcini, Joyce
Twenty-eight states have laws and regulations limiting the ability of nurse practitioners (NPs) to practice to the full extent of their education and training, thereby preventing patients from fully accessing NP services. Revisions to state laws and regulations require NPs to engage in the political process. Understanding the political engagement of NPs may facilitate the efforts of nurse leaders and nursing organizations to promote change in state rules and regulations. The purpose of this study was to describe the political efficacy and political participation of U.S. NPs and gain insight into factors associated with political interest and engagement. In the fall of 2015, we mailed a survey to 2,020 NPs randomly chosen from the American Academy of Nurse Practitioners' database and 632 responded (31% response rate). Participants completed the Trust in Government (external political efficacy) and the Political Efficacy (internal political efficacy) scales, and a demographic form. Overall, NPs have low political efficacy. Older age ( p≤.001), health policy mentoring ( p≤.001), and specific education on health policy ( p≤.001) were all positively associated with internal political efficacy and political participation. External political efficacy was not significantly associated with any of the study variables. Political activities of NPs are largely limited to voting and contacting legislators. Identifying factors that engage NPs in grassroots political activities and the broader political arena is warranted, particularly with current initiatives to make changes to state laws and regulations that limit their practice.
Kleinpell, Ruth; Kapu, April N
Evaluating the impact of nurse practitioner (NP) practice has become a priority area of focus for demonstrating outcomes. A number of quality measures are available to enable practice-specific evaluation of NP roles and initiatives. This article reviews sources of quality measures that can be used to facilitate quantifying the outcomes of NP practice as part of an overall evaluation agenda. National resources and published literature on NP quality measures were reviewed. Various resources and toolkits exist to assist NPs in identifying outcomes of practice using quality measures. The need to demonstrate outcomes of NP practice remains an ongoing priority area regardless of the clinical practice setting. A variety of sources of quality measures exist that can be used to showcase the effect of NP care. The use of quality measures can be effectively integrated into evaluation of NP role and NP-directed initiatives to demonstrate impact, and enhance the conduct of an NP outcomes assessment. The use of organizational, NP-specific, and national-related quality measures can help to showcase how NP care improves the quality, safety, and costs of health care. ©2017 American Association of Nurse Practitioners.
Full Text Available Much of the literature on reentry of formerly incarcerated individuals revolves around discussions of failures they incur during reintegration or the identification of needs and challenges that they have during reentry from the perspective of community corrections officers. The present research fills a gap in the reentry literature by examining the needs and challenges of formerly incarcerated individuals and what makes for reentry success from the perspective of correctional practitioners (i.e., wardens and non-wardens. The views of correctional practitioners are important to understand the level of organizational commitment to reentry and the ways in which social distance between correctional professionals and their clients may impact reentry success. This research reports on the results from an email survey distributed to a national sample of correctional officials listed in the American Correctional Association, 2012 Directory. Specifically, correctional officials were asked to report on needs and challenges facing formerly incarcerated individuals, define success, identify factors related to successful reentry, recount success stories, and report what could be done to assist them in successful outcomes. Housing and employment were raised by wardens and corrections officials as important needs for successful reentry. Corrections officials adopted organizational and systems perspectives in their responses and had differing opinions about social distance. Policy implications are presented.
Weiland, Sandra A
To examine factors that influence the ability of nurse practitioners (NPs) to practice as independent primary care providers. Extensive literature search on CINAHL, OVID, MEDLINE, Internet journal sources, and professional association Web sites. The legal authority for NPs to practice independently is recognized; however, the ability to put that authority into practice is undermined by the historical failure of political, professional, and social entities to recognize NPs as providers capable of providing primary care autonomously. Nonrecognition is responsible for complex reimbursement policies (both federal and state) that economically and professionally restrain the NP role; hence, NPs remain in a financially dependent relationship despite 40 years of proven safe practice. NPs must articulate their independence as practitioners more vociferously in order to meet society's healthcare requirements, as well as to attain professional fulfillment and forge collegial relationships. NPs will never be seen as members of a profession by either themselves or others without the practicality of independence and autonomy. Although legal independence is a fact, real practice independence in the pragmatic sense is contingent upon reimbursement. Without fiscal sustainability, practice independence is an impossibility. And, without professional autonomy, NPs will have only an employee's voice in the dynamic healthcare system in which they are really key players in providing healthcare services to the poor and undeserved populations.
Full Text Available OBJETIVO: Determinar la prevalencia de vaginosis bacteriana (VB en trabajadoras sexuales chilenas y relacionar los hallazgos con variables sociodemográficas, sexuales y clínicas. MÉTODO: Se estudió una muestra de 379 trabajadoras sexuales que asistían para control a Unidades de Atención y Control de Salud Sexual de Chile. A todas se las entrevistó para obtener antecedentes sociodemográficos y sexuales, se les realizó evaluación clínica que incluyó características del flujo vaginal, pH y prueba de aminas, y se les tomó una muestra vaginal para tinción de Gram. Para el diagnóstico de VB se empleó el criterio de Nugent. Los datos fueron analizados con EPI-INFO 3.4.1 y BioStat, utilizándose un grado de significación de P OBJECTIVE: To determine the prevalence of bacterial vaginosis (BV in Chilean sex workers and relate the findings to sociodemographic, sexual, and clinical variables. METHODS: A sample of 379 sex workers seen in Chilean Sexual Health Monitoring and Care Units for check-ups was studied. All of them were interviewed to obtain their sociodemographic and sexual history. A clinical examination was performed that included the characteristics of vaginal discharge, pH, and amine test. A vaginal sample was taken for Gram stain. The Nugent criteria were used for the diagnosis of BV. The data was analyzed with EPI-INFO 3.4.1 and BioStat, using a degree of significance of P < 0.005. RESULTS: BV prevalence was 69.1%. The syndrome was not associated with the sociodemographic variables, age or education. BV was less common in women (married or unmarried who lived with their partners than in single women (P < 0.001. There were no sexual variables associated with BV, whereas use of intrauterine devices was related (P < 0.0001. The presence of vaginal discharge, abnormal vaginal pH, and positive amine test were associated with infection (P < 0.0001. CONCLUSIONS: Like other studies conducted in different countries, this study
Barlow, Ian M
Adding or incorporating clinical interpretative comments on biochemistry results is widespread in UK laboratories; although this consumes considerable human resource, there is still little evidence to suggest that it is either effective or appreciated by our clinical colleagues. I therefore decided to survey our local general practitioners (GPs) and nurse practitioners to analyse whether they found biochemistry comments on reports helpful. A simple questionnaire was designed and sent to 159 GPs and 81 nurse practitioners asking them whether they found this activity useful for the limited range of test groups that we routinely comment on and also whether they would like to see commenting on more groups of tests. Overall, 49.6% of questionnaires were returned. Of these, there was overwhelming support for commenting on reports and 77% would like to see comments on a greater range of tests. Although adding clinical interpretative comments is very time-consuming for senior laboratory staff, there is overwhelming support of this activity among our GPs and nurse practitioner users; therefore, our local policy of routinely adding clinical comments will remain for the foreseeable future.
Molinari, D L; Monserud, M A
The lack of rural nursing studies makes it impossible to know whether rural and urban nurses perceive personal and organizational factors of job satisfaction similarly. Few reports of rural nurse job satisfaction are available. Since the unprecedented shortage of qualified rural nurses requires a greater understanding of what factors are important to retention, studies are needed. An analysis of the literature indicates job satisfaction is studied as both an independent and dependent variable. In this study, the concept is used to examine the intention to remain employed by measuring individual and organizational characteristics; thus, job satisfaction is used as a dependent variable. One hundred and three rural hospital nurses, from hospitals throughout the Northwest region of the United States were recruited for the study. Only nurses employed for more than one year were accepted. The sample completed surveys online. The McCloskey/Mueller Satisfaction Scale, the Gerber Control Over Practice Scale, and two open-ended job satisfaction questions were completed. The qualitative analysis of the open-ended questions identified themes which were then used to support the quantitative findings. Overall alphas were 0.89 for the McCloskey/Mueller Scale and 0.96 for the Gerber Control Over Practice Scale. Rural nurses indicate a preference for rural lifestyles and the incorporation of rural values in organizational practices. Nurses preferred the generalist role with its job variability, and patient variety. Most participants intended to remain employed. The majority of nurses planning to leave employment were unmarried, without children at home, and stated no preference for a rural lifestyle. The least overall satisfied nurses in the sample were employed from 1 to 3 years. Several new findings inform the literature while others support previous workforce studies. Data suggest some job satisfaction elements can be altered by addressing organizational characteristics and by
The intent and purpose of this manual is to describe the various guideliness and administrative procedures associated with the Alberta Rural Gas Program and to consolidate and expand upon the legislation under which the Program has been developed. It is intended primarily for the use and information of rural gas distributors, their agents, and other private or government parties having an interest in the Rural Gas Program. Information is presented on: rural gas franchises, technical applications, contracts and tenders, determination of system capital costs for grant support, grants, Gas Alberta brokerage arrangements, insurance coverage, utility rights-of-way, and lien notes.
Full Text Available Background: In 2012, a pilot health policy of contractual service relations between general practitioners and patients was implemented in China. Due to the decline in body and cognitive function, as well as the lack of family care and narrow social support networks, the demand of health services among the elderly is much higher than that among the general population. This study aims to probe into the empty nesters’ willingness-to-pay for general practitioners using a contractual service policy, investigating empty nesters’ payment levels for the service, and analyze the main factors affecting the willingness of empty-nesters’ general practitioners using contractual service supply cost. Methods: This cross-sectional study adopted a multistage stratified sampling method to survey 865, city empty nesters (six communities in three districts of one city aged 60–85 years. A condition value method was used to infer the distribution of the willingness-to-pay; Cox’s proportional hazards regression model was used to analyze the influencing factors of willingness-to-pay. Results: More than seventy percent (76.6% of the empty nesters in this city were willing to pay general practitioners using contract service in Chongqing. The level of willingness-to-pay for the surveyed empty nesters was 34.1 yuan per year. The median value was 22.1 yuan per year, which was below the Chongqing urban and rural cooperative medical insurance individual funding level (60 yuan per year in 2013. Cox’s proportional hazards regression model analysis showed that the higher the education level was, the worse the self-reported health status would be, accompanied by higher family per capita income, higher satisfaction of community health service, and higher willingness-to-pay empty nesters using a contract service. Women had a higher willingness-to-pay than men. Conclusions: The willingness-to-pay for general practitioners by contractual service is high among city empty
Chen, Fei; Xu, Xiang-Long; Yang, Zhan; Tan, Hua-Wei; Zhang, Liang
In 2012, a pilot health policy of contractual service relations between general practitioners and patients was implemented in China. Due to the decline in body and cognitive function, as well as the lack of family care and narrow social support networks, the demand of health services among the elderly is much higher than that among the general population. This study aims to probe into the empty nesters' willingness-to-pay for general practitioners using a contractual service policy, investigating empty nesters' payment levels for the service, and analyze the main factors affecting the willingness of empty-nesters' general practitioners using contractual service supply cost. This cross-sectional study adopted a multistage stratified sampling method to survey 865, city empty nesters (six communities in three districts of one city) aged 60-85 years. A condition value method was used to infer the distribution of the willingness-to-pay; Cox's proportional hazards regression model was used to analyze the influencing factors of willingness-to-pay. More than seventy percent (76.6%) of the empty nesters in this city were willing to pay general practitioners using contract service in Chongqing. The level of willingness-to-pay for the surveyed empty nesters was 34.1 yuan per year. The median value was 22.1 yuan per year, which was below the Chongqing urban and rural cooperative medical insurance individual funding level (60 yuan per year) in 2013. Cox's proportional hazards regression model analysis showed that the higher the education level was, the worse the self-reported health status would be, accompanied by higher family per capita income, higher satisfaction of community health service, and higher willingness-to-pay empty nesters using a contract service. Women had a higher willingness-to-pay than men. The willingness-to-pay for general practitioners by contractual service is high among city empty nesters in Chongqing, thus, individual financing is feasible. However
Pérez-Ayuso, Rosa María; Hernández, Verónica; González, Berta; Carvacho, Claudia; Navarrete, Carlos; Alvarez, Manuel; González, Robinson; Marshall, Guillermo; Miquel, Juan Francisco; Nervi, Flavio
Cholelithiasis is the second cause of hospital admissions in Chile. To study the prevalence of symptomatic gallstone disease and opportunity of cholecystectomy in La Florida, Santiago and among Mapuche Indians in Huapi Island. In the period 2000-2001, we contacted to 71% (1127 subjects) and to 61% (145 subjects) patients of La Florida and Huapi Island, respectively, that had previously participated in an epidemiological study on cholelithiasis in 1993. We defined symptomatic gallstone patients as those with a history of biliary colic. Each patient was subjected to gallbladder ultrasound. In 1993, 30-35% of gallstone patients were symptomatic (approximately 70% women). During the lapse 1993-2001, only 50% of subjects from La Florida and 25% of patients from Huapi Island were cholecystectomized (p Mapuche Indians from Huapi, cholecystectomy was indicated in 2001. After five months of the indication, only one of these subjects had been operated. Laparoscopic cholecystectomy represented 40% of all cholecystectomies performed in the National Health Service Hospitals. This study demonstrates an unacceptable high prevalence of symptomatic gallstone patients remaining non-operated in both the urban and rural communities. This reciprocally correlates with the high frequency of emergency cholecystectomies and the high incidence of gallbladder cancer among Chileans. This study contrasts negatively with the situation of Scotland, where 73.5% of cholecystectomies were laparoscopic in 1998-1999. To reach Scotland standards, the Chilean Public Health System should increase the number of cholecystectomies from 27,000 in 2001 to 57,510
Llewellyn, Paul Francis
Resumé of History major: “The attitude of the Chilean newspaper ‘El Mercurio’ towards the main economic policies of the Popular Unity government of Salvador Allende (1970-73)” By Paul Francis Llewellyn Department of History University of Oslo, Norway Autumn 2002 Introduction This investigation will show in what manner the conservative daily newspaper El Mercurio presented the main economic policies of the Chilean left-wing Popular Unity (UP) government during its ter...
Hidalgo-Ruz, Valeria; Honorato-Zimmer, Daniela; Gatta-Rosemary, Magdalena; Nuñez, Paloma; Hinojosa, Iván A; Thiel, Martin
We examined the hypothesis that in an emerging economy such as Chile the abundances of Anthropogenic Marine Debris (AMD) on beaches are increasing over time. The citizen science program Científicos de la Basura ("Litter Scientists") conducted three national surveys (2008, 2012 and 2016) to determine AMD composition, abundance, spatial patterns and temporal trends. AMD was found on all beaches along the entire Chilean coast. Highest percentages of AMD in all surveys were plastics and cigarette butts, which can be attributed to local sources (i.e. beach users). The Antofagasta region in northern Chile had the highest abundance of AMD compared with all other zones. Higher abundances of AMD were found at the upper stations from almost all zones. No significant tendency of increasing or decreasing AMD densities was observed during the 8years covered by our study, which suggests that economic development alone cannot explain temporal trends in AMD densities. Copyright © 2017 Elsevier Ltd. All rights reserved.
Rojas-Barahona, Cristian A; Zegers, Beatriz; Förster, Carla E
Self-esteem is positively associated to the well being of people and could be a good mental health indicator. To determine the reliability and validity of the Rosenberg Self-esteem Scale in a Chilean adult sample. The instrument was applied to 473 subjects living in the Metropolitan Region of Santiago, evenly distributed according to gender, age, educational level and income. The Neugarten Life Satisfaction index (LSI-A) was also applied to the sample. Cronbach's alpha for reliability of the scale was 0.754. There was no gender bias and factor analysis grouped items into two factors (5 positive and 5 negative). The instrument had a correlation of 0.455 with the LSI-A. The Rosenberg Self-esteem Scale meets the criteria for validity and reliability of a quality instrument to measure self-esteem in Chile.
Han, Yoonsun; Grogan-Kaylor, Andrew; Bares, Cristina; Ma, Julie; Castillo, Marcela; Delva, Jorge
This study investigated the role of discrepancies between parent and youth reports of perceived parental monitoring in adolescent problem behaviors with a Chilean sample (N= 850). Higher levels of discordance concerning parental monitoring predicted greater levels of maladaptive youth behaviors. A positive association between parent-youth discordance and externalizing problems indicated that large adult-youth disagreement in parental monitoring may impose a great risk, despite protective efforts of parental monitoring. Although the direct relationship between parental monitoring and youth internalizing behaviors was not significant, parent-youth incongruence in monitoring was associated with greater levels of internalizing behaviors. Therefore, differing assessments of parental behaviors, as an indicator of less optimal family functioning, may provide important information about youth maladjustment and may potentially provide a beginning point for family-focused intervention. PMID:23097593
Luis Fernando De Matheus e Silva
Full Text Available The intention of this paper is to present a renewed and critical reading about the contradictions engendered by the neoliberal modernization of the Chilean agriculture. This task is carried out through the lens of the "historical-geographical materialism" developed mainly by the British geographer David Harvey, and also through agrarian studies linked to the critical thinking, especially Marxists. As the main empirical substrate, information and data supplied by documents and studies that have sought to understand the specific case of contemporary capitalist development in Chile as well as its consequences for the countryside and national peasants are used. It is sustained here that the mechanisms of “accumulation by dispossession” were (and still are of critical importance to make Chile a world-wide agricultural and food.
González-Martín, Ma Inmaculada; Wells Moncada, Guillermo; González-Pérez, Claudio; Zapata San Martín, Nelson; López-González, Fernando; Lobos Ortega, Iris; Hernández-Hierro, Jose-Miguel
Instrumental techniques such a near-infrared spectroscopy (NIRS) are used in industry to monitor and establish product composition and quality. As occurs with other food industries, the Chilean flour industry needs simple, rapid techniques to objectively assess the origin of different products, which is often related to their quality. In this sense, NIRS has been used in combination with chemometric methods to predict the geographic origin of wheat grain and flour samples produced in different regions of Chile. Here, the spectral data obtained with NIRS were analysed using a supervised pattern recognition method, Discriminat Partial Least Squares (DPLS). The method correctly classified 76% of the wheat grain samples and between 90% and 96% of the flour samples according to their geographic origin. The results show that NIRS, together with chemometric methods, provides a rapid tool for the classification of wheat grain and flour samples according to their geographic origin. Copyright © 2013 Elsevier Ltd. All rights reserved.
Jorge Castellá Sarriera
Full Text Available This study compared the 7-item Personal Wellbeing Index (PWI with two other versions which include the domains "Spirituality" and "Religion", separately, in a sample of Brazilian (n = 1.047 and Chilean (n = 1.053 adolescents. A comparison of psychometric properties between the PWI versions was carried out through multigroup confirmatory factor analysis showing adequate adjustments (CFI > .95, RMSEA < .08, whereas the item spirituality presented better performance. For the analysis of the differential contribution of each domain to the notion of global satisfaction, a regression on the item Overall Life Satisfaction (OLS was applied using structural equations. It is recommended the inclusion of the item spirituality in the original scale, considering the importance of such domain in both cultures.
Patricio De los Ríos-Escalante
Full Text Available Chilean inland-water ecosystems are characterized by their low species-level biodiversity. This study analyses available data on surface area, maximum depth, conductivity, chlorophyll-α concentration, and zooplankton crustacean species number in lakes and ponds between 23° and 51°S. The study uses multiple regression analysis to identify the potential factors affecting the species number. The partial correlation analysis indicated a direct significant correlation between chlorophyll-α concentration and species number, whereas the multiple regression analysis indicated a direct significant response of species number to latitude and chlorophyll-α concentration. These results agree with findings from comparable ecosystems in Argentina and New Zealand.
Petitpierre, Eduard; Elgueta, Mario
Three species of Chilean leaf beetles were chromosomally analyzed. The endemic Araucanomela wellingtonensis displays a male meioformula of 13 + Xyp with 2n = 28 chromosomes and an asymmetric karyotype with two large autosome pairs and 12 medium/small pairs of autosomes and sex-chromosomes, a diploid number which had not been found among the other species of the subtribe Paropsina sensu lato studied to date. Strichosa eburata presents a meioformula of 11 + Xyp, 2n = 24 chromosomes, as occurs in many species of chrysomelines belonging to different subtribes. Furthermore, Phaedon cyanopterum has a 16 + Xyp meioformula, that is 2n = 34 chromosomes, of small size mostly, also in agreement with the karyological findings obtained in all the other congeneric species so far examined. These cytogenetic data are discussed with respect to the previous ones in this subfamily and with other characters of taxonomic and evolutionary value.
Guzowski, C.; Recalde, M.
From the mid eighties on, most of Latin American Countries reformed their energy systems. The impact of these reforms over electricity markets was different in each case. However, in the majority of these cases there was a shift to private participation, instead of State, and a convergence of electricity systems to hydro and thermal technologies. This is the case of Argentina and Chile. In this context, the aim of this paper is to discuss the current situation of renewable energies in Chilean and Argentinean electric markets and the potential to increase their share in total energy supply. To this purpose, we firstly study electricity deregulation process and its current situation. Secondly, we analyze renewable energy share in these electricity systems comparatively to worldwide situation. Finally, we briefly present the policy instruments used in each country. (author)
Raineri, R.; Giaconi, P.
This paper presents and analyzes a model of electricity distribution in Chile with three alternative regulatory pricing contract schemes for assigning a common capacity cost to final customers and competitive energy sellers. The first scheme involves Ramsey Pricing, while under the second and third schemes the monopoly chooses final prices and access charges subject either to a peak-load Physical Cap or a total revenue Price Cap constraint. In addition, we consider circumstances in which the regulator does not know consumer demand, the monopoly cannot price discriminate beyond a range defined by the marginal cost as a floor and the stand-alone cost as a ceiling, and access charges are set at the fully distributed cost allocation level currently in force. The model is calibrated with Chilean data, and demonstrates that in terms of social welfare the fully distributed cost contract scheme currently in effect can be improved by discriminatory pricing complemented by certain of the analyzed constraints. (author)
Full Text Available The by-catch of sharks in artisanal demersal pink cusk-eel (Genypterus blacodes and yellownose skate (Dipturus chilensis fisheries is frequent within their fishing effort. Nevertheless, there is no registry of landings, which could help to control this problem. This is particularly evident for endemic species, which includes most coastal and deep water Chilean sharks. The main systematic characteristic of these Chondrichthyan species is the external morphology of the neurocraneum. The form and arrangement of the teeth and dermal denticles allow specific differences to be identified. The objective of this paper is to contribute to the biology and systematic knowledge of demersal shark species, teeth and dermal denticle morphology and neurocraneum morphometrics of two species of Scyliorhinids, the redspotted catshark (Schroederichthys chilensis and the dusky catshark (Halaelurus canescens, as well as three Squaliforms, the granular dogfish (Centroscyllium granulatum, the birdbeak dogfish (Deania calcea and the spiny dogfish (Squalus acanthias.
María Angélica Franken Osorio
Full Text Available The following paper explores the recent Chilean narrative which recalls childhood during the dictatorship, the so-called “literatura de los hijos” (literature of sons and daughters, establishing an aesthetic and discoursive link between shared memory and the development imaginaries of those who were children during the dictatorial past and that are writers in the post-dictatorial present. The affective continuity of a conflict, between a present state of memory and a past of childhood learning, still incomplete or with potential for understanding, explains the perspective chosen of sons and daughters of the narrators in some of the fictional works by Nona Fernández (1971, Álvaro Bisama (1975, and Alejandro Zambra (1975. In the three imaginary constructions explored in the following pages, the aim of these authors is described, in terms of their intention to articulate, within fiction, childhood imaginaries that establish and explain their current social, intellectual, and affective positions.
Previous studies have demonstrated that justifying the social, economic, and political systems is associated with psychological well-being, which has been termed as the palliative function of ideology. However, little research has been conducted on gender stereotypes among children, comparing by socioeconomic status. This study aimed to fill this gap in the system justification literature. We present data from the Chilean version of the International Survey of Children Well-Being (ISCWeB), which was conducted in 2012. We found that the palliative function of gender stereotypes is present among this sample, being qualified by a socioeconomic status by hostile gender stereotype interaction. In other words, the effect on the psychological well-being was observed in low-status, but not in high-status students. These results extend the previous knowledge about the palliative function of the ideology, suggesting why the low-status members of a society actively engage in system justification. PMID:29046657
According to the Pan American Health Organization and the World Health Organization, in 2020, depression will become the second cause of disability worldwide. In Chile, anxiety and depressive disorders account for almost 28% of the total years of healthy life lost due to illness. This research seeks to explore a profile of social problem solving and coping present in people who suffer from anxious and depressive symptoms. The sample consisted of 1179 analogous Chilean participants (55.9% women), with a mean of 22.23 years (range between 18-48 years). The results suggest statistically significant differences for all social problem solving and coping strategies evaluated. Thus, if anxious or depressive symptoms increase, social problem solving or coping strategies become less adaptive.
Patricio M Arana
Full Text Available The Chilean jagged lobster (Projasus bahamondei is a deep-water crustacean (175-550 m occurring in certain areas of the southeastern Pacific Ocean, including the Nazca Ridge, Desventuradas Islands, the Juan Fernandez archipelago and ridge, and the continental slope off the central coast of Chile. This review describes the taxonomic status, geographical and bathymetric distribution, some biological aspects and habitat characteristics of this species. Additionally, both artisanal and industrial exploitation attempts made within the region are detailed, as well as fishing operation results, chemical composition, different elaboration procedures and the destination of the catch. The main objectives of this review are to contribute to the knowledge of P. bahamondei as a component of the deep-sea ecosystem and to highlight its importance as a potential fishery resource.
Burgos, Soledad; Yohannessen, Karla; Álvarez, Andrea; Rebolledo, Alejandro; Valenzuela, María Teresa
To describe the interests, preferred topics and learning in public health issues emerging from Chilean students with their participation in a science education experience. A qualitative exploratory study was conducted in 29 school research groups through the project Salud Con-Ciencia en tu Barrio, based on a content analysis of texts and narratives of students. Students prioritize the situation of abandoned animals, waste management, security and urban infrastructure, mainly. They view the role of social actors, the positive/negative impacts on the community, valuing the knowledge gained through observation neighborhoods and interaction with neighbors. Scientific inquiry school in the neighborhood context provides teaching strategies for the promotion of local health, develops basic notions of community health and motivation in students linked to the socio-environmental reality of their neighborhoods.
The Chilean electrical sector was deregulated in 1982, where unbundling was applied, and generation competition and marginal costing were introduced. Description of the main features of the generation market and system operation is presented, followed by a synthesis of the main achievements and difficulties experienced in the practical application. The experience with the troubles faced in the reformed power sector after 18 years is used to look at the possible advantages of the second stage of deregulation. The challenges of a new legislation, where the system is expected to join the second generation of deregulation are discussed. Advantage and risks of opening the energy market with a bidding system separate from ancillary service market are analysed. The experience with the troubles faced in the reformed power sector after 18 years is used to look at the possible advantages of the second stage of deregulation. (author)
Full Text Available Davidson Trauma Scale (DTS measures the frequency and severity of the posttraumatic Stress Disorder pTSD. Since chile has limited data about validity and reliability of instruments to measure pTSD, this study evaluated psychometric properties of the scale in a sample of 130 adolescents between 13 and 18 years (M= 15,78; DT= 1,40. Some of them were traumatized patients and others were from general population. They answered the DTS, a depression and an anxiety scale. The scale obtained adequate internal consistency scores, showed convergent validity (DTS score was associated moderately, directly and significantly with depression and anxiety scores, and discriminated between clinical sample and general population. DTS seems to be a valid and reliable instrument in chilean adolescents.
Herrera, Tania; Sánchez, Sergio
Stewardship is the most important political function of a health system. It is a government responsibility carried out by the health authority. Among other dimensions, it is also a meta-function that includes conduction and regulation. The Health Authority and Management Act, which came about from the health reform of 2004, separated the functions of service provision and stewardship with the aim of strengthening the role of the health authority. However, the current structure of the health system contains overlapping functions between the different entities that leads to lack of coordination and inconsistencies, and a greater weight on individual health actions at the expense of collective ones. Consequently, a properly funded national health strategy to improve the health of the population is missing. Additionally, the components of citizen participation and governance are weak. It is necessary, therefore, to revisit the Chilean health structure in order to develop one that truly enables the exercise of the health authoritys stewardship role.
Full Text Available Previous studies have demonstrated that justifying the social, economic, and political systems is associated with psychological well-being, which has been termed as the palliative function of ideology. However, little research has been conducted on gender stereotypes among children, comparing by socioeconomic status. This study aimed to fill this gap in the system justification literature. We present data from the Chilean version of the International Survey of Children Well-Being (ISCWeB, which was conducted in 2012. We found that the palliative function of gender stereotypes is present among this sample, being qualified by a socioeconomic status by hostile gender stereotype interaction. In other words, the effect on the psychological well-being was observed in low-status, but not in high-status students. These results extend the previous knowledge about the palliative function of the ideology, suggesting why the low-status members of a society actively engage in system justification.
ANA MARÍA FERNÁNDEZ
Full Text Available In the present study we investigated sexual assymetries in the subjective experience of jealousy amongChilean young people. The sample included a total of 241 participants (132 females and 109 males thatanswered two forced-choice questions developed by Buss, Larsen, Westen & Semmelroth (1992, askingwether sexual or emotional infidelity would cause them the most distress. The evolutionary hypothesispredicted that men would be more distressed than women by the sexual infidelity, and that womenwould be more distressed than men by the emotional infidelity. The results support the evolutionaryprediction, providing an important tool to understand mate choice in Latin America, and are comparedto the results from other countries, analyzing some of the criticisms that have arised from socioculturalperspectives.
Fica, Alberto; Acosta, Gerardo; Dabanch, Jeannette; Perret, Cecilia; Torres, Marisa; López, Javier; Jofré, Leonor; Weitzel, Thomas
During year 2011 two outbreaks of Salmonella infection captured media attention in the Metropolitan Area (MA) in Chile: one of typhoid fever associated to Salmonella serotype Typhi, and the other, of gastroenteritis related to Salmonella serotype Enteritidis, both with decreasing or stable rates in the previous years. The aim of this work is to analyze probable causes of their reemergence. Several government websites were searched looking for epidemiological data. Typhoid fever rates have declined to current values of 1 case per 100.000 habitants, a decreased associated to improvements in the human development index. The typhoid outbreak was associated to a predominant clone within the MA. The only risk factor identified was consumption of raw vegetables acquired in open fairs, but without identifying a common source. Despite improvements in disease notification and molecular epidemiology capabilities, this outbreak is coincidental with a reduced number of food inspection visits in the MA, probably explained by the limited personnel available for this task. In the case of Salmonella Enteritidis, rates have increased twice since 1998 (5.3 to 10.7 per 100.000 habitants) with an important increase in the number of outbreaks linked to this agent (7 to 31 annual outbreaks) since year 2005. Persistence of this problem is probably associated to the low surveillance of poultry farms made by the Chilean state, to the absence of a cold chain during collection, distribution and selling of eggs, and to the lack of an educational program directed to the population. The recent regulation that bans home-made mayonnaise in restaurant or fast food stores is an important advance that requires further evaluation. The persistence and reemergence of different kind of Salmonellosis in Chile suggests chronic problems on the size and role of the Chilean state regarding food safety.
Mayol, E.; Ruiz-Halpern, S.; Duarte, C. M.; Castilla, J. C.; Pelegrí, J. L.
CO2-driven compromises to marine life were examined along the Chilean sector of the Humboldt Current System, a particularly vulnerable hypoxic and upwelling area, applying the Respiration index (RI = log10 pO2) and the pH-dependent aragonite saturation (Ω) to delineate the water masses where aerobic and calcifying organisms are stressed. There was a remarkable negative relationship between oxygen concentration and pH or pCO2 in the studied area, with the subsurface hypoxic Equatorial Subsurface Waters extending from 100 m to about 300 m depth and supporting elevated pCO2 values. The RI reached a minimum at about 200 m depth and decreased towards the Equator. Increased pCO2 in the hypoxic water layer reduced the RI values by as much as 0.59 RI units, with the upper water layer that presents conditions suitable for aerobic life (RI>0.7) declining by half between 42° S and 28° S. The intermediate waters hardly reached those stations closer to the equator so that the increased pCO2 lowered pH and the saturation of aragonite. A significant fraction of the water column along the Chilean sector of the Humboldt Current System suffers from CO2-driven compromises to biota, including waters corrosive to calcifying organisms, stress to aerobic organisms or both. The habitat free of CO2-driven stresses was restricted to the upper mixed layer and to small water parcels at about 1000 m depth. pCO2 acts as a hinge connecting respiratory and calcification challenges expected to increase in the future, resulting in a spread of the challenges to aerobic organisms.
Full Text Available The genus Liolaemus is one of the most ecologically diverse and species-rich genera of lizards worldwide. It currently includes more than 250 recognized species, which have been subject to many ecological and evolutionary studies. Nevertheless, Liolaemus lizards have a complex taxonomic history, mainly due to the incongruence between morphological and genetic data, incomplete taxon sampling, incomplete lineage sorting and hybridization. In addition, as many species have restricted and remote distributions, this has hampered their examination and inclusion in molecular systematic studies. The aims of this study are to infer a robust phylogeny for a subsample of lizards representing the Chilean clade (subgenus Liolaemus sensu stricto, and to test the monophyly of several of the major species groups. We use a phylogenomic approach, targeting 541 ultra-conserved elements (UCEs and 44 protein-coding genes for 16 taxa. We conduct a comparison of phylogenetic analyses using maximum-likelihood and several species tree inference methods. The UCEs provide stronger support for phylogenetic relationships compared to the protein-coding genes; however, the UCEs outnumber the protein-coding genes by 10-fold. On average, the protein-coding genes contain over twice the number of informative sites. Based on our phylogenomic analyses, all the groups sampled are polyphyletic. Liolaemus tenuis tenuis is difficult to place in the phylogeny, because only a few loci (nine were recovered for this species. Topologies or support values did not change dramatically upon exclusion of L. t. tenuis from analyses, suggesting that missing data did not had a significant impact on phylogenetic inference in this data set. The phylogenomic analyses provide strong support for sister group relationships between L. fuscus, L. monticola, L. nigroviridis and L. nitidus, and L. platei and L. velosoi. Despite our limited taxon sampling, we have provided a reliable starting hypothesis for
Amanda J Mason-Jones
Full Text Available To explore the link between alcohol use, binge drinking and mental health problems in a representative sample of adolescent and young adult Chileans.Age and sex-adjusted Odds Ratios (OR for four mental wellbeing measures were estimated with separate conditional logistic regression models for adolescents aged 15-20 years, and young adults aged 21-25 years, using population-based estimates of alcohol use prevalence rates from the Chilean National Health Survey 2010.Sixty five per cent of adolescents and 85% of young adults reported drinking alcohol in the last year and of those 83% per cent of adolescents and 86% of young adults reported binge drinking in the previous month. Adolescents who reported binging alcohol were also more likely, compared to young adults, to report being always or almost always depressed (OR 12.97 [95% CI, 1.86-19.54] or to feel very anxious in the last month (OR 9.37 [1.77-19.54]. Adolescent females were more likely to report poor life satisfaction in the previous year than adolescent males (OR 8.50 [1.61-15.78], feel always or almost always depressed (OR 3.41 [1.25-9.58]. Being female was also associated with a self-reported diagnosis of depression for both age groups (adolescents, OR 4.74 [1.49-15.08] and young adults, OR 4.08 [1.65-10.05].Young people in Chile self-report a high prevalence of alcohol use, binge drinking and associated mental health problems. The harms associated with alcohol consumption need to be highlighted through evidence-based prevention programs. Health and education systems need to be strengthened to screen and support young people. Focussing on policy initiatives to limit beverage companies targeting alcohol to young people will also be needed.
Domínguez, Isabel; Rosales, Ruth; Cabello, Ángela; Bavestrello, Luis; Labarca, Jaime
Surveillance of antimicrobial consumption is a central part in programs of antibiotic stewardship. However, in Chile there are no national data on antibiotic consumption representing a significant number of hospitals by clinical services. In 2013 a survey was sent to multiple Chilean hospitals to evaluate antimicrobial consumption in medical services (MS), surgery services (SS) and critical care units (ICU). We used the standardized methodology recommended by the WHO, using the number of DDD/100 days beds. In the MS and SS beta-lactam and no beta-lactam antibiotics commonly used were evaluated. In the ICU consumption vancomycin, linezolid, imipenem, merope-nem, colistin and tigecycline was evaluated. Fifteen hospitals reported the density of antimicrobial consumption. Ceftriaxone and cloxacillin were the most commonly used antibiotics in general services (average cloxacillin 4,9 DDD/100 bed days in MS and 8,0 DDD/100 in SS; ceftriaxone 13,5 DDD/100 in MS and 16,7 DDD/100 in SS). In the SS there was also a significant consumption of metronidazole (average 14,5 DDD/100 bed days). In the ICU there was an important variability of consumption of selected antibiotics. This study reports the average and range of antibiotic consumption in MS, SS, and ICU from a significant number of hospitals in the country, during 2013. This information allows hospitals to compare their consumption of antibiotics with a significant sample of Chilean hospitals. Analysis of this information should consider a careful interpretation according to the sample shown here and the reality of each hospital.
Full Text Available Cristina B Bares1, Jorge Delva2, Andrew Grogan-Kaylor2, Fernando Andrade31Curtis Research and Training Center, School of Social Work, 2School of Social Work, 3School of Education, University of Michigan, Ann Arbor, MI, USAObjective: Family involvement and several characteristics of parenting have been suggested to be protective factors for adolescent substance use. Some parenting behaviors may have stronger relationships with adolescent behavior while others may have associations with undesirable behavior among youth. Although it is generally acknowledged that families play an important role in the lives of Chilean adolescents, scant research exists on how different family and parenting factors may be associated with marijuana use and related problems in this population which has one of the highest rates of drug use in Latin America.Methods: Using logistic regression and negative binomial regression, we examined whether a large number of family and parenting variables were associated with the possibility of Chilean adolescents ever using marijuana, and with marijuana-related problems. Analyses controlled for a number of demographic and peer-related variables.Results: Controlling for other parenting and family variables, adolescent reports of parental marijuana use showed a significant and positive association with adolescent marijuana use. The multivariate models also revealed that harsh parenting by fathers was the only family variable associated with the number of marijuana-related problems youth experienced. Conclusion: Of all the family and parenting variables studied, perceptions of parental use of marijuana and harsh parenting by fathers were predictors for marijuana use, and the experience of marijuana-related problems. Prevention interventions need to continue emphasizing the critical socializing role that parental behavior plays in their children's development and potential use of marijuana.Keywords: parenting, families, adolescent
Diaz, E.O.; Salazar, G.; Uauy, R.
It has been found that children and adults in the Chilean population are getting obese in a rapidly raising proportion. There is a cohort of children less than six years old, which are regularly controlled by the Ministry of Health. From this information and studies carried out at INTA, it is known that the prevalence is raising continuously. Unfortunately, this can not be ascertained in adults where the nutritional situation is assessed only in small groups, which are not representative of the general population. The problem with adults is that the healthy population does not attend to the medical clinics unless they are already ill. The studies conducted in Chilean adults have found that >40% of low socio-economic status (SES) women are suffering from obesity. A intriguing aspect in our situation is that although sedentarism is frequent in adult women (as a possible cause of positive energy balance), their intake is based on a high proportion of carbohydrates (CHO) but not much fat (50-70 g on average). It may be suggested that the excess CHO can be converted into fat through denovo lipogenesis but this process is less important as cause of obesity in humans. A more plausible cause of this problem is likely to be related to the diet. The oxidation hierarchy of macronutrients shows that whenever CHO and fat are available, the former will be firstly oxidised. This way, fat can be spared even when eaten in small amounts, accumulating in the mid-long term. Another important dietary aspect is provided by its fatty acids composition that according to animal studies, seems to modulate fat oxidation. In addition to these, glycemic effects of CHO eaten in combination with the same meal can further potentiate fat storage. This proposal aims to test the dietary effects mentioned above by using indirect calorimetry in tandem with stable isotopes methodologies in a group of normal weight and obese women. (author)
Cordaro, Enrique G.; Venegas, Patricio; Laroze, David
We present a different view of secular variation of the Earth's magnetic field, through the variations in the threshold rigidity known as the variation rate of geomagnetic cutoff rigidity (VRc). As the geomagnetic cutoff rigidity (Rc) lets us differentiate between charged particle trajectories arriving at the Earth and the Earth's magnetic field, we used the VRc to look for internal variations in the latter, close to the 70° south meridian. Due to the fact that the empirical data of total magnetic field BF and vertical magnetic field Bz obtained at Putre (OP) and Los Cerrillos (OLC) stations are consistent with the displacement of the South Atlantic magnetic anomaly (SAMA), we detected that the VRc does not fully correlate to SAMA in central Chile. Besides, the lower section of VRc seems to correlate perfectly with important geological features, like the flat slab in the active Chilean convergent margin. Based on this, we next focused our attention on the empirical variations of the vertical component of the magnetic field Bz, recorded in OP prior to the Maule earthquake in 2010, which occurred in the middle of the Chilean flat slab. We found a jump in Bz values and main frequencies from 3.510 to 5.860 µHz, in the second derivative of Bz, which corresponds to similar magnetic behavior found by other research groups, but at lower frequency ranges. Then, we extended this analysis to other relevant subduction seismic events, like Sumatra in 2004 and Tohoku in 2011, using data from the Guam station. Similar records and the main frequencies before each event were found. Thus, these results seem to show that magnetic anomalies recorded on different timescales, as VRc (decades) and Bz (days), may correlate with some geological events, as the lithosphere-atmosphere-ionosphere coupling (LAIC).
Diaz, E O; Salazar, G; Uauy, R [Energy and Metabolism and Stable Isotopes Laboratory, Instituto de Nutricion y Tecnologia de los Alimentos (INTA), Santiago (Chile)
It has been found that children and adults in the Chilean population are getting obese in a rapidly raising proportion. There is a cohort of children less than six years old, which are regularly controlled by the Ministry of Health. From this information and studies carried out at INTA, it is known that the prevalence is raising continuously. Unfortunately, this can not be ascertained in adults where the nutritional situation is assessed only in small groups, which are not representative of the general population. The problem with adults is that the healthy population does not attend to the medical clinics unless they are already ill. The studies conducted in Chilean adults have found that >40% of low socio-economic status (SES) women are suffering from obesity. A intriguing aspect in our situation is that although sedentarism is frequent in adult women (as a possible cause of positive energy balance), their intake is based on a high proportion of carbohydrates (CHO) but not much fat (50-70 g on average). It may be suggested that the excess CHO can be converted into fat through denovo lipogenesis but this process is less important as cause of obesity in humans. A more plausible cause of this problem is likely to be related to the diet. The oxidation hierarchy of macronutrients shows that whenever CHO and fat are available, the former will be firstly oxidised. This way, fat can be spared even when eaten in small amounts, accumulating in the mid-long term. Another important dietary aspect is provided by its fatty acids composition that according to animal studies, seems to modulate fat oxidation. In addition to these, glycemic effects of CHO eaten in combination with the same meal can further potentiate fat storage. This proposal aims to test the dietary effects mentioned above by using indirect calorimetry in tandem with stable isotopes methodologies in a group of normal weight and obese women. (author)