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Background: 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 Aim: To identify protective factors for suicidal ideation according to parenting styles, as described by Barber et al. Material and Methods: 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. Results: 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. Conclusions: 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.

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BACKGROUND: 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 AIM: To identify protective factors for suicidal ideation according to parenting styles, as described by Barber et al. MATERIAL AND METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.

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Las conductas de riesgo de los adolescentes (uso de drogas o comportamientos auto o hetero-agresivos) pueden ser comparadas geográficamente. En Chile, la mayoría de los estudios se han concentrado en la Región Metropolitana, aplicándose diversos modelos conceptuales para explicar las correlaciones encontradas. Aquí se estudia la teoría de Barber et al en la Universidad de Tennessee, que relaciona estilos de crianza parentales con conductas y problemas adolescentes, a través de la aplicación de la escala CNAP Plus en versión validada en Chile a una muestra aleatoria trietápica estratificada de 2322 adolescentes 3º y 4º Medios de colegios municipalizados, privados y subvencionados de las ciudades de Santiago, Antofagasta y Concepción. El consumo de alcohol y tabaco fue mayor en estudiantes de colegios privados que en los municipales y subvencionados, mientras que en los municipales hubo mayor consumo de sustancias químicas ilegales. La ideación suicida fue mayor en establecimientos municipales (8,2 por ciento) que en los privados (5,5 por ciento). Las conductas hetero-agresivas tales como robo, vandalismo o riñas son más frecuentes en establecimientos municipales que en los privados. Las conductas de riesgo se correlacionan positivamente entre sí (consumo de sustancias ilegales con auto-agresión y violencia; conductas auto-agresivas con hetero-agresivas).

Adolescent risk behaviors (substance abuse or auto- hetero-aggressive behaviors) can be compared between geographical locations. En Chile, most studies about them have concentrated in the Región Metropolitana of Santiago, and different theoretical frameworks have been used to explain the correlations between them. Here we study Barber et al framework at the University of Tennesee, that relates parenting styles with adolescent problems, applying the CNAP Plus scale in its version validated in Chile, to a randomized three-stage sample of 2322 youths in 3th and 4th grades of secondary education of private, state subsidized and municipality owned schools in Santiago, Antofagasta and Concepción. Frequent consumption of tobacco and alcohol was higher among private school students, while in the municipal and subsidized school there was more use of tobacco. In municipal schools there was more consumption of illegal chemicals. Suicidal ideation was higher in municipal schools (8,2 percent) than in private ones (5,5 percent). Hetero-aggressive behaviors such as theft, vandalism or fights were more frequent in municipal schools than in private ones. Risk behaviors correlate positively with each other (ilegal drug use with aggression towards self, and violence toward others, as ahto-aggression correlates with hetero-aggression.

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Objetivos: Describir las condiciones laborales, económicas y académicas de un grupo representativo de médicos chilenos de la Región Metropolitana. Investigamos las diferencias de estas características según sexo y edad. Metodología: Estudio cuantitativo, de corte transversal: las variables en estudio se registran a través de instrumento “EVALMED” (1), que es una encuesta anónima, auto-aplicada, realizada previa firma de un consentimiento informado. Los médicos que formaron la muestra fueron seleccionados en forma aleatoria desde la base de datos del Consejo Regional Santiago del Colegio Médico de Chile. Se consideró un 95 por ciento de confi anza, un 5 por ciento de error y una tasa de respuesta del 80 por ciento. Resultados: Se evaluaron 163 médicos (58,9 por ciento varones y 41,1 por ciento mujeres) de todos los rangos de edad. En ellos se encuentran diferencias signifi cativas en los distintos aspectos laborales evaluados entre médicos de ambos sexos; en particular llaman la atención las diferencias por sexo en el tipo de contrato laboral, el ingreso, el tipo de trabajo, horario de trabajo, percepciones sobre el trabajo así como el clima laboral. Todos estos aspectos se presentan en situación de relativa desventaja para las mujeres médicos y para los médicos de edades extremas.

Objectives: To describe the working conditions, economic and academic situation of a representative group of Chilean physicians in the Metropolitan Region. To examine the relationships between these characteristics on one hand, and sex and age, on the other. Methodology: Quantitative, cross sectional design. The variables were recorded by “EVALMED” instrument, which is an anonymous, self-applied instrument. An informed consent document was previously signed by the participants. The physicians who made up the sample were randomly selected from the database of the Regional Medical Council of Santiago. We arranged for 95 percent confi dence and 5 percent error limits and for a response rate of 80 percent. Results: We studied 163 physicians (58.9 percent men and 41.1 percent women) of all age groups. There were significant sex and age differences in the various aspects of labor assessed, in particular in the type of employment contract, income, type of work, working hours, work perceptions and work environment. Women and physicians of both young and senior age groups were found to be at a disadvantage.

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This study evaluates the difference in risk behavior and depressive symptomalogy in adolescents, as parenting styles change through developmental stages. A group of students older and younger than 15 years old, in Santiago's Metropolitan Region were screened for these behaviors and symptoms, focusing upon the relationship with parents. Barber's Cross National Adolescent Program test, adapted and validated in Chile, was given to a 1 447 students, randomly selected in 14 Middle Schools. Barber's model was used to compare upbringing styles. Results show that parental support correlates with children's social initiative, psychological control shows positive correlation with depressive symptomatology, and behavioral control shows a negative correlation with antisocial behavior. The only variable showing age bracket variability is antisocial adolescent behavior, when external and internal aggressive behavior are compared. The results suggest that Barber's model can be applied among Chilean adolescents 10 to 19 years of age. The implications of these findings, and possible preventive actions are presented.

Este trabajo estudió la variación de las conductas de riesgo y sintomatología depresiva en adolescentes, según los cambios de estilos de crianza parentales en las distintas etapas del desarrollo. En él, se describe la frecuencia de esas conductas y síntomas en una muestra representativa de estudiantes de la Región Metropolitana de Santiago de Chile, con foco en las relaciones con sus padres, y en cómo éstos enfrentan la crianza en los hijos mayores o menores de 15 años. Se aplicó el instrumento CNAP (Cross National Adolescent Program), de Barber y cols, adaptado y validado para Chile por éste equipo de investigadores. En éste trabajo se analizan resultados de una primera aplicación a 1 447 estudiantes de 14 establecimientos de enseñanza media aleatoriamente seleccionados. Se utiliza el modelo explicativo de Barber para comparar los estilos parentales diferenciales de crianza, encontrando que el apoyo parental se correlaciona positivamente con la iniciativa social de los hijos, que el control psicológico se correlaciona positivamente con síntomas depresivos y el control conductual lo hace negativamente con la conducta antisocial. Sólo el comportamiento antisocial adolescente muestra diferencias por grupo de edad al comparar conductas autoagresivas y heteroagresivas. Se concluye que el modelo de Barber puede aplicarse a la realidad chilena a adolescentes entre de 10 a 19 años y se analizan las implicancias de estos hallazgos para posibles intervenciones preventivas.

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The aim of this study is to corroborate a reference framework that relates parental styles with drugs consumption, depression, self and other aggressive behaviors. We found that parents' acceptance correlates positively with adolescents' initiative and negatively with depressive and suicidal symptoms; psychological control with depression and behavioral control with antisocial behavior. Material and Methods: The CNAP+ (Cross National Adolescent Program) questionnaire (version CNAP Plus) was adapted in interaction with its author; and then was applied to a representative, random, three-stages sample of the Metropolitan Region (n = 1.447). Results: The worse the relation with parents, the higher the consumption, depression, suicidal ideation and hetero aggressive behaviors. Spearman's correlation coefficients were found in the same direction of a previous transcultural CNAP study. Frequent consumption of alcohol was found in 26.9 percent, of tobacco in 31.2 percent, of marihuana in 6.9 percent and of cocaine or other drugs in 2.3 percent) of the sample studied. The same sample has suicide ideation 7.76 percent and depressive symptoms 6.9 percent. Self aggression prevailed among women and hetero aggression among men. With age there was an increase in alcohol consumption ( percent2 = 107.95, p = 0.0001), of tobacco (f = 63.02, p = 0.0001), of marihuana (f = 18.78, p = 0.001) and of cocaine ( percent2 = 8.995, p = 0.06). There is differential by age in violent behaviors, suicide ideation or depressive symptoms. Conclusion: The results obtained by Barber et al in the multicultural application of his model in 16 countries is confirmed in this study run in Santiago de Chile. This is relevant to consider when designing public policies and preventive interventions. This survey confirms previous studies regarding sex, age and parental styles; there is higher consumption of chemical substances and hetero aggressive conducts among men, and of depressive...

Este estudio busca corroborar en Santiago de Chile el marco referencial de Brian Barber1 que relaciona consumo de drogas, depresión, suicidalidad y conductas violentas con estilos parentales. Encontramos que la aceptación de los padres se correlaciona positivamente con iniciativa adolescente y negativamente con síntomas depresivos y suicidas; el control psicológico con depresión, y el control conductual con conducta antisocial. Material y Métodos: En conjunto con su autor, se adapta el instrumento CNAP, Cross National Adolescent Program (Versión CNAP Plus) y se aplica a una muestra representativa aleatoria trietápica de la Región Metropolitana (n = 1.447). Resultados: A peor relación con los padres mayor consumo, depresión, ideación suicida, y conductas heteroagresivas. Se encuentran coeficientes de correlación de Spearman en la misma dirección de los del estudio internacional CNAP. Se encontró consumo frecuente de alcohol en 26,9 por ciento>, de tabaco en 31,2 por ciento, de marihuana en 6,9 por ciento, de cocaína u otras drogas en 2,3 por ciento de la muestra estudiada. Hay en la misma muestra ideación suicida en 7,7 por ciento y síntomas depresivos en 6,9 por ciento. La autoagresión predomina en mujeres y la heteroagresión en varones. Con la edad aumenta el consumo de alcohol (porcentage 2 =107,95, p = 0,0001), de tabaco ( pocentage 2= 63,02, p = 0,0001), de marihuana (porcentage 2 = 18,78, p = 0,001) y de cocaína (porcentage 2 = 8,995, p = 0,06). No hay diferencias por edad en conductas violentas, ideación suicida o síntomas depresivos. Conclusiones: Los resultados obtenidos por Barber en la aplicación multicultural de su modelo en 16 países se confirman en este estudio en Santiago de Chile, lo que importa como base de información posible de considerar en el diseño de políticas públicas (estatales y privadas) y de intervenciones preventivas. Esta encuesta confirma estudios previos sobre sexo, edad y estilos parentales: hay mayor consumo de sustancias químicas y conductas heteroagresivas entre los varones y de sentimientos depresivos e ideación suicida entre las mujeres. Las conductas estudiadas aumentan con la edad, con excepción de la violencia; estas conductas se correlacionan entre sí, y disminuyen con una buena relación con los padres.

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BACKGROUND: Family is an important protective factor in the prevention of risk behaviors in Chilean adolescents. AIM: To determine the prevalence of risk and protective factors and behaviors in Chilean students, and to study the association between family functioning and adolescent risk behaviors. MATERIAL AND METHODS: Descriptive cross sectional study of 815 adolescents aged 15 +/- 2 years (51% male), studying 7th to 12th grade in three educational facilities in Santiago, Chile. They answered the Adolescent Risk Behavior Score, adapted from the Adolescent Health Survey and the "How is your family" survey of the Pan American Health Organization. RESULTS: Tobacco, alcohol and marihuana consumption was reported by 31%, 27% and 24% of students, respectively. Twelve percent reported being sad all the time, 23% being desperate and 13% being anxious. Forty four percent have had a sexual intercourse. The risk to have these behaviors was greater in adolescents who perceive their families as dysfunctional. CONCLUSIONS: In this sample, there was a high prevalence of risk behaviors, emotional symptoms and premature sexual intercourse. The risk of having these behaviors is higher among students who perceive their families as dysfunctional. The study emphasizes the protective function of family in the prevention of risk behaviors in Chilean students.

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Background: Family is an important protective factor in the prevention of risk behaviors in Chilean adolescents. Aim To determine the prevalence of risk and protective factors and behaviors in Chilean students, and to study the association between family functioning and adolescent risk behaviors. Material and methods: Descriptive cross sectional study of 815 adolescents aged 15 ± 2 years (51 percent male), studying 7th to 12th grade in three educational facilities in Santiago, Chile. They answered the Adolescent Risk Behavior Score, adapted from the Adolescent Health Survey and the "How is your family" survey of the Pan American Health Organization. Results: Tobacco, alcohol and marihuana consumption was reported by 31 percent, 27 percent and 24 percent of students, respectively. Twelve percent reported being sad all the time, 23 percent being desperate and 13 percent being anxious. Forty four percent have had a sexual intercourse. The risk to have these behaviors was greater in adolescents who perceive their families as dysfunctional. Conclusions: In this sample, there was a high prevalence of risk behaviors, emotional symptoms and premature sexual intercourse. The risk of having these behaviors is higher among students who perceive their families as dysfunctional. The study emphasizes the protective function of family in the prevention of risk behaviors in Chilean students.

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OBJECTIVE: To develop, apply, and evaluate an educational model for the primary prevention of sexually transmitted diseases (STDs) and acquired immunodeficiency syndrome (AIDS) that was based on the sexual knowledge, attitudes, and practices (KAPs) of adolescents and on their perceptions and behaviors in this area, with the ultimate goal of helping develop educational tools to prevent infection with STDs and the human immunodeficiency virus (HIV). METHODS: An STD/HIV/AIDS primary prevention model was applied with adolescent schoolchildren (12 to 15 years old) in the canton of Santo Domingo de los Colorados, Ecuador. Two groups with similar characteristics were formed: the experimental group, with 358 students, and the control group, with 288 students. Schools were selected according to inclusion criteria, and adolescents at each school were chosen at random. A discussion guide was applied with 16 focus groups, and the resulting information was used to prepare a KAP survey. After being validated, the KAP survey was applied to the experimental group and to the control group. A prevention education program geared to students and teachers was implemented with the experimental group. Eight months later a second KAP survey was done with the experimental group and the control group. The differences in KAPs before and after the intervention were evaluated using the chi-square test. RESULTS: There were no statistically significant differences between the two groups before the intervention, but afterwards the differences were statistically significant (P = 0.012), with an increase in the knowledge of sexuality and STDs/AIDS in the experimental group, even though the long-term behavior changes have not been evaluated. CONCLUSIONS: This study validated a multifactorial STD/AIDS prevention model adapted to the reality of adolescents, and it suggests the possibility of extrapolating this experience more broadly to contexts similar to those of this Ecuador population.

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Se realiza un análisis de 2 211 pacientes diagnósticados como accidentes en el servicio de urgencia durante 1988. Existe un predominio del sexo masculino, niños de una zona urbana y con la edad de 1 a 5 años. Las principales causas de accidentes producidas por instrumentos cortantes, objetos contundentes y caídas a un mismo nivel, destacando un predominio en las hembras de las quemaduras e intoxicaciones. Se observa que la mayor cantidad de accidentes se producen en el hogar, siendo la de prónostico más grave las producidas por el transito con 4 fallecidos, para una tasa de 0,4 x 1000 habitantes. Se destaca la magnitud de este problema de salud pública y la connotación económico social que representa. Se determina una relación entre estos accidentes y la situación socio-cultural de los padres. (AU)

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