Revista de salud pública 18 by Jana Stojanova

RC SP Director Giorgio Solimano Equipo editorial editor Yuri Carvajal editores asociados Jorge Gaete Miguel Kottow coordinación editorial Jana Stojanova Verónica Zúñiga referencia, indexación y publicación Katherinne Rivas traducción Emily Seiter secretaria Sandra Bravo

Representante legal Cecilia Sepúlveda Domicilio Escuela de Salud Pública Universidad de Chile Independencia 939 Santiago de Chile Fono: (56-2) 9786525 E mail: revistasp@med.uchile.cl www.revistasaludpublica.uchile.cl La Revista Chilena de Salud Pública está registrada en las bases de datos Lilacs y Dialnet

REVISTA CHILENA DE SALUD PÚBLICA Vol. 18 Nº 1, 2014

ISSN 0717-3652

Editada por la Escuela de Salud Pública de la Universidad de Chile. Edición cuatrimestral

Nuestra portada: Guillermo NĂşĂąez, Serie El cielo como abismo, 2011. (Gentileza del artista)

INDICE Rev Chil Salud Pública 2014; Vol 18 (1): 3-4

EDITORIAL r "DFOUPT DPNVOFT Yuri Carvajal 4ðéúíì ë÷öëíúöû r 5JNFSPTBM FO WBDVOBT y$ÓNP BWBO[BS FO SFTPMWFS MB DPOUSPWFSTJB Dr. Jaime Cerda r 5JNFSPTBM Z WBDVOBDJÓO PCMJHBUPSJB Miguel Kottow 5ðñ÷õíúûéô éöì ë÷õøýôû÷úā þéëëñöéüñ÷ö TEMAS DE ACTUALIDAD r %JMJHFODJB VOJWFSTJUBSJB Miguel Kottow 6öñþíúûñüā ûüéöìéúìû r 1SPCMFNBT EF TBMVE EFSJWBEPT EF MB DPOUBNJOBDJÓO SBEJBDUJWB VO EFTBGÎP QBSB MB TBMVE QÙCMJDB FO FM NFEJBOP QMB[P Dra. Muriel Ramírez )íéôüð øú÷êôíõû ìíúñþíì îú÷õ úéìñ÷éëüñþí ë÷öüéõñöéüñ÷ö é õíìñýõ üíúõ øýêôñë ðíéôüð øú÷êôíõ r 3FGPSNBT BM 4JTUFNB $IJMFOP EF 4FHVSJEBE Z 4BMVE FO FM 5SBCBKP 445 María Carolina Vargas 3íî÷úõ ÷î üðí $ðñôíéö 4āûüíõ î÷ú 0ëëýøéüñ÷öéô 4éîíüā éöì )íéôüð r $VMNJOB FM QSJNFS DJDMP EF MB GPSNBDJÓO EF FTQFDJBMJTUBT QBSB MB BUFODJÓO QSJNBSJB Z FM TJTUFNB QÙCMJDP EF BUFODJÓO EF TBMVE y2VÊ IBDFS FO BEFMBOUF Carlos Montoya-Aguilar, Manuel Ipinza, Nelson Vargas, Jorge Lastra 5úéñöñöï øú÷ïúéõ ÷î ûøíëñéôñûüû ñöë÷úø÷úéüíì ñö üðí øúñõéúā ðíéôüð ëéúí üíéõû "ü üðí íöì ÷î üðí îñúûü ûñĀ āíéú ëāëôí ÿðñëð ï÷éôû î÷ú üðí öíĀü ûüéïí r %FàOJDJÓO EF QFSàMFT EF OVUSJFOUFT SFRVJTJUP QBSB QSPNPWFS DBNCJPT BMJNFOUBSJPT FO MB QPCMBDJÓO Marcia Erazo, Roberto Del Águila /ýüúñíöü øú÷îñôíû "ö íûûíöüñéô úíùýñúíõíöü î÷ú øú÷õ÷üñöï ìñíüéúā ëðéöïíû ñö üðí ø÷øýôéüñ÷ö CIFRAS DE HOY r /P UPEPT UJFOFO DÃODFS QFSP UPEPT OPT SFTGSJBNPT Jorge Cienfuegos /÷ü íþíúā÷öí ïíüû ëéöëíú êýü íþíúā÷öí ïíüû ë÷ôìû ARTÍCULOS ORIGINALES r i&MMPT UBNCJÊO DVFOUBOu -B NPSUBMJEBE EF MPT OJÒPT Z BEPMFTDFOUFT EF BÒPT "SHFOUJOB Eleonora Rojas i5ðíā éôû÷ ë÷ýöüu .÷úüéôñüā éõ÷öï ŏ ŋœ āíéú ÷ôì ëðñôìúíö éöì éì÷ôíûëíöüû "úïíöüñöé ŋœœő ŌŊŋŊ

r %JTUSJCVDJÓO EFM SJFTHP QTJDPTPDJBM MBCPSBM FO $IJMF Juan Pérez-Franco %ñûüúñêýüñ÷ö ÷î øûāëð÷û÷ëñéô úñûó ñö üðí ÿ÷úóøôéëí ñö $ðñôí r *OáVFODJB EF BQPZP TPDJBM Z VTP EF TFSWJDJPT EF TBMVE TPCSF MB EFQSFTJÓO FO DVJEBEPSFT EF BEVMUPT NBZPSFT FO [POB SVSBM Daniel Serrani *öîôýíöëí ÷î û÷ëñéô ûýøø÷úü éöì ýûí ÷î ðíéôüð ûíúþñëíû ÷ö ìíøúíûûñ÷ö éõ÷öï ëéúíüéóíúû ÷î ûíöñ÷ú ëñüñĂíöû ñö úýúéô éúíéû r *ODPSQPSBDJÓO EF MPT PEPOUÓMPHPT FO MPT QSPDFTPT EF USBOTGPSNBDJÓO BM NPEFMP EF TBMVE GBNJMJBS EF MB BUFODJPO QSJNBSJB FO $IJMF Jaime Farfán, María Teresa Valenzuela *öëôýûñ÷ö ÷î %íöüñûüû ñö üðí üúéöûñüñ÷ö ü÷ üðí 'éõñôā )íéôüð $éúí .÷ìíô ÷î 1úñõéúā $éúí ñö $ðñôí

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r 1SFWBMFODJB EF SFUJOPQBUÎB EJBCÊUJDB Z FEFNB NBDVMBS FO QPCMBDJÓO EJBCÊUJDB EFM $&4'". $PSEJMMFSB "OEJOB EF -PT "OEFT Sergio Abuauad, Pablo Guzmán, Cristhian Urzúa 1úíþéôíöëí ÷î ìñéêíüñë úíüñö÷øéüðā éöì õéëýôéú íìíõé ñö üðí ìñéêíüñë ø÷øýôéüñ÷ö ÷î üðí $÷úìñôôíúé "öìñöé ìí -÷û "öìíû 'éõñôā )íéôüð $íöüíú $&4'".

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CARTAS AL EDITOR r 'BMMFDJNJFOUP EFM %S &SOFTUP .FEJOB - Dr. Alfredo Hidalgo San Martín

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EDITORIAL Rev Chil Salud Pública 2014; Vol 18 (1): 5-6

YURI CARVAJAL Escuela de Salud Pública, Facultad de Medicina, Universidad de Chile. ycarvajal@uchile.cl

ACENTOS COMUNES SHARED CONCERNS

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REVISTA CHILENA DE SALUD PÚBLICA

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EDITORIAL Rev Chil Salud Pública 2014; Vol 18 (1): 7-8

DR. JAIME CERDA Pediatra, Especialista en Salud Pública. Profesor Asistente, Facultad de Medicina, P. Universidad Católica de Chile. Integrante Comité Consultivo de Inmunizaciones, Sociedad Chilena de Infectología. jcerda@med.puc.cl

TIMEROSAL EN VACUNAS. ¿CÓMO AVANZAR EN RESOLVER LA CONTROVERSIA?

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EDITORIAL Rev Chil Salud Pública 2014; Vol 18 (1): 9-10

MIGUEL KOTTOW Escuela de Salud Pública Facultad de Medicina Universidad de Chile mhkottow@gmail.com

TIMEROSAL Y VACUNACIÓN OBLIGATORIA THIOMERSAL AND COMPULSORY VACCINATION

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TEMAS DE ACTUALIDAD Rev Chil Salud Pública 2014; Vol 18 (1): 11-14

DILIGENCIA UNIVERSITARIA UNIVERSITY STANDARDS

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DILIGENCIA UNIVERSITARIA - Miguel Kottow

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REVISTA CHILENA DE SALUD PÚBLICA

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TEMAS DE ACTUALIDAD Rev Chil Salud Pública 2014; Vol 18 (1): 15-18

PROBLEMAS DE SALUD DERIVADOS DE LA CONTAMINACIÓN RADIACTIVA: UN DESAFÍO PARA LA SALUD PÚBLICA EN EL MEDIANO PLAZO HEALTH PROBLEMS DERIVED FROM RADIOACTIVE CONTAMINATION: A MEDIUM TERM PUBLIC HEALTH PROBLEM

DRA. MURIEL RAMÍREZ Departamento de Salud Pública Facultad de Medicina Universidad Católica del Norte mramirezs@ucn.cl

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PROBLEMAS DE SALUD DERIVADOS DE LA CONTAMINACIÓN RADIACTIVA: UN DESAFÍO PARA LA SALUD PÚBLICA EN EL MEDIANO PLAZO - Dra. Muriel Ramírez

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TEMAS DE ACTUALIDAD Rev Chil Salud PĂşblica 2014; Vol 18 (1): 19-24

REFORMAS AL SISTEMA CHILENO DE SEGURIDAD Y SALUD EN EL TRABAJO (SST)1 REFORM OF THE CHILEAN SYSTEM FOR OCCUPATIONAL SAFETY AND HEALTH

RESUMEN Luego del suceso â&#x20AC;&#x153;Rescate en la Mina San JosĂŠâ&#x20AC;? se abriĂł un debate sobre la necesidad de hacer modificaciones al sistema de protecciĂłn de seguridad y salud en el trabajo chileno, se crearon comisiones, se hicieron informes y propuestas y se presentaron varios proyectos de ley. En el presente artĂculo se analiza el escenario actual, los avances y situaciones pendientes a tres aĂąos del accidente. ABSTRACT After the San Jose Mine Rescue incident, a debate was opened in the country over the need to modify the present occupational safety and health system in Chile. Several commissions were formed and many reports and proposals were made. Also some legislation projects were sent to Congress for its approval. This article analyses the current scenery, advances and pending issues on these matter after three years of the San Jose Mine successful rescue. INTRODUCCIĂ&#x201C;N MARĂ?A CAROLINA VARGAS Abogada, Universidad de Chile carolina.vargas@ seguridadysalud.cl

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DIAGNÓSTICO DEL SISTEMA CHILENO

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REFORMAS AL SISTEMA CHILENO DE SEGURIDAD Y SALUD EN EL TRABAJO (SST) - María Carolina Vargas

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REVISTA CHILENA DE SALUD PÚBLICA

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REFORMAS AL SISTEMA CHILENO DE SEGURIDAD Y SALUD EN EL TRABAJO (SST) - María Carolina Vargas

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REVISTA CHILENA DE SALUD PÚBLICA

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TEMAS DE ACTUALIDAD Rev Chil Salud PĂşblica 2014; Vol 18 (1): 25-32

CULMINA EL PRIMER CICLO DE LA FORMACIĂ&#x201C;N DE ESPECIALISTAS PARA LA ATENCIĂ&#x201C;N PRIMARIA Y EL SISTEMA PĂ&#x161;BLICO DE ATENCIĂ&#x201C;N DE SALUD. ÂżQUĂ&#x2030; HACER EN ADELANTE? TRAINING PROGRAM OF SPECIALISTS INCORPORATED IN THE PRIMARY HEALTH CARE TEAMS. AT THE END OF THE FIRST SIX YEAR CYCLE, WHICH GOALS FOR THE NEXT STAGE?

RESUMEN

JORGE LASTRA

El Programa de formaciĂłn de especialistas para la atenciĂłn primaria de salud y el sistema pĂşblico, fue iniciado por el Ministerio de Salud de Chile en el aĂąo 2007 y se implementa en ocho facultades de Medicina. El Programa dura seis aĂąos; la mitad del perĂodo transcurre en centros de salud familiar. La primera cohorte de mĂŠdicos se graduarĂĄ a comienzos del aĂąo 2014. Participan 498 mĂŠdicos jĂłvenes, estudiando en hospitales de nivel universitario y trabajando en 73 centros de salud que atienden una poblaciĂłn de cerca de dos millones de usuarios potenciales. Actualmente hay suficiente evidencia de que las autoridades, los profesores de clĂnica, los residentes, las municipalidades y los evaluadores externos consideran que el Programa es necesario y efectivo. El Ministerio proporciona el financiamiento adecuado; pero todavĂa preocupa su estatus legal y organizacional. Las actividades se orientan a la consolidaciĂłn de la gestiĂłn clĂnica, al fortalecimiento de las funciones de promociĂłn y prevenciĂłn en los centros de salud, al progreso en la equidad y efectividad del sistema y a la educaciĂłn de los usuarios y de las comunidades. Durante la formaciĂłn tambiĂŠn se desarrolla un curso (diploma) de Salud PĂşblica. Los objetivos de mayor alcance incluyen: la planificaciĂłn de la cobertura a alcanzar durante el prĂłximo ciclo de seis aĂąos, la definiciĂłn de las condiciones deseables para ejecutar la atenciĂłn primaria, y la evaluaciĂłn del costoefectividad de las acciones, incluyendo el destino ulterior de los egresados.

Coordinador del Programa de FormaciĂłn de Especialistas para la APS, SSM Sur.

Palabras clave: TJTUFNB EF BUFODJĂ&#x201C;O EF TBMVE FEVDBDJĂ&#x201C;O NĂ&#x160;EJDB EF QPTHSBEP BUFODJĂ&#x201C;O QSJNBSJB EF TBMVE

CARLOS MONTOYA-AGUILAR Profesor Titular de Salud PĂşblica, Universidad de Chile, carlerne@gmail.com

MANUEL IPINZA Coordinador Nacional del Programa de FormaciĂłn de Especialistas para la AtenciĂłn Primaria de Salud, Ministerio de Salud, Chile.

NELSON VARGAS Profesor Titular. Departamento de PediatrĂa y CirugĂa Infantil Occidente, Facultad de Medicina, Universidad de Chile.

REVISTA CHILENA DE SALUD PĂ&#x161;BLICA

ABSTRACT The Training Program of specialists incorporated in the primary health care teams and in the public medical care system was started by the Ministry of Health of Chile in 2007 and is carried out in cooperation with eight Medical Faculties. The program lasts six years; half of the time is spent in primary care clinics. The fist cohort will graduate as specialists beginning of 2014. In all, 498 young physicians are now participating in the Program in 73 clinics that cover nearly 2 million potential users. It is generally agreed by all concerned â&#x20AC;&#x201C; authorities, faculty, residents, municipalities, external evaluators - that the Program is necessary and effective. However, at this stage and in spite of the financial and administrative support so far provided, there is a concern regarding the legal and organizational status of the Program. Current efforts are being directed towards consolidating the clinical management of patients, strengthening promotion and prevention in the clinics, improving the equity and effectiveness of the system and educating the users and the communities. This is supported by a public health course delivered during the entire duration of the Program. Broader objectives include: planning the coverage to be attained during the next six-year cycle; defining the required type of PHC facilities, and evaluating the cost-effectiveness of the Program, including the subsequent destination of its graduates. Key words: IFBMUI DBSF TZTUFN QPTUHSBEVBUF NFEJDBM FEVDBUJPO QSJNBSZ IFBMUI DBSF

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CULMINA EL PRIMER CICLO DE LA FORMACIÓN DE ESPECIALISTAS PARA LA ATENCIÓN PRIMARIA Y EL SISTEMA PÚBLICO DE ATENCIÓN DE SALUD… - Carlos Montoya-Aguilar, Manuel Ipinza, Nelson Vargas, Jorge Lastra

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TEMAS DE ACTUALIDAD Rev Chil Salud PĂşblica 2014; Vol 18 (1): 33-39

DEFINICIĂ&#x201C;N DE PERFILES DE NUTRIENTES: REQUISITO PARA PROMOVER CAMBIOS ALIMENTARIOS EN LA POBLACIĂ&#x201C;N NUTRIENT PROFILES: AN ESSENTIAL REQUIREMENT FOR PROMOTING DIETARY CHANGES IN THE POPULATION

RESUMEN

MARCIA ERAZO

Departamento de Nutricion, Facultad de Medicina, Universidad de Chile. Instituto de Salud Poblacional, Facultad de Medicina, Universidad de Chile.

OrganizaciĂłn Panamericana de la Salud merazo@med.uchile.cl

ROBERTO DEL Ă GUILA OrganizaciĂłn Panamericana de la Salud.

IntroducciĂłn: Las enfermedades no transmisibles son la primera causa de mortalidad a nivel mundial. Para prevenirlas, un grupo de expertos recomendĂł la reducciĂłn del consumo de grasas saturadas, trans, sodio y azĂşcares. Para informar a la poblaciĂłn respecto del alto contenido de nutrientes de los alimentos, es necesario poder identificarlos, para lo cual se requiere desarrollar una metodologĂa que sustente la clasificaciĂłn de â&#x20AC;&#x153;alto enâ&#x20AC;?. MĂŠtodos: Se hizo una bĂşsqueda bibliogrĂĄfica en PubMed focalizada en artĂculos cientĂficos y en documentos tĂŠcnicos de gobiernos que hubiesen implementado estas reglamentaciones. Resultados: La definiciĂłn de perfil de nutrientes es relativamente nueva, y ha sido liderada por paĂses europeos, destacando Reino Unido. Proponen un modelo que contiene diversas fases: definir el propĂłsito de uso, y poblaciĂłn objetivo; decidir si el criterio abarcarĂĄ todos los alimentos o por categorĂas; decidir los nutrientes, la base sobre la cual se expresarĂĄ el contenido del nutriente; si el tipo de modelo serĂĄ categĂłrico o continuo y el punto de corte. Las decisiones que se tomen tienen repercusiones sobre la conducta alimentaria de la poblaciĂłn, ya que podrĂan inducir a los consumidores a preferir alimentos saludables o alimentos mĂĄs saludables dentro de una misma categorĂa. ConclusiĂłn: La definiciĂłn de perfiles de nutrientes es crucial para poder apoyar polĂticas pĂşblicas de cambio en los hĂĄbitos alimentarios de la poblaciĂłn. Es recomendable hacer estas definiciones en grupos de expertos y con datos nacionales que reflejen el consumo alimentario a nivel de poblaciĂłn. Palabras clave: 1FSĂ M EF OVUSJFOUFT SFHMBNFOUBDJĂ&#x201C;O DPOEVDUB BMJNFOUBSJB

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ABSTRACT Introduction: Non-communicable diseases are the leading cause of mortality worldwide. To prevent them, an expert panel recommended reducing consumption of saturated and trans fats, sodium and sugars. To inform the public about the high content of these nutrients, it is necessary to identify the foods that fit the criteria â&#x20AC;&#x153;high inâ&#x20AC;?, for which theDevelopment of a methodology that supports the classification of â&#x20AC;&#x153;highâ&#x20AC;?, is required. Methods: Literature search of PubMed articles that focused on scientific and technical documents from governments which had implemented these regulations. Results: The nutrient profile definition is relatively new, and has been led by European countries, especially UK. They proposed a model containing several phases: to define the purpose of use and target population, to decide if the criteria encompass all foods or by categories, to decide the nutrients to be used, the based on which the nutrient content will be expressed, if the type of model will be categorical or continuous and the cutoff point. The decisions will have an impact on feeding behavior of the population, and could lead consumers to prefer healthy foods or healthier foods within the same category. Conclusion: The definition of nutrient profiles is crucial in order to support public policiesaimed to change eating habits of the population. It is advisable to make these definitions in expert groups meetings and the use of national data that reflects food consumption at population level. Keywords: /VUSJFOU QSPĂ MF SFHVMBUJPO FBUJOH CFIBWJPS

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DEFINICIÓN DE PERFILES DE NUTRIENTES: REQUISITO PARA PROMOVER CAMBIOS ALIMENTARIOS EN LA POBLACIÓN Marcia Erazo, Roberto Del Águila

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DJÓO PCKFUJWP DPNP OJÒPT FO DSFDJNJFOUP FNCBSB[BEBT MBDUBOUFT Z BEVMUPT NBZPSFT %FDJEJS TJ FM DSJUFSJP B VTBS BCBSDBSÃ UPEPT MPT BMJNFOUPT P TF IBSÃ QPS DBUFHPSÎBT FTQFDÎàDBT EF BMJNFOUPT $VBOEP TF EFàOF iBMUP FOu TF IB BTVNJEP RVF FTUF BMJNFOUP DPOUJFOF VO BMUP DPOUFOJEP EF VO EFUFSNJOBEP OVUSJFOUF FO DPNQBSBDJÓO DPO UPEPT MPT PUSPT OVUSJFOUFT Z OP FO SFMBDJÓO B BMJNFOUPT TJNJMBSFT 1PS FM DPOUSBSJP DVBOEP TF EFTDSJCF iSFEVDJEP FOu TF IBDF BMVTJÓO B RVF FM BMJNFOUP QSFTFOUB NFOPSFT WBMPSFT EF VO OVUSJFOUF FTQFDÎàDP FO DPNQBSBDJÓO DPO BMJNFOUPT EF MB NJTNB DBUFHPSÎB %FDJEJS RVÊ OVUSJFOUFT P DPNQPOFOUFT EF BMJNFOUPT TF WBO B VTBS -B 0SHBOJ[BDJÓO .VOEJBM EF MB 4BMVE IB JEFOUJàDBEP OVUSJFOUFT Z PUSPT DPNQPOFOUFT EF MPT BMJNFOUPT RVF UJFOFO SFMBDJÓO DPO FM EFTBSSPMMP EF FOGFSNFEBEFT OP USBOTNJTJCMFT " TV WF[ MB 6OJÓO &VSPQFB JEFOUJàDÓ OVUSJFOUFT /P PCTUBOUF TF IBO FTUBCMFDJEP DVBUSP OVUSJFOUFT QSJPSJUBSJPT RVF EFCFO TFS EFDMBSBEPT FOFSHÎB QSPUFÎOBT HSBTB Z DBSCPIJESBUPT -PT OVUSJFOUFT EFCFO TFS QSJPSJ[BEPT EFCJEP B TV JNQPSUBODJB FO MB TBMVE QÙCMJDB %FDJEJS RVÊ CBTF P DPNCJOBDJÓO EF CBTF TF WB B VTBS &O UFPSÎB FYJTUFO NÙMUJQMFT GPSNBT QPS MBT DVBMFT TF QVFEF FYQSFTBS FM DPOUFOJEP EF VO OVUSJFOUF FO VO BMJNFOUP MBT GPSNBT NÃT QSÃDUJDBT TPO QPS QPSDJÓO QPS H Z QPS ,+ 5PEBT MBT CBTFT QSFTFOUBO WFOUBKBT Z EFTWFOUBKBT Z TV FMFDDJÓO FT DSVDJBM ZB RVF PSEFOB MPT BMJNFOUPT FO EJTUJOUB QPTJDJÓO %FDJEJS RVÊ UJQP EF NPEFMP TF WB B VTBS &O HFOFSBM FYJTUFO EPT UJQPT EF NPEFMPT DBUFHÓSJDP Z DPOUJOVP &M NPEFMP DBUFHÓSJDP EJWJEF MPT BMJNFOUPT FO DBUFHPSÎBT QFSP VOB WF[ FGFDUVBEB MB DBUFHPSJ[BDJÓO MB UPUBMJEBE EF MPT BMJNFOUPT ZB OP TPO DPNQBSBCMFT -PT NPEFMPT DBUFHÓSJDPT CBTBO TV DPNQBSBDJÓO FO GVODJÓO EF VO NBZPS P NFOPS DPOUFOJEP EF VO BMJNFOUP DPNQBSBEP EFOUSP VOB DBUFHPSÎB EF BMJNFOUPT 1PS TV QBSUF FM NPEFMP DPOUJOVP FOUSFHB VO iSBOLJOHu EF BMJNFOUPT CBTBEP FO VO QVOUBKF EF BDVFSEP BM DPOUFOJEP

REVISTA CHILENA DE SALUD PÚBLICA

EF OVUSJFOUFT EF DBEB QSFTFOUBDJÓO &TUPT NPEFMPT DPOUJOVPT BM TFS NÃT áFYJCMFT QVFEFO TFS VTBEPT QBSB DPOTUSVJS EJGFSFOUFT DBUFHPSÎBT EF BMJNFOUPT EF BDVFSEP B QSPQÓTJUPT EFUFSNJOBEPT &MFHJS FM QVOUP EF DPSUF *EFBMNFOUF MPT QVOUPT EF DPSUF VUJMJ[BEPT QBSB EFàOJS MPT BMJNFOUPT iBMUPT FOu EFCJFSBO FTUBS EJSFDUBNFOUF SFMBDJPOBEPT DPO MBT SFDPNFOEBDJPOFT BMJNFOUBSJBT FO TBMVE QÙCMJDB &TUP FT QPTJCMF NFEJBOUF EPT WÎBT VOB VUJMJ[B FM DSJUFSJP EF DPNQBSBDJÓO EF UPEPT MPT BMJNFOUPT FO RVF TF VTBO QSPQPSDJPOFT FTUÃOEBS DPNP MBT VTBEBT FO MBT HVÎBT EF QPSDJPOFT EJBSJBT MB PUSB BQMJDB FM NPEFMP EF DBUFHPSÎBT FTQFDÎàDBT EF BMJNFOUPT FO RVF TF NPEFMB MB EJGFSFODJB FOUSF MB JOHFTUB BDUVBM Z MB JOHFTUB EFTFBEB %F UPEBT MBT GBTFT QSPQVFTUBT VOB RVF IB QSFTFOUBEP FTQFDJBM EJTDVTJÓO IB TJEP MB EF TFMFDDJPOBS MB CBTF TPCSF MB DVBM TF EFàOJSÃ FM MÎNJUF EF iBMUP FOu ZB RVF MBT USFT CBTFT FYJTUFOUFT QPS H QPS ,+ P QPS QPSDJÓO FYQSFTBO DPODFQUPT EJTUJOUPT FTDBTBNFOUF PCKFUJWBCMFT QPS MP RVF MB EFDJTJÓO RVF MPT EJWFSTPT QBÎTFT FGFDUÙFO TFSÃ SFáFKP EF MB EJTDVTJÓO FYQFSUB EF TVT QSPT Z DPOUSBT 1PS FKFNQMP TF QVFEF TFÒBMBS RVF FM 1BSMBNFOUP &VSPQFP FO FM BÒP IJ[P VOB QSPQVFTUB EF SFHVMBDJÓO QBSB HFOFSBS BMFSUBT OVUSJDJPOBMFT FO BMJNFOUPT DPO BMUP DPOUFOJEP EF TBM B[ÙDBSFT FOFSHÎB Z HSBTBT &O FTF EPDVNFOUP MB CBTF RVF TF QSPQPOF QBSB MBT EJWFSTBT EFàOJDJPOFT FT iQPS Hu P iQPS NMu EFQFOEJFOEP EF TJ FM BMJNFOUP FT TÓMJEP P MÎRVJEP &O DBNCJP FO &TUBEPT 6OJEPT MB '%" SFDPNJFOEB VUJMJ[BS VOB CBTF iQPS QPSDJÓOu QBSB HFOFSBS FM FUJRVFUBEP OVUSJDJPOBM 1BSB DBEB VOB EF MBT CBTFT JEFOUJàDBEBT TF IBO BOBMJ[BEP MPT QSPT Z DPOUSBT RVF QSFTFOUBO DBEB VOB EF FMMBT Z RVF EFCFO TFS DPOTJEFSBEPT BM NPNFOUP EF MB FMFDDJÓO 5BCMB -B SFWJTJÓO EF MJUFSBUVSB JOEJDB RVF MB CBTF NÃT VUJMJ[BEB FT i1PS QPSDJÓOu TFHVJEB EF i1PS Hu TJFOEP i1PS ,+u MB NFOPT GSFDVFOUF $PNP VOB NBOFSB EF BQPZBS MB UPNB EF EFDJTJPOFT FO SFMBDJÓO B RVÊ CBTF VUJMJ[BS MPT

FYQFSUPT QMBOUFBSPO RVF UBM WF[ VOB DPNCJOBDJÓO EF CBTFT TFSÎB VOB BMUFSOBUJWB WJBCMF QBSB QPEFS DPNCJOBSMBT Z BTÎ QPUFODJBS TVT WFOUBKBT -BT CBTFT iQPS Hu Z iQPS ,+u PSEFOBO MPT BMJNFOUPT EF NBOFSB TJNJMBS FO GVODJÓO EF TVT DPOUFOJEPT EF OVUSJFOUFT 1PS MP UBOUP VTBS iQPS Hu P iQPS ,+u FO DPNCJOBDJÓO DPO iQPS QPSDJÓOu QPESÎB TFS VOB BMUFSOBUJWB WJBCMF QBSB VOJS MBT WFOUBKBT EF BNCBT CBTFT &TUB UÊDOJDB TF IB VTBEP QBSB EFUFSNJOBS DVÃOUP EF VO OVUSJFOUF FT BQPSUBEP QPS VO BMJNFOUP B MB EJFUB 1PS FKFNQMP FO FM Codex Alimentarius MB EFàOJDJÓO EF iCBKP FO HSBTB TBUVSBEBu TF VTB QBSB VO BMJNFOUP RVF QPTFF NFOPT EF H EF HSBTB TBUVSBEB QPS H Z NFOPT EF ,+ EF HSBTB TBUVSBEB QPS ,+ 1BSB DPNCJOBS MBT CBTFT TF EFCF EFDJEJS MB GPSNB FO MB RVF FMMBT TF WBO B VTBS &O FTUF TFOUJEP FYJTUFO EPT QPTJCJMJEBEFT FTQFDJàDBS RVF VO BMJNFOUP DVNQMF DPO MPT DSJUFSJPT EF H iyu QPS QPSDJÓO P CJFO QPS H iou QPS QPSDJÓO -B NBOFSB FO RVF TF WBO B DPNCJOBS Z P EFQFOEF EF MBT CBTFT RVF TF WBO B DPNCJOBS Alcances del uso de las distintas definiciones de perfil de nutrientes &M EFTBSSPMMP EF VO QFSàM EF OVUSJFOUFT QBSB EFàOJS iBMUP FOu BZVEBSÎB B MBT QFSTPOBT B DPNQBSBS MB DBOUJEBE EF HSBTB TBM Z B[ÙDBS RVF VO BMJNFOUP BQPSUB B TV EJFUB NÃT RVF DPNQBSBS MB DBMJEBE OVUSJDJPOBM EF FTPT BMJNFOUPT MP RVF TF MPHSB BM VUJMJ[BS VOB CBTF iQPS QPSDJÓOu 1BSB TFMFDDJPOBS MBT CBTFT FT JNQPSUBOUF DPOTJEFSBS FM UJQP EF DSJUFSJP B VUJMJ[BS FO MB EFàOJDJÓO EF QFSàM EF OVUSJFOUFT &TUP TJHOJàDB RVF QPS FKFNQMP TJ TF TFMFDDJPOB FM DSJUFSJP EF DBUFHPSÎB FTQFDÎàDB EF BMJNFOUP FM DPOUFOJEP EF BHVB P FM UBNBÒP EF MB QPSDJÓO WBSÎB NFOPT FO VOB EFUFSNJOBEB DBUFHPSÎB EF BMJNFOUPT QPS MP RVF MB FMFDDJÓO EF MB CBTF FT NFOPT JNQPSUBOUF OP BTÎ DVBOEP TF VUJMJ[B UPEP FM SBOHP EF BMJNFOUPT FO RVF MBT WBSJBDJPOFT FOUSF MPT EJTUJOUPT BMJNFOUPT FO TV DPOUFOJEP EF BHVB Z QPSDJPOFT FT NBZPS QPS MP RVF MB CBTF B VUJMJ[BS TF WVFMWF DSVDJBM

DEFINICIÓN DE PERFILES DE NUTRIENTES: REQUISITO PARA PROMOVER CAMBIOS ALIMENTARIOS EN LA POBLACIÓN Marcia Erazo, Roberto Del Águila

4F IB TFÒBMBEP RVF BNCPT FOGPRVFT TPO VUJMJ[BEPT UBOUP QPS BHFODJBT HVCFSOBNFOUBMFT DPNP QPS MB JOEVTUSJB EF BMJNFOUPT Z FO MPT EPT DBTPT MB DBUFHPSÎB FTQFDÎàDB EF BMJNFOUPT FT MB NÃT VTBEB -B EFTWFOUBKB EF FMMP FT RVF B WFDFT FM TÎNCPMP RVF TF VUJMJ[B TJHOJàDB BMJNFOUP iTBMVEBCMFu Z FO PUSBT PDBTJPOFT iNÃT TBMVEBCMFu RVF PUSP BMJNFOUP EF MB NJTNB DBUFHPSÎB TJUVBDJÓO RVF QVFEF MMFWBS B DPOGVTJÓO B MPT DPOTVNJEPSFT -PT QFSàMFT OVUSJDJPOBMFT RVF VUJMJ[BO FM DSJUFSJP EF JODPSQPSBS UPEPT MPT BMJNFOUPT QBSB DMBTJàDBSMPT FO iTBMVEBCMFTu P iNÃT TBMVEBCMFTu TPO FTDBTPT Z FO HFOFSBM TF IBO VUJMJ[BEP

QBSB SFHVMBS MB QSPNPDJÓO EF BMJNFOUPT EFTUJOBEPT B OJÒPT -B FMFDDJÓO EFM VTP EFM DSJUFSJP EF QFSàM EF OVUSJFOUFT CBTBEP FO DBUFHPSÎB FTQFDÎàDB EF BMJNFOUPT P JODMVJS B UPEPT MPT BMJNFOUPT EFQFOEFSÃ EFM PCKFUJWP RVF TF QSFUFOEF MPHSBS 1PS FKFNQMP TJ TF EFTFB RVF MPT DPOTVNJEPSFT TFMFDDJPOFO BMJNFOUPT iNÃT TBMVEBCMFTu EFOUSP EF VOB NJTNB DBUFHPSÎB EF BMJNFOUPT FOUPODFT TF EFCF BEPQUBS FM DSJUFSJP EF DBUFHPSÎBT EF BMJNFOUPT &O DBNCJP TJ MP RVF TF RVJFSF MPHSBS FT RVF MB QPCMBDJÓO QSFàFSB DPOTVNJS MPT BMJNFOUPT EF las categorías NÃT TBMVEBCMFT FOUPODFT IBCSÃ RVF VUJMJ[BS FTF

Tabla 1. Pros y contras de las distintas bases BASE

PROS

CONTRAS

1PS H

6O BMJNFOUP RVF FT BMUP FO VO OVUSJFOUF FO VOB CBTF EF H QVFEF BQPSUBS QPDP EF FTF OVUSJFOUF TJ FT DPOTVNJEP FO QFRVF&T MB CBTF NÃT VUJMJ[BEB ZB RVF CSJOEB MB JOGPSNBDJÓO ÒBT DBOUJEBEFT P EF NBOFSB JOGSFDVFOUF TPCSF MB DPNQPTJDJÓO EF OVUSJFOUFT EF VO BMJNFOUP 1PS FM DPOUSBSJP VO BMJNFOUP RVF DPOUJFOF FTDBTB DBOUJEBE EF &T SFMBUJWBNFOUF GÃDJM EF DPODFQUVBMJ[BS VO OVUSJFOUF FO VOB CBTF EF H QVFEF BQPSUBS VOB BMUB DBOUJEBE EF FTF OVUSJFOUF TJ FM BMJNFOUP FT DPOTVNJEP FO HSBOEFT DBOUJEBEFT P EF NBOFSB GSFDVFOUF

1PS ,+

-PT BMJNFOUPT RVF UJFOFO VO FTDBTP DPOUFOJEP EF BHVB TPO FOFSHÊUJDBNFOUF EFOTPT Z UJFOEFO B TFS DPOTVNJEPT FO QPSDJPOFT SFMBUJWBNFOUF QFRVFÒBT Z B MB JOWFSTB BMJNFOUPT DPO BMUP DPOUFOJEP FO BHVB UJFOEFO B DPOUFOFS VOB NFOPS EFOTJEBE FOFSHÊUJDB Z B TFS DPOTVNJEPT FO NBZPSFT DBOUJEBEFT %FCJEP B MP BOUFSJPS FYJTUF VOB NBZPS DPSSFMBDJÓO FOUSF OVUSJFOUFT QPS QPSDJÓO Z OVUSJFOUFT QPS ,+ RVF OVUSJFOUFT QPS QPSDJÓO Z OVUSJFOUFT QPS H QPS MP RVF UPNBS VOB CBTF EF FOFSHÎB DPOTJEFSB QBSDJBMNFOUF MPT UBNBÒPT EF MBT QPSDJPOFT %FCJEP B RVF MB DBOUJEBE EF BMJNFOUP RVF MB HFOUF DPOTVNF FTUÃ SFHVMBEB QPS MBT SFDPNFOEBDJPOFT EF JOHFTUB EJBSJB EF OVUSJFOUFT TFHÙO TVT OFDFTJEBEFT EF FOFSHÎB FTUBT UJFOEFO B TFS VOB QSPQPSDJÓO EFM UPUBM EF FOFSHÎB 1PS MP UBOUP VTBS VOB CBTF EF ,+ QVFEF DPSSFTQPOEFS EJSFDUBNFOUF DPO MBT SFDPNFOEBDJPOFT EJFUBSJBT FO DBNCJP FM DSJUFSJP EF H UJFOF RVF TFS DPOWFSUJEP B HSBNPT QPS EÎB VUJMJ[BOEP VO QSPNFEJP EF JOHFTUB EF FOFSHÎB

&YJTUFO BMHVOPT BMJNFOUPT RVF TPO FOFSHÊUJDBNFOUF EFOTPT RVF BQBSFDFO DPO VO BMUP DPOUFOJEP EF VO OVUSJFOUF DVBOEP TF NJEFO QPS ,+ BVORVF TFBO DPOTVNJEPT FO QFRVFÒBT DBOUJEBEFT Z QPS MP UBOUP BQPSUBO FTDBTP DPOUFOJEP EF FTF OVUSJFOUF FO DBNCJP BMHVOPT BMJNFOUPT DPNP GSVUBT Z WFSEVSBT DPOUJFOFO VO BMUP DPOUFOJEP EF BHVB Z FTDBTB DBOUJEBE EF FOFSHÎB UBOUP QPS QPSDJÓO DPNP QPS H 4JO FNCBSHP TJ FTUB QFRVFÒB DBOUJEBE EF FOFSHÎB QSPWJFOF EF HSBTBT TBUVSBEBT P B[ÙDBSFT TPCSF VOB CBTF EF QPSDJÓO FM BMJNFOUP BQBSFDFSÃ UFOJFOEP VOB HSBO DBOUJEBE EF FTF OVUSJFOUF DVBOEP TF NJEB QPS ,+

1PS QPSDJÓO

3FDPOPDF RVF MB HFOUF DPOTVNF DBOUJEBEFT JSSFHVMBSFT EF EJTUJOUPT BMJNFOUPT Z RVF MPT BMJNFOUPT RVF DPOTVNFO FO HSBOEFT DBOUJEBEFT QSPWFFO NÃT EF MPT OVUSJFOUFT RVF FMMPT DPOUJFOFO DPNQBSBEPT DPO MPT BMJNFOUPT RVF DPOTVNFO FO FTDBTB DBOUJEBE &M UBNBÒP EF MB QPSDJÓO Z MB GSFDVFODJB EF DPOTVNP TPO MPT QSJODJQBMFT EFUFSNJOBOUFT EF MB DBOUJEBE EF OVUSJFOUFT RVF VO BMJNFOUP FOUSFHB B MB EJFUB EF MBT QFSTPOBT

-PT UBNBÒPT EF MBT QPSDJPOFT EFQFOEFO QBSDJBMNFOUF EF MBT OFDFTJEBEFT EF FOFSHÎB EF MPT DPOTVNJEPSFT QPS MP UBOUP FT EJGÎDJM EFàOJS FM UBNBÒP EF MBT QPSDJPOFT EF BMHVOPT BMJNFOUPT &TUB CBTF OP UPNB FO DPOTJEFSBDJÓO MB GSFDVFODJB EF DPOTVNP EF BMHVOPT BMJNFOUPT QPS MP RVF QVFEFO TFS DPOTVNJEPT FO QFRVFÒBT QPSDJPOFT QFSP TJ TF JOHJFSFO EF NBOFSB GSFDVFOUF QVFEFO BQPSUBS VOB HSBO DBOUJEBE EF VO OVUSJFOUF EFUFSNJOBEP B MB EJFUB EF VOB QFSTPOB /J MBT CBTFT EF ,+ OJ EF H DPOTJEFSBO MB GSFDVFODJB EF DPOTVNP

REVISTA CHILENA DE SALUD PÚBLICA

DSJUFSJP QBSB EFàOJS MPT QFSàMFT EF OVUSJFOUFT 4J FM NFOTBKF B FOUSFHBS FT iNÃT BMUP FO B[ÙDBS HSBTBT P TBMu FM DSJUFSJP RVF NFKPS QFSNJUF FTUB DMBTJàDBDJÓO FT FM EF iNJTNB DBUFHPSÎB EF BMJNFOUPu ZB RVF FM iNÃT BMUP FOu JNQMJDB VOB DPNQBSBDJÓO DPO BMJNFOUPT TJNJMBSFT FO DBNCJP TJ FM NFOTBKF RVF EFTFB FOUSFHBS B MB QPCMBDJÓO FT FM EF iBMUP FO TBM B[ÙDBS P HSBTBTu FM DSJUFSJP RVF BENJUF FTUB DPNQBSBDJÓO FT FM EF JODPSQPSBS B UPEPT MPT BMJNFOUPT ZB RVF BZVEBSÃ B DPOGSPOUBS B MPT DPOTVNJEPSFT DPO MBT EJTUJOUBT BMUFSOBUJWBT RVF TF PGSFDFO QPS FKFNQMP QBSB FM EFTBZVOP 6O FMFNFOUP RVF UBNCJÊO FT OFDFTBSJP DPOTJEFSBS FT RVF VUJMJ[BS FM DSJUFSJP EF DBUFHPSÎB FTQFDÎàDB EF BMJNFOUPT JNQMJDB JEFOUJàDBS MBT DBUFHPSÎBT EF BMJNFOUPT TJUVBDJÓO RVF OP FTUÃ VOJWFSTBMNFOUF BDFQUBEB OJ DPOTFOTVBEB &O 3FJOP 6OJEP TF IJ[P VO FTUVEJP RVF VUJMJ[Ó MB CBTF EF EBUPT EF MB &ODVFTUB /BDJPOBM EF %JFUB Z /VUSJDJÓO BÒP Z MB JOGPSNBDJÓO EF DPNQPTJDJÓO EF BMJNFOUPT EFM #BODP EF %BUPT EF /VUSJFOUFT EFM 3FJOP 6OJEP SFDPMFDUBEB QBSB BQPZBS MB &ODVFTUB EF %JFUB Z /VUSJDJÓO RVF QSFUFOEÎB JEFOUJàDBS RVÊ DSJUFSJP QPEÎB TFS VUJMJ[BEP QBSB EFàOJS FM QFSàM EF OVUSJFOUFT Z QPS FTB WÎB BZVEBS B RVF MB QPCMBDJÓO NFKPSBSB TV EJFUB &O FTF FTUVEJP TF PCTFSWÓ RVF FYJTUF VOB GVFSUF UFOEFODJB BM DPOTVNP EF WFSTJPOFT NÃT TBMVEBCMFT EF BMJNFOUPT EFOUSP EF VOB DBUFHPSÎB EF BMJNFOUPT FO MPT HSVQPT EF QFSTPOBT RVF QSFTFOUBCBO EJFUBT NÃT TBMVEBCMFT &ODVFTUB EF DPOTVNP RVF FO $IJMF OP FTUÃ EJTQPOJCMF 0USP BSHVNFOUP B DPOTJEFSBS QBSB MB EFàOJDJÓO EF QFSàM EF OVUSJFOUFT EJDF SFMBDJÓO DPO RVF FM DSJUFSJP RVF JODMVZF B UPEPT MPT BMJNFOUPT HFOFSBMNFOUF BQPZB VO NÊUPEP EF cambio EF BMJNFOUPT QBSB NFKPSBS MB EJFUB NJFOUSBT FM DSJUFSJP RVF DPOTJEFSB DBUFHPSÎBT FTQFDÎàDBT EF BMJNFOUPT BQPZB FM NÊUPEP EF sustitución EF BMJNFOUPT QBSB NFKPSBS MB EJFUB &TUP TJHOJàDB RVF QBSB BMDBO[BS MB EJFUB DPOTVNJEB QPS MPT HSVQPT DPO EJFUB EF BMUB DBMJEBE MPT RVF DPOTVNFO EJFUBT QPDP TBMVEBCMFT EFCFSÎBO DPOTVNJS EJGFSFOUFT DBOUJEBEFT EF DBUFHPSÎBT EF BMJNFOUPT DBNCJP Z DPOTVNJS WFSTJPOFT NÃT TBMVEBCMFT EF BMJNFOUPT EFOUSP EF MB NJTNB DBUFHPSÎB EF BMJNFOUPT

TVTUJUVDJÓO -P BOUFSJPS TVHJFSF RVF VUJMJ[BS HVÎBT EJFUBSJBT CBTBEBT FO BMJNFOUPT FT VOB FTUSBUFHJB DPSSFDUB QBSB BQPZBS NFOTBKFT EF DBNCJP Z TVTUJUVDJÓO &T EJGÎDJM EFàOJS MBT DBUFHPSÎBT EF BMJNFOUPT &TUP FT QBSUJDVMBSNFOUF DJFSUP DVBOEP FYJTUF MB OFDFTJEBE EF EFàOJS VO NPEFMP QBSB àOFT EF SFHVMBDJÓO WFSTVT VOP EF BQMJDBDJÓO WPMVOUBSJB $VBOEP TF EJTFÒBO NPEFMPT DPO àOFT SFHVMBUPSJPT HFOFSBMNFOUF TF GBWPSFDF MB DSFBDJÓO EF QPDBT DBUFHPSÎBT EF BMJNFOUPT QBSB GBDJMJUBS TV BQMJDBDJÓO JODMVTP TF IB PCTFSWBEP RVF MB IBCJMJEBE EF VO NPEFMP EF QFSàM EF OVUSJFOUFT RVF BQPZF JOUFSWFODJPOFT EFTUJOBEBT B FTUJNVMBS FM DBNCJP TF WF EFCJMJUBEB TJ TF JODMVZFO NVDIBT DBUFHPSÎBT EF BMJNFOUPT -BT DBUFHPSÎBT EF BMJNFOUPT B TFS JODMVJEBT EFCJFSBO TFS BRVFMMBT FO RVF FYJTUF FWJEFODJB EF RVF MBT QFSTPOBT DPO EJFUBT BQSPQJBEBT DPOTVNFO MBT WFSTJPOFT NÃT TBMVEBCMFT EF BMJNFOUPT EFOUSP EF FTB DBUFHPSÎB CONCLUSIONES -B EFàOJDJÓO EF QFSàMFT EF OVUSJFOUFT FT DSVDJBM QBSB QPEFS BQPZBS QPMÎUJDBT QÙCMJDBT EF DBNCJP FO MPT IÃCJUPT BMJNFOUBSJPT EF MB QPCMBDJÓO 1BSB FMMP FT OFDFTBSJP UPNBS VOB TFSJF EF EFDJTJPOFT FO WJSUVE EFM PCKFUJWP àOBM B QFSTFHVJS ZB RVF MBT EFàOJDJPOFT EF CBTFT EF OVUSJFOUFT P EFM NPEFMP B FNQMFBS JOEVDJSÃO B MB QPCMBDJÓO B PQUBS QPS VO BMJNFOUP FO EFTNFESP EF PUSP 4J TF EFTFB RVF MBT QFSTPOBT QVFEBO FMFHJS VO BMJNFOUP NÃT TBMVEBCMF EFOUSP EF VOB NJTNB DBUFHPSÎB EF BMJNFOUPT FT OFDFTBSJP DPOTJEFSBS RVF FM DPOUFOJEP EF BHVB P FM UBNBÒP EF MB QPSDJÓO WBSÎB NFOPT FO VOB EFUFSNJOBEB DBUFHPSÎB EF BMJNFOUPT QPS MP RVF MB FMFDDJÓO EF MB CBTF FT NFOPT JNQPSUBOUF /P PDVSSF MP NJTNP DVBOEP TF VUJMJ[B UPEP FM SBOHP EF BMJNFOUPT FO RVF MBT WBSJBDJPOFT FOUSF MPT EJTUJOUPT BMJNFOUPT FO TV DPOUFOJEP EF BHVB Z QPSDJPOFT FT NBZPS QPS MP RVF MB CBTF B VUJMJ[BS TF WVFMWF DSVDJBM "TÎ UBNCJÊO BM EFUFSNJOBS FM QVOUP EF DPSUF QBSB JEFOUJàDBS iBMUP FOu FT SFDPNFOEBCMF DPNCJOBS EJTUJOUBT CBTFT ZB RVF BMHVOBT DPOTJEFSBO FM DPOUFOJEP EF BHVB EF MPT BMJNFOUPT Z PUSBT MB EFOTJEBE FOFSHÊUJDB

DEFINICIÓN DE PERFILES DE NUTRIENTES: REQUISITO PARA PROMOVER CAMBIOS ALIMENTARIOS EN LA POBLACIÓN Marcia Erazo, Roberto Del Águila

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CIFRAS DE HOY Rev Chil Salud Pública 2014; Vol 18 (1): 40-42

NO TODOS TIENEN CÁNCER PERO TODOS NOS RESFRIAMOS* NOT EVERYONE GETS CANCER, BUT EVERYONE GETS COLDS

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JORGE CIENFUEGOS Químico farmacéutico Departamento de Políticas Públicas. jcienfuegos@cefds.org

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Ilustración 1. Construida a partir de información extraída del documento “Acceso a Medicamentos de Alto Costo y Enfermedades de Baja Frecuencia”)

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REVISTA CHILENA DE SALUD PÚBLICA

-B GBMUB EF QSPDFEJNJFOUPT DMBSPT QPS QBSUF EFM &TUBEP Z QPS PUSP MBEP MB SFMFWBODJB RVF BERVJFSFO MPT HSVQPT EF QSFTJÓO NBOJQVMBCMFT QPS MB JOEVTUSJB V PUSPT HSVQPT EF JOUFSÊT FYQMJDJUB MB GSBHJMJEBE EF OVFTUSP TJTUFNB EF TBMVE FO NBUFSJB EF BDDFTP B NFEJDBNFOUPT &TUP QVFEF EBS MVHBS B FTQBDJPT QBSB DPSSVQDJÓO iCPMTPOFT EF DPSSVQDJÓOu FO FM TJTUFNB FO EPOEF FM iDBTP B DBTPu Z MBT EFDJTJPOFT FO CBTF B QSFTJPOFT QPS NFEJP EF MB NBOJQVMBDJÓO EF MB iBHFOEBu TPO SFHMB Z OP FYDFQDJÓO &M Mapeo de Actores FT VO FKFSDJDJP JOUFSFTBOUF Z VOB CVFOB NBOFSB EF SFWJTBS MBT JOUFSBDDJPOFT FOUSF MPT BDUPSFT JOWPMVDSBEPT MP RVF QFSNJUF QFOTBS FO VO SFQMBOUFBNJFOUP P FWPMVDJÓO EF MBT JOTUJUVDJPOFT F JOTUJUVDJPOBMJEBE RVF TF DPOEJHB DPO MBT OFDFTJEBEFT Z EFNBOEBT EF MB QPCMBDJÓO La fuente de financiamiento más relevante de la salud en Chile ha sido el gasto

de bolsillo, siendo la forma de financiamiento menos justa y menos eficiente, según la OMS. -B TFHVSJEBE TPDJBM Z FM BOEBNJBKF JOTUJUVDJPOBM RVF QFSNJUB VO àOBODJBNJFOUP Z BTFHVSBNJFOUP EF BDDFTP B ESPHBT FO OVFTUSP QBÎT FT JOFYJTUFOUF &M FTUVEJP EF MB 6OJWFSTJEBE $BUÓMJDB USBUB FTUF UFNB EF VOB NBOFSB iBTÊQUJDBu Z OP JOUFHSB FM UFNB SFWJTBEP DPO PUSBT QPMÎUJDBT EF TBMVE Z EF NFEJDBNFOUPT B OJWFM OBDJPOBM &T JNQPSUBOUF SFWJTBS MBT QPMÎUJDBT FO TV DPOKVOUP OP DPNP JTMBT JOEFQFOEJFOUFT QBSB QMBTNBS VOB QPMÎUJDB GBSNBDÊVUJDB DPIFSFOUF Z BMJOFBEB B MBT QPMÎUJDBT EF TBMVE EF $IJMF “Un sistema sanitario no es bueno por lo que gasta o por quién lo gasta. Es bueno por los resultados sanitarios que genera por cada unidad monetaria invertida”.11

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ARTĂ?CULOS ORIGINALES Rev Chil Salud PĂşblica 2014; Vol 18 (1): 43-51

â&#x20AC;&#x153;ELLOS TAMBIĂ&#x2030;N CUENTANâ&#x20AC;?. LA MORTALIDAD DE LOS NIĂ&#x2018;OS Y ADOLESCENTES DE 5-19 AĂ&#x2018;OS. (ARGENTINA, 1997-2010) â&#x20AC;&#x153;THEY ALSO COUNTâ&#x20AC;?. MORTALITY AMONG 5-19 YEAR OLD CHILDREN AND ADOLESCENTS (ARGENTINA, 1997-2010)

RESUMEN

ELEONORA ROJAS Centro de Investigaciones y Estudios sobre la Cultura y la Sociedad (CIECS)CONICET, Universidad Nacional de CĂłrdoba. eleonorarojascabrera@ gmail.com

Objetivo: El presente trabajo propone analizar la evoluciĂłn y composiciĂłn de la mortalidad de la poblaciĂłn de 5-19 aĂąos en la RepĂşblica Argentina por causas evitables, teniendo en cuenta la atenciĂłn diferencial que la misma ha recibido en relaciĂłn a la que tiene lugar en las primeras edades. Material y mĂŠtodo: Se utiliza fundamentalmente informaciĂłn producida por la DirecciĂłn de EstadĂstica e InformaciĂłn de Salud (Ministerio de Salud de la NaciĂłn, Argentina) y el Instituto Nacional de EstadĂsticas y Censos, a partir de la cual se calculan tasas especĂficas de mortalidad por sexo, edad quinquenal y grupos de causas definidos basadas en la combinaciĂłn de distintas clasificaciones confeccionadas por el Sistema Ă&#x161;nico de Salud de Brasil y la OrganizaciĂłn Mundial de la Salud. Resultados: Los principales resultados acusan un incremento de los niveles de mortalidad asociados a las causas evitables, lo que deriva, en algunos casos, en el aumento de su participaciĂłn en el total de defunciones registradas, mĂĄs acentuado en los varones entre 15 y 19 aĂąos. Asimismo, se observa un incremento en los niveles de mortalidad por accidentes de transporte, homicidios y suicidios. Conclusiones: No obstante los retrocesos que se detectan en la garantĂa de los derechos a la salud y a la vida de la poblaciĂłn bajo estudio, cabe destacar la incipiente puesta en marcha de acciones estatales destinadas a revertir esta situaciĂłn. Palabras clave: NPSUBMJEBE DBVTBT FWJUBCMFT OJĂ&#x2019;PT EF BĂ&#x2019;PT BEPMFTDFOUFT

REVISTA CHILENA DE SALUD PÚBLICA

ABSTRACT Objective: This paper aims to analyze the evolution and breakdown of mortality due to preventable causes in the population of 5-19 year olds in Argentina, given the relatively limited attention it has received compared to children under 5 years old. Material and Methods: Data produced by the Statistics and Health Information Office (Ministry of Health of the Nation, Argentina) and the National Institute of Statistics and Censuses are used to calculate mortality rates by sex, five-year age group and group of causes, which are constructed from the combination of different classifications generated by the Brazilian Unified Health System and the World Health Organization. Results: The main results show an increase in the levels of mortality associated with preventable causes. This is related to the increase of their proportion in the total number of deaths, which is more pronounced among 15-19 years old men. Also, there is an increase in mortality levels related to transportation accidents, homicides and suicides. Conclusions: Despite the setbacks in guaranteeing the rights to health and life of the population under study, there are recent state actions that attempt to reverse this situation. Keywords: NPSUBMJUZ QSFWFOUBCMF DBVTFT ZFBS PME DIJMESFO BEPMFTDFOUT

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“ELLOS TAMBIÉN CUENTAN”. LA MORTALIDAD DE LOS NIÑOS Y ADOLESCENTES DE 5-19 AÑOS. (ARGENTINA, 1997-2010) Eleonora Rojas

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“ELLOS TAMBIÉN CUENTAN”. LA MORTALIDAD DE LOS NIÑOS Y ADOLESCENTES DE 5-19 AÑOS. (ARGENTINA, 1997-2010) Eleonora Rojas

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Tabla 2. Argentina. Participación de las causas evitables en el nivel de la mortalidad de la población de 5-19 años por sexo y grupos de edad (en porcentajes). Trienios 1997-99/2008-10 1SPQPSDJÓO EF NVFSUFT FWJUBCMFT FO FM UPUBM EF NVFSUFT SFHJTUSBEBT FO

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Tabla 3. Argentina. Tasas de mortalidad por causas evitables de la población de 5-19 años por sexo y grupos de edad (por 100.000 habitantes). Trienios 1997-99/2008-10 Tasa de mortalidad por causas evitables (SVQP EF FEBE

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“ELLOS TAMBIÉN CUENTAN”. LA MORTALIDAD DE LOS NIÑOS Y ADOLESCENTES DE 5-19 AÑOS. (ARGENTINA, 1997-2010) Eleonora Rojas

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โ ELLOS TAMBIร N CUENTANโ . LA MORTALIDAD DE LOS NIร OS Y ADOLESCENTES DE 5-19 Aร OS. (ARGENTINA, 1997-2010) Eleonora Rojas

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ARTĂ?CULOS ORIGINALES Rev Chil Salud PĂşblica 2014; Vol 18 (1): 52-60

DISTRIBUCIĂ&#x201C;N DEL RIESGO PSICOSOCIAL LABORAL EN CHILE* DISTRIBUTION OF PSYCHOSOCIAL RISK IN THE WORKPLACE IN CHILE

RESUMEN

JUAN PĂ&#x2030;REZ-FRANCO Departamento de PsiquiatrĂa y Salud Mental Sur. DFacultad de Medicina

IntroducciĂłn: El riesgo psicosocial laboral (RPSL) ha sido reconocido como un factor de creciente importancia para la salud de los trabajadores. La prevenciĂłn de este riesgo estĂĄ vinculada a la posibilidad de diferenciar aquellas actividades econĂłmicas donde se concentra. Objetivo: Diferenciar las actividades econĂłmicas en Chile por su nivel de RPSL. MĂŠtodo: A partir de la base de datos ENETS 2009-2010, aplicando anĂĄlisis factorial y de consistencia interna (alfa de Cronbach), se determinĂł la presencia de 11 escalas de RPSL. Con ellas se realizĂł un anĂĄlisis de las actividades econĂłmicas (de acuerdo a la ClasificaciĂłn Industrial Internacional Uniforme) en Chile. Resultados: El mayor RPSL se concentra en servicios administrativos y de apoyo (oficina, aseo y jardinerĂa), en los hogares familiares (trabajadoras domĂŠsticas) y en el SFUBJM (grandes tiendas y supermercados). Los RPSL mĂĄs elevados son el incumplimiento de la seguridad social, la insatisfacciĂłn con el nivel de salarios y la carga de tareas domĂŠsticas. A la inversa, los menores niveles de RPSL son el sentido del trabajo y la ausencia de abuso. El abuso, de una manera contraintuitiva, destacĂł como una dimensiĂłn de bajo nivel de riesgo. En la mayorĂa de las dimensiones las mujeres son las mĂĄs desfavorecidas, concentrando mayores niveles de RPSL. Conclusiones: El nivel de RPSL en Chile no estĂĄ uniformemente distribuido y son las mujeres las que se exponen a mayores niveles de riesgo. Estos hallazgos permiten diseĂąar polĂticas focalizadas de intervenciĂłn sobre el RPSL. Palabras clave: SJFTHP QTJDPTPDJBM USBCBKP HĂ&#x160;OFSP QPMĂ&#x17D;UJDBT EF TBMVE

Universidad de Chile. jperez@med.uchile.cl

* Este trabajo no contĂł con un financiamiento especial. El autor declara no tener conflicto de intereses.

DISTRIBUCIĂ&#x201C;N DEL RIESGO PSICOSOCIAL LABORAL EN CHILE - Juan PĂŠrez-Franco

ABSTRACT Introduction: Psychosocial risk in the workplace (PSRW) has been recognized as an increasingly important factor for workersâ&#x20AC;&#x2122; health. Prevention of this risk is linked to the possibility of differentiating those economic activities where it is most frequently found. Objective: To differentiate economic activities in Chile by their level of PSRW. Method: From the database ENETS 2009-2010, using factor analysis and internal consistency (Cronbachâ&#x20AC;&#x2122;s alpha) analysis, the presence of 11 PSRW scales was detected. Using these scales we performed an analysis of economic activities (according to the International Standard Industrial Classification) in Chile. Results: Highest PSRW was found in administrative and support services (office activities, cleaning and gardening), family households (domestic workers) and SFUBJM (department stores and supermarkets). The higher PSRW include: lack of respect for social security rights, dissatisfaction with wages and the burden of household chores. Conversely, lower levels of PSRW include: sense of meaning of work and the absence of abuse. In a counterintuitive way, abuse emerged as a low risk dimension. In most dimensions, women are the most disadvantaged, with higher levels of PSRW. Conclusions: The level of PSRW in Chile is not evenly distributed and women are exposed to higher levels of risk. These findings allow for the design of targeted intervention policies on the PSRW. Keywords: QTZDIPTPDJBM SJTL XPSLQMBDF HFOEFS IFBMUI QPMJDJFT

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Tabla 1. Niveles de Riesgo Psicosocial Laboral en Chile, por actividad económica y género, en puntos como porcentaje sobre el máximo posible, en base a la ENETS 2009-2010. Diferencias de medias. Dimensión de RPSL

Hombres

Mujeres

Total

Dif (m-h)

p-value

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Tabla 2. Diferencias de medias y puntaje total de dimensiones de riesgo psicosocial laboral (RPSL). Hombres y mujeres. ENETS 2009-2010. Dimensión de RPSL 3FTQFUP B TFHVSJEBE TPDJBM 4BMBSJP $BSHB EF UBSFBT EPNÊTUJDBT *OáVFODJB TPCSF MB UBSFB 1SFTJÓO EF USBCBKP "NCJFOUF MBCPSBM -JEFSB[HP "DDFTP B QFSNJTPT 1SFPDVQBDJÓO QPS UBSFBT EPNÊTUJDBT "CVTP 4FOUJEP EFM USBCBKP

Hombres

Mujeres

Dif (m-h)

Media

p-value

Tabla 3. Mayores puntajes de RPSL por actividad. ENETS 2009-2010. Dimensión de RPSL 1SFTJÓO 4FOUJEP EFM USBCBKP *OáVFODJB 4BMBSJP "CVTP 3FTQFUP B TFHVSJEBE TPDJBM 1FSNJTPT -JEFSB[HP 1SFPDVQBDJÓO QPS UBSFBT EPNÊTUJDBT $BSHB EF UBSFBT EPNÊTUJDBT "NCJFOUF MBCPSBM 3JFTHP UPUBM

Actividad 4FSWJDJPT BTJTUFODJB TPDJBM IPHBSFT )PHBSFT 1PEFS +VEJDJBM QPMJDÎB HFOEBSNFSÎB )PHBSFT 4FSWJDJPT BENJOJTUSBUJWPT BQPZP )PHBSFT Retail 4FSWJDJPT BENJOJTUSBUJWPT BQPZP )PHBSFT )PHBSFT 4FSWJDJPT BENJOJTUSBUJWPT BQPZP 4FSWJDJPT BENJOJTUSBUJWPT BQPZP

Puntaje

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Tabla 4. Menores puntajes de RPSL por actividad. ENETS 2009-2010. Riesgo 1SFTJร O EF USBCBKP 4FOUJEP EFM USBCBKP *OรกVFODJB 4BMBSJP "CVTP 3FTQFUP B TFHVSJEBE TPDJBM 1FSNJTPT -JEFSB[HP 1SFPDVQBDJร O QPS UBSFBT EPNร TUJDBT $BSHB EF UBSFBT EPNร TUJDBT "NCJFOUF MBCPSBM 3JFTHP UPUBM

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Puntaje

Tabla 5. Menores puntajes de RPSL en dimensiones sentido del trabajo y abuso. ENETS 2009-2010 Actividad &OTFร BO[B TVQFSJPS 1PEFS +VEJDJBM QPMJDร B HFOEBSNFSร B &OTFร BO[B Cร TJDB Z NFEJB 'VFS[BT BSNBEBT 4BMVE 4FSWJDJPT QSPGFTJPOBMFT .JOFSร B "ENJOJTUSBDJร O Qร CMJDB 4FSWJDJPT EF BTJTUFODJB TPDJBM IPHBSFT *OGPSNร UJDB DPNVOJDBDJPOFT "DUJWJEBEFT EF PSHBOJ[BDJPOFT JHMFTJBT 'JOBODJFSBT TFHVSPT 1FTDB BDVJDVMUVSB $POTUSVDDJร O .VOJDJQBMJEBEFT 'PSFTUBMFT *ONPCJMJBSJBT 4FSWJDJPT Cร TJDPT *OEVTUSJB "DUJWJEBEFT BSUร TUJDBT FOUSFUFOJNJFOUP )PUFMFT DPNJEB 5SBOTQPSUF $PNFSDJP "HSJDVMUVSB HBOBEFSร B 4FSWJDJPT BENJOJTUSBUJWPT BQPZP Retail )PHBSFT

Puntaje sentido del trabajo

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DISTRIBUCIÓN DEL RIESGO PSICOSOCIAL LABORAL EN CHILE - Juan Pérez-Franco

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ARTĂ?CULOS ORIGINALES Rev Chil Salud PĂşblica 2014; Vol 18 (1): 61-71

INFLUENCIA DE APOYO SOCIAL Y USO DE SERVICIOS DE SALUD SOBRE LA DEPRESIĂ&#x201C;N EN CUIDADORES DE ADULTOS MAYORES EN ZONA RURAL INFLUENCE OF SOCIAL SUPPORT AND USE OF HEALTH SERVICES ON DEPRESSION AMONG CARETAKERS OF SENIOR CITIZENS IN RURAL AREAS

RESUMEN

DANIEL SERRANI Facultad de PsicologĂa, Universidad Nacional de Rosario Rosario, Santa Fe, Argentina. danielserrani@argentina.com

Objetivos: Investigar la influencia de las redes sociales, apoyo social y uso de servicios de salud sobre la depresiĂłn en cuidadores de adultos mayores rurales. Sujetos: 100 cuidadores rurales proveedores de cuidados para adultos mayores. MĂŠtodo: Estudio transversal con muestreo aleatorio estratificado; se administra a los cuidadores la escala de apoyo social (EAS), de redes sociales (ERS) y de depresiĂłn (CES-D). Resultados: Los cuidadores se dividieron en dos grupos segĂşn proveyeran cuidados a adultos mayores sanos (AMS) o enfermos (AME). Los cuidadores para AMS y AME fueron esposa (28 y 43%), hijos y nueras (51 y 40%) y nietos (2 y 7,5%) respectivamente. Los tres servicios de salud mĂĄs usados por cuidadores fueron visita mĂŠdica (65,2%), ayuda de familiares/amigos (41,2%), curadores alternativos o medicinas no tradicionales (31,9%). Hubo diferencias significativas entre cuidadores de adultos mayores sanos y enfermos en depresiĂłn (t=3.195, p<0.01) y ERS (t=1.955, p<0.05). La depresiĂłn se asocia con edad de cuidadores ( =2.332), ingresos ( =â&#x2C6;&#x2019;0.325), tiempo de cuidados ( =0.253), ERS ( =â&#x2C6;&#x2019;1.984, p=0.001) y gĂŠnero del adulto mayor ( =0.143, p<0.003). DiscusiĂłn: La familia es la principal fuente de cuidados en medios rurales de menores ingresos socioeconĂłmicos, la esposa e hijas ocupan roles centrales, usando recursos mĂŠdicos y no tradicionales. La depresiĂłn de cuidadores se asocia con caracterĂsticas de adultos mayores, siendo la disponibilidad de fuentes de apoyo un mediador potencial. ConclusiĂłn: La disponibilidad de apoyos sociales y uso de servicios de salud son importantes para cuidadores rurales, como recursos para disminuir la severidad y presencia de depresiĂłn Palabras clave: BEVMUPT NBZPSFT DVJEBEPSFT SVSBM NFEJPT TPDJP FDPOĂ&#x201C;NJDPT BQPZP TPDJBM SFDVSTPT TPDJBMFT EFQSFTJĂ&#x201C;O

REVISTA CHILENA DE SALUD PĂ&#x161;BLICA

ABSTRACT Goals: Investigate the influence of social networks, social support and health service used for depression among rural elder care providers. Subjects: 100 rural elder care providers. Method: Cross sectional study with a randomized stratified sample, using the elder care providersâ&#x20AC;&#x2122; social support scale (EAS), social networks (ERS), and depression (CES-D). Results: Elder care providers were divided into two groups according to whether they provided care to healthy or ill elders. Care providers for healthy and ill elders were ususally wives (28 and 43%), son/daughters or daughters-in-law (51 and 40 %) and granddaughters (2 and 7.5%). The three health services most frequently used by care providers were medical visits (65.2%), friends or relatives (41.2%) and alternative healers or non-traditional medicine (31.9%). There were significant differences between healthy and ill eldersÂ´ care providers on depression (t= 3.195, p<0.01) and ERS (t=1.955, p<0.05). Depression is associated with care providers age ( =2.332), incomes ( =â&#x2C6;&#x2019;0.325), duration of care ( =0.253), eldersâ&#x20AC;&#x2122; gender ( =0.143, p<0.003) and ERS ( =â&#x2C6;&#x2019;1.984, p=0.001). Discussion: Family is the main source of care for rural elders with lower socioeconomic income; wives and daughters assume the central role. They use medical and non-traditional resources. Care providersâ&#x20AC;&#x2122; depression is associated with characteristics of the elders, with availability of resources being a potential mediator. Conclusion: Availability of social support and health service use are important for rural care providers, as resources to reduce the severity and presence of depression. Key words: FMEFST DBSF QSPWJEFST SVSBM TPDJPFDPOPNJD SFTPVSDFT TPDJBM TVQQPSU IFBMUI TFSWJDFT VTF EFQSFTTJPO

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INFLUENCIA DE APOYO SOCIAL Y USO DE SERVICIOS DE SALUD SOBRE LA DEPRESIÓN EN CUIDADORES DE ADULTOS MAYORES EN ZONA RURAL - Daniel Serrani

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Figura 1. Esquema del marco teórico propuesto.

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REVISTA CHILENA DE SALUD PÚBLICA

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INFLUENCIA DE APOYO SOCIAL Y USO DE SERVICIOS DE SALUD SOBRE LA DEPRESIÓN EN CUIDADORES DE ADULTOS MAYORES EN ZONA RURAL - Daniel Serrani

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REVISTA CHILENA DE SALUD PÚBLICA

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Tabla 1. Características demográficas de cuidadores (C) y adultos mayores (AM) en una zona rural. Características &EBE NFEJB %& BÒPT

AMS (N=36)

AME (N=64)

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5JFNQP EF DVJEBEPT <IS TFN> NFEJB %4 $$* $$* DPFàDJFOUF EF DPSSFMBDJÓO JOUSBDMBTF

INFLUENCIA DE APOYO SOCIAL Y USO DE SERVICIOS DE SALUD SOBRE LA DEPRESIÓN EN CUIDADORES DE ADULTOS MAYORES EN ZONA RURAL - Daniel Serrani

EF DVJEBEPSFT EF ".4 Z ".& &M DPFàDJFOUF EF DPSSFMBDJÓO JOUSBDMBTF QSPNFEJP FOUSF DVJEBEPSFT EF ".4 Z ".& GVF EF NVZ CBKP MP RVF JOEJDB RVF TPMP FM EF MB JODJEFODJB EF MB EFQSFTJÓO FOUSF MPT DVJEBEPSFT GVF FYQMJDBEP QPS MBT DPOTFDVFODJBT EF MB JOVOEBDJÓO USO DE LOS SERVICIOS DE SALUD, APOYO SOCIAL Y EVALUACIÓN DE LA DEPRESIÓN $PNP TF PCTFSWB FO MB 'JHVSB FM TFSWJDJP EF TBMVE NÃT VTBEP GVF FM EF WJTJUBS B VO NÊEJDP 46 TFHVJEP EF SFDVSSJS B MPT BNJHPT QBSB PCUFOFS BQPZP BEJDJPOBM 46

Z CVTDBS BZVEB QPS QBSUF EF MPT QSBDUJDBOUFT JOGPSNBMFT curanderos P manosantas 46 -B 5BCMB NVFTUSB FM VTP EF FTUPT USFT TFSWJDJPT SFDVSSJS BM NÊEJDP BNJHPT P QSBDUJDBOUFT JOGPSNBMFT FOUSF MPT DVJEBEPSFT -B NBZPSÎB EF MPT DVJEBEPSFT OP WF BM NÊEJDP NVZ TFHVJEP P WF[ NFT $FSDB EF MB NJUBE WJTJUB NÊEJDPT NBZPSNFOUF QBSB FM BEVMUP NBZPS Z B NÃT EF MB NJUBE MF SFTVMUB NVZ ÙUJM &M DVJEBEPS EF ".& NPTUSÓ VOB NBZPS UFOEFODJB B SFDVSSJS B MPT TFSWJDJPT EF NÊEJDPT DPJODJEFOUF DPO MPT SFTVMUBEPT EF PUSPT FTUVEJPT Q &M VTP EF PUSPT TFSWJDJPT OP EJàSJÓ TJHOJàDBUJWBNFOUF FOUSF BNCPT HSVQPT Q

/PUB 46 DVJEBEPT EF EÎB 46 DVJEBEPSFT EPNJDJMJBSJPT 46 WJTJUB NÊEJDB 46 JOUFSOBDJÓO EPNJDJMJBSJB 46 BDPNQBÒBNJFOUP QBHP 46 NFKPSBT EPNJDJMJBSJBT 46 BTJTUFOUF EPNJDJMJBSJB 46 EFTDBOTP 46 USBCBKBEPS TPDJBM 46 FOUSFHB EF DPNJEBT B EPNJDJMJP 46 USBOTQPSUF 46 BTFTPSBNJFOUP EF TBMVE NFOUBM 46 DPOTFKP MFHBM 46 DPOTFKP àOBODJFSP 46 DVSBOEFSPT P TBOBEPSFT 46 NÊEJDPT 46 HSVQPT EF BQPZP 46 BNJHPT P QBSJFOUFT

REVISTA CHILENA DE SALUD PÚBLICA

Tabla 2. Uso de tres servicios comunes de salud entre cuidadores en área rural. Frecuencia de uso (%)

Para quién (%)

Utilidad (%)

BNCPT

7JTJUB BM NÊEJDP

#VTDBS BZVEB EF BNJHPT

7FS B QSBDUJDBOUF JOGPSNBM

'SFDVFODJB EJBSJB EÎBT TFNBOB WF[ TFNBOB EÎBT TFNBOB WF[ TFNBOB WF[ TFNBOB WF[ NFT VOB WF[ NFT WF[ NFT 6UJMJEBE OBEB ÙUJM BMHP ÙUJM NVZ ÙUJM $ DVJEBEPS ". BEVMUP NBZPS

-PT QVOUBKFT EF MBT SFTQVFTUBT EF MB &"4 TF FYIJCFO FO MB 5BCMB /P IVCP EJGFSFODJBT TJHOJàDBUJWBT FOUSF BNCPT HSVQPT FO MB &"4 U Q -PT DVJEBEPSFT EF ".& QVOUVBSPO NÃT BMUP FO MB FTDBMB EF EFQSFTJÓO Z NFOPS FO MB EF &34 RVF MPT DVJEBEPSFT EF ".4 U Q Z U Q SFTQFDUJWBNFOUF &M BOÃMJTJT EF DPSSFMBDJÓO EF 1FBSTPO FODPOUSÓ VOB SFMBDJÓO QPTJUJWB FOUSF MBT &"4 Z &34 S Q TVHJSJFOEP MB DPOTJTUFODJB EF BNCBT FTDBMBT QBSB MB FWBMVBDJÓO EF BQPZP TPDJBM Z UBNCJÊO FODPOUSÓ VOB DPSSFMBDJÓO OFHBUJWB FOUSF MB $&4 % Z &"4 S ¢ Q Z MB $& % Z &34 S ¢ Q &TUPT SFTVMUBEPT TVHJFSFO RVF MB TFWFSJEBE EF MB EFQSFTJÓO EJTNJOVZF B NFEJEB RVF BVNFOUB FM HSBEP EF BQPZP TPDJBM -B DPNQBSBDJÓO FOUSF MBT &"4 &34 Z $&4 % TF NVFTUSB FO MB 5BCMB EPOEF TF PCTFSWB RVF MBT EJGFSFODJBT TPO NÃT TJHOJàDBUJWBT FOUSF MPT DVJEBEPSFT EF ".4 Z ".& FO MBT FTDBMBT EF SFEFT TPDJBMFT Z EFQSFTJÓO FO UBOUP OP IBZ UBOUBT EJGFSFODJBT FO BQPZP TPDJBM RELACIONES ENTRE LA DEPRESIÓN Y LAS CARACTERÍSTICAS DE LOS CUIDADORES Y ADULTOS MAYORES $PNP TF NVFTUSB FO MB 5BCMB FM BOÃMJTJT EF SFHSFTJÓO MPHÎTUJDB UPNBOEP DPNP WBSJBCMF EFQFOEJFOUF MB QSFTFODJB EF EFQSFTJÓO FO FM DVJEBEPS NPTUSÓ RVF MBT WBSJBCMFT DPOGVOEJEPSBT JODMVZFOEP FEBE Z HÊOFSP EF ". Z DVJEBEPSFT JOHSFTPT SFTJEFODJB Z UJFNQP EFEJDBEP B DVJEBEPT OP PCUVWJFSPO EJGFSFODJBT FTUBEÎTUJDBNFOUF TJHOJàDBUJWBT DPO FYDFQDJÓO EFM UJFNQP EF DVJEBEPT Z FM OJWFM EF FEVDB-

DJÓO EFM DVJEBEPS DPO VOB SFMBDJÓO JOWFSTB FT EFDJS B NFOPS OJWFM FEVDBUJWP FT NBZPS MB TFWFSJEBE EF MB EFQSFTJÓO NPEFMP 5PNBOEP FO DVFOUB FM FGFDUP EF MBT WBSJBCMFT JOEFQFOEJFOUFT TF DPNQSPCÓ RVF IVCP VOB SFMBDJÓO TJHOJàDBUJWB FOUSF MB FEBE F JOHSFTPT EF MPT DVJEBEPSFT Z FM UJFNQP EF DVJEBEPT MPT WBMPSFT EF SFEFT TPDJBMFT Z VTP EF TFSWJDJPT EF TBMVE DPO MB TFWFSJEBE EF MB EFQSFTJÓO NPEFMP FO 5BCMB DISCUSIÓN -B IJQÓUFTJT QMBOUFBEB BM DPNJFO[P EFM FTUVEJP GVF RVF OP TPMP FM SFTVMUBEP EF MPT DVJEBEPT SFDJCJEPT QPS MPT BEVMUPT NBZPSFT TFSÎB JOáVJEP QPS MBT DBSBDUFSÎTUJDBT TPDJPFDPOÓNJDBT Z BNCJFOUBMFT EF MPT DVJEBEPSFT TJOP RVF FTUBT UBNCJÊO FKFSDFSÎBO VOB JOáVFODJB TPCSF MB QSFTFODJB EF EFQSFTJÓO FO FM DVJEBEPS B USBWÊT EF MB NFEJBDJÓO FKFSDJEB QPS MPT BQPZPT Z SFDVSTPT TPDJBMFT EFOUSP EFM DPOUFYUP EF VOB DPNVOJEBE SVSBM -PT SFTVMUBEPT QSFMJNJOBSFT JOGPSNBO RVF MB NBZPSÎB EF DVJEBEPSFT VTBO SFDVSTPT NÊEJDPT EVSBOUF FM DVJEBEP EFM BODJBOP UBOUP QBSB TÎ NJTNPT DPNP QBSB FM ". MB EFQSFTJÓO EJàFSF TJHOJàDBUJWBNFOUF FOUSF MPT DVJEBEPSFT EF BODJBOPT TBOPT Z FOGFSNPT MB TFWFSJEBE EF MB EFQSFTJÓO FTUÃ SFMBDJPOBEB DPO MBT DBSBDUFSÎTUJDBT EF MPT DVJEBEPSFT DPNP TV OJWFM EF JOHSFTPT FEBE UJFNQP EFEJDBEP B MPT DVJEBEPT MB NBZPS QBSUF EF MPT DVJEBEPSFT GVFSPO FTQPTB F IJKBT DPOTJTUFOUF DPO MBT USBEJDJPOFT SVSBMFT FO UBOUP RVF MPT IJKPT USBCBKBO GVFSB EFM IPHBS Z EJTQPOFO EF NBZPSFT SFEFT TPDJBMFT RVF SFEVDFO MB EFQSFTJÓO B NFOPS OJWFM EF JOHSFTPT BVNFOUB FM SJFTHP EF EFQSFTJÓO QPS BVNFOUP

INFLUENCIA DE APOYO SOCIAL Y USO DE SERVICIOS DE SALUD SOBRE LA DEPRESIÓN EN CUIDADORES DE ADULTOS MAYORES EN ZONA RURAL - Daniel Serrani

Tabla 3. Promedio de respuesta a las preguntas en la EAS. Preguntas

Promedio de frecuencias (%)

3FDJCP WJTJUBT EF BNJHPT Z GBNJMJBSFT

3FDJCP BNPS Z BGFDUP

3FDJCP BZVEB FO BTVOUPT SFMBDJPOBEPT DPO NJ DBTB

3FDJCP FMPHJPT Z SFDPOPDJNJFOUP DVBOEP IBHP CJFO NJ USBCBKP

5FOHP PQPSUVOJEBE EF IBCMBS DPO BMHVJFO BDFSDB EF NJT QSPCMFNBT FO FM USBCBKP P FO MB DBTB

5FOHP PQPSUVOJEBE EF IBCMBS DPO BMHVJFO EF NJT QSPCMFNBT GBNJMJBSFT P QFSTPOBMFT

5FOHP PQPSUVOJEBE EF IBCMBS DPO BMHVJFO EF QSPCMFNBT FDPOÓNJDPT

3FDJCP JOWJUBDJPOFT QBSB EJTUSBFSNF Z TBMJS DPO PUSBT QFSTPOBT

3FDJCP DPOTFKPT ÙUJMFT BDFSDB EF DPTBT JNQPSUBOUFT FO MB WJEB

3FDJCP BZVEB DVBOEP FTUPZ FOGFSNP FO DBNB

Tabla 4. Comparación entre los puntajes de escala apoyo social, redes sociales y CES-D. Puntajes de Escalas

CAS/CAE

$"4 O

$"& O

.FEJB %&

&TDBMB BQPZP TPDJBM

&TDBMB SFEFT TPDJBMFT

$&4 %

$"4 DVJEBEPSFT BEVMUPT TBOPT $"& DVJEBEPSFT BEVMUPT FOGFSNPT

Tabla 5. Regresión logística para variable dependiente CES-D. Modelo 1

Modelo 2

Coeficientes no estandarizados B &EBE *OHSFTPT ". 3FTJEFODJB ". (ÊOFSP ". &EBE ". 5JFNQP DVJEBEPT ' NFEJBEPSFT &EBE $ *OHSFTP $ 3FTJEFODJB $ (ÊOFSP $ &EVDBDJÓO $ &"4 &34 6TP TFSWJDJPT TBMVE

Coef. Beta

(p)

Coeficientes no estandarizados B

Coef. Beta

(p)

0.003 0.001

0.004 -0.001 0.001 0.001

$ DVJEBEPSFT ". BEVMUPT NBZPSFT ' NFEJBEPSFT GBDUPSFT NFEJBEPSFT $PFG #FUB DPFàDJFOUF CFUB

REVISTA CHILENA DE SALUD PÚBLICA

EF MB EFQFOEFODJB FDPOÓNJDB Z DBSHB EF USBCBKP Z NFOPSFT PQPSUVOJEBEFT EF NBOUFOFS WÎODVMPT TPDJBMFT MB NBZPSÎB EF DVJEBEPSFT WJTJUBO BM NÊEJDP QBSB MPT QSPCMFNBT EF TBMVE Z FO BVTFODJB EF DBVTBT EFàOJEBT EF FOGFSNFEBE FTQFDJBMNFOUF DSÓOJDBT TF SFDVSSF B DVSBEPSFT JOGPSNBMFT MPT DVJEBEPSFT EF ".4 UFOÎBO NFOPT EFQSFTJÓO RVF MPT DVJEBEPSFT EF ".& ZB RVF FTUPT ÙMUJNPT EFNBOEBO VOB NBZPS DBSHB EF DVJEBEPT BMHP DPJODJEFOUF DPO PUSPT FTUVEJPT

"EFNÃT EF DPOàSNBS MB IJQÓUFTJT JOJDJBM TPCSF BVNFOUP EF EFQSFTJÓO FO DVJEBEPSFT BTPDJBEB B DBSBDUFSÎTUJDBT TPDJPBNCJFOUBMFT Z NFEJBEB NPEFSBEB QPS SFEFT TPDJBMFT Z VTP EF TFSWJDJPT BTJTUFODJBMFT TF TVHJFSFO NPEPT EF JOUFSWFODJÓO QBSB SFEVDJS MB EFQSFTJÓO FO FTUF HSVQP QPCMBDJPOBM QSPNPWFS SFEFT TPDJBMFT BMUFSOBUJWBT QBSB MPT DVJEBEPSFT Z TFSWJDJPT TPDJBMFT EF BZVEB QBSB TVT UBSFBT NBOUFOFS WJHJMBODJB FQJEFNJPMÓHJDB QBSB FTUPT DVJEBEPSFT FEBE QSPNFEJP BÒPT QBSB QSFWFOJS EFQSFTJÓO Z PUSBT FOGFSNFEBEFT BTPDJBEBT BM FTUSÊT IJQFSUFOTJÓO UBCBRVJTNP BMDPIPMJTNP ZB RVF MB NBZPSÎB EF MPT DVJEBEPSFT FTUBCBO DBTBEPT EFCFSÎBO SFDJCJS BZVEB FDPOÓNJDB Z P TPDJBM QBSB DPNQFOTBS TVT FTGVFS[PT Z NBOUFOFS MB DPIFTJÓO GBNJMJBS BEBQUBS MBT JOTUSVDDJPOFT EF BDVFSEP BM CBKP OJWFM FEVDBUJWP EF MPT DVJEBEPSFT QSJNBSJP JODPNQMFUP FO TV NBZPSÎB MP RVF EF QPS TÎ SFQSFTFOUB VO PCTUÃDVMP BEJDJPOBM QBSB DPOTUSVJS SFEFT TPDJBMFT Z NBOUFOFS FNQMFPT GPSNBMFT FO DPOTPOBODJB DPO MP BOUFSJPS TFSÎB DPOWFOJFOUF GPNFOUBS QMBOFT FEVDBUJWPT JOGPSNBMFT BTPDJBEPT B MB BZVEB TPDJBM QBSB DPNQFOTBS MB JOTUSVDDJÓO GBMUBOUF EFCJEP BM FTDBTP VTP EF TFSWJDJPT JOGPSNBMFT DPNP USBOTQPSUF WJTJUBT BM NÊEJDP P BNJHPT Z QBSJFOUFT BTÎ DPNP MPT FTDBTPT QFSÎPEPT EF EFTDBOTP QBSB MPT DVJEBEPSFT DPO NÃT EFQSFTJÓO EFCFSÎB GBDJMJUBSTF FTUF UJQP EF SFDVSTPT DPO WJTJUBT EPNJDJMJBSJBT QSPHSBNBEBT EF EJGFSFOUFT BHFOUFT EF TBMVE Z TFSWJDJPT TPDJBMFT FOTFÒBS FTUSBUFHJBT EF BGSPOUBNJFOUP EF MPT QSPCMFNBT CBTBEBT FO SFDPOPDJNJFOUP EF PCTUÃDVMPT Z SFDMBNP EF TPMVDJPOFT BOUFT RVF FO MB OFHBDJÓO EF MPT NJTNPT RVF UFSNJOBO EFSJWBOEP FO DVBESPT EFQSFTJWPT EF EJGÎDJM SFTPMVDJÓO àOBMNFOUF FOTFÒBS UÊDOJDBT

EF DVJEBEP UBOUP EF ".4 DPNP ".& QSFGFSFOUFNFOUF FO UFSSFOP UFOJFOEP FO DVFOUB MB FTDBTB FYQFSJFODJB Z SFEVDJEPT SFDVSTPT DPHOJUJWPT Z BNCJFOUBMFT EF MPT DVJEBEPSFT -JNJUBDJPOFT 3FEVDJEP UBNBÒP NVFTUSBM QPCMBDJÓO SVSBM RVF JNQJEF HFOFSBMJ[BS MPT SFTVMUBEPT B PUSPT ÃNCJUPT FTUVEJP USBOTWFSTBM RVF JNQJEF FTCP[BS SFMBDJPOFT DBVTBMFT CONCLUSIÓN -PT DVJEBEPSFT SVSBMFT EF ".4 Z ".& SFQSFTFOUBO VO HSVQP QPCMBDJPOBM TVCFTUJNBEP Z QPDP FTUVEJBEP DPO BMUB DBSHB EF USBCBKP Z SFQFSDVTJPOFT GÎTJDBT Z QTJDPMÓHJDBT EFQSFTJÓO OP TJFNQSF EFUFDUBEBT QPS MP RVF TF SFRVJFSFO NÃT FTUVEJPT QBSB FYQMJDBS Z FYQMPSBS FM BQPZP TPDJBM RVF SFDJCFO Z TV TBMVE NFOUBM BTÎ DPNP QBSB JNQMFNFOUBS QMBOFT TPDJPBNCJFOUBMFT QSFWFOUJWPT RVF MFT QFSNJUBO NBOUFOFS TV BVUPOPNÎB Z TBMVE REFERENCIAS 8FOHFS ($ 4DPUU " 4FEEPO % 5IF FYQFSJFODF PG DBSJOH GPS PMEFS QFPQMF XJUI EFNFOUJB JO B SVSBM BSFB VTJOH TFSWJDFT Aging & Mental Health 'SFVOE % 4NFFEJOH 5. 5IF GVUVSF DPTUT PG IFBMUI DBSF JO BHFJOH TPDJFUJFT JT UIF HMBTT IBMG GVMM PS IBMG FNQUZ &O 5VMKBQVSLBS 4 0HBXB / (BVUIJFS /) FET Ageing in advanced industrial states 4QSJOHFS QQ #FOKVNFB $ $VJEBEP GBNJMJBS FO DPOEJDJPOFT DSÓOJDBT 6OB BQSPYJNBDJÓO B MB MJUFSBUVSB Teto Contexto Enferm. .PMJOB +. *ÃÒF[ . *ÃÒF[ # &M BQPZP TPDJBM DPNP NPEVMBEPS EF MB DBSHB EFM DVJEBEPS EF FOGFSNPT EF "M[IFJNFS Psicol Salud %PNÎOHVF[ +" 3VJ[ . (ÓNF[ * (BMMFHP & 7BMFSP + *[RVJFSEP .5 "OTJFEBE Z EFQSFTJÓO FO DVJEBEPSFT EF QBDJFOUFT EFQFOEJFOUFT Semergen %VFÒBT & .BSUÎOF[ ." .PSBMFT # .VÒP[ $ 7JÃGBSB "4 )FSSFSB +" 4ÎOESPNF EFM

INFLUENCIA DE APOYO SOCIAL Y USO DE SERVICIOS DE SALUD SOBRE LA DEPRESIÓN EN CUIDADORES DE ADULTOS MAYORES EN ZONA RURAL - Daniel Serrani

DVJEBEPS EF BEVMUPT NBZPSFT EJTDBQBDJUBEPT Z TVT JNQMJDBDJPOFT QTJDPTPDJBMFT Colomb Méd 4VQM (BSDÎB $BMWFOUF .%. .BUFP 3PESÎHVF[ * &HVJHVSFO "1 &M TJTUFNB JOGPSNBM EF DVJEBEPT FO DMBWF EF EFTJHVBMEBE Gac Sanit. 1FBSMJO -* .VMMBO +5 4FNQMF 4+ 4LBGG .. $BSFHJWJOH BOE UIF TUSFTT QSPDFTT BO PWFSWJFX PG DPODFQUT BOE UIFJS NFBTVSFT Gerontologist m (BCPSJU . %FTBTUSFT Z USBVNB QTJDPMÓHJDP Pensamiento psicológico #SPBEIFBE 8& (FIMCBDI 4) EF (SVZ '7 ,BQMBO #) 5IF %VLF 6/$ 'VODUJPOBM 4PDJBM 4VQQPSU 2VFTUJPOOBJSF NFBTVSFNFOU PG TPDJBM TVQQPSU JO GBNJMZ NFEJDJOF QBUJFOUT Med Care -VCCFO +& "TTFTTJOH TPDJBM OFUXPSLT BNPOH FMEFSMZ QPQVMBUJPOT Fam Comm Health -VCFDL %1 )VCFSU )& 4FMG SFQPSU XBT B WJBCMF NFUIPE GPS PCUBJOJOH IFBMUI DBSF VUJMJ[BUJPO EBUB JO DPNNVOJUZ EXFMMJOH TFOJPST J Clin Epidemiol 3BEMPGG -4 5IF $&4 % TDBMF " TFMG SFQPSU EFQSFTTJPO TDBMF GPS SFTFBSDI JO UIF HFOFSBM QPQVMBUJPO Appl Psychol Meas. 3PCJOTPO - /FVUPOT ++ Research techniques for the health sciences /FX :PSL .BDNJMMBO "MWBSBEP 3 /VNIBVTFS + -VJTB ( $VBESPT EFQSFTJWPT Z VUJMJ[BDJÓO EF TFSWJDJPT EF TBMVE

FO NVKFSFT EF MB JTMB EF $IJMPÊ Rev Chil Sa-

lud Pública 7JEBM (VUJÊSSF[ % ;BWBM (VUJÊSSF[ . $BTUSP 4BMBT . 2VJSPHB -ÓQF[ 1 ,MBBTFO 1JOUP ( &M TJHOJàDBEP EFM QBDJFOUF DPO EFNFODJB QBSB FM DVJEBEPS FO VOB DPNVOJEBE VSCBOB Z SVSBM Rev Servicio Social (SBOU +4 #BSUPMVDDJ "" &MMJPU 53 (JHFS +/ 4PDJP EFNPHSBQIJD QIZTJDBM BOE QTZDIPTPDJBM DIBSBDUFSJTUJDT PG EFQSFTTFE BOE OPO EFQSFTTFE GBNJMZ DBSFHJWFST PG TUSPLF TVSWJWPST Brain Injury /JFCPFS "1 4DIVM[ 3 .BUUIFXT ," 4DIFJFS .' 0SNFM + -JOEFOCFSH 4. 4QPVTBM DBSFHJWFST BDUJWJUZ SFTUSJDUJPO BOE EFQSFTTJPO " NPEFM GPS DIBOHFT PWFS UJNF Social Sci Med 4DISBH " )PWSJT " .PSMFZ % 2VJOO / +BIBOTIBIJ . $BSFHJWFS CVSEFO JO 1BSLJOTPO T EJTFBTF JT DMPTFMZ BTTPDJBUFE XJUI QTZDIJBUSJD TZNQUPNT GBMMT BOE EJTBCJMJUZ Parkinsonism Relat Disord +BO .JOI )7 )VPOH %- 8BMM 4 $IVD / #ZBTT 1 .VMUJMFWFM BOBMZTJT PG DPWBSJBUJPO JO TPDJPFDPOPNJD QSFEJDUPST PG QIZTJDBM GVODUJPOJOH BOE QTZDIPMPHJDBM XFMM CFJOH BNPOH PMEFS QFPQMF JO SVSBM 7JFUOBN BMC Geriatrics 7BOEFSWPPSU % 4LPSJLPW 7 1IZTJDBM IFBMUI BOE TPDJBM OFUXPSL DIBSBDUFSJTUJDT BT EFUFSNJOBOUT PG NFOUBM IFBMUI BDSPTT DVMUVSFT Current Psychol

ARTĂ?CULOS ORIGINALES Rev Chil Salud PĂşblica 2014; Vol 18 (1): 72-80

INCORPORACIĂ&#x201C;N DE LOS ODONTĂ&#x201C;LOGOS EN LOS PROCESOS DE TRANSFORMACIĂ&#x201C;N AL MODELO DE SALUD FAMILIAR DE LA ATENCION PRIMARIA EN CHILE INCLUSION OF DENTISTS IN THE TRANSITION TO THE FAMILY HEALTH CARE MODEL OF PRIMARY CARE IN CHILE

RESUMEN

JAIME FARFĂ N OdontĂłlogo, MagĂster Salud PĂşblica jaime.farfan@gmail.com

MARĂ?A TERESA VALENZUELA MagĂster Salud PĂşblica, Escuela Salud PĂşblica Universidad de Chile

Objetivo: Describir la incorporaciĂłn de los odontĂłlogos en la implementaciĂłn del modelo de salud familiar de la atenciĂłn primaria. MetodologĂa: Se realizĂł estudio descriptivo de corte transversal, mediante encuesta enviada vĂa e-mail a 183 jefes de programas odontolĂłgicos de CESFAM acreditados del paĂs. Resultados: El 94% de los equipos tiene a lo menos un odontĂłlogo capacitado en relaciĂłn al modelo; de ellos solo un 37% lo ha hecho mediante un diplomado de Salud Familiar, el resto ha realizado cursos o jornadas de capacitaciĂłn en su establecimiento. Con respecto a la participaciĂłn en actividades que ofrece el modelo, se observa una autopercepciĂłn positiva, la que disminuye con respecto a la incorporaciĂłn de otros profesionales de la salud en los programas odontolĂłgicos o en la realizaciĂłn de nuevas prestaciones (14% realiza consejerĂas familiares, 33% no realiza atenciĂłn sectorizada). El 83% de los equipos realiza actividades de promociĂłn y prevenciĂłn en establecimientos educacionales; sin embargo se desaprovechan instancias que permitirĂan ejecutar el programa en forma integral (46% participa del programa â&#x20AC;&#x153;Chile Crece Contigoâ&#x20AC;? y solo 15% en comitĂŠs â&#x20AC;&#x153;Vida Sanaâ&#x20AC;?). DiscusiĂłn: Se observa un alto porcentaje de capacitaciĂłn de los equipos encuestados, que difieren en el tipo de formaciĂłn y carga acadĂŠmica. AdemĂĄs, la alta participaciĂłn en las actividades que ofrece el modelo no se ve reflejada en la integraciĂłn de temas de salud bucal en ellas. Por Ăşltimo, se genera la necesidad de que a nivel central se formulen protocolos que permitan a los equipos odontolĂłgicos programar y ejecutar nuevas estrategias cuantificando su rendimiento. Palabras clave: TBMVE GBNJMJBS BUFODJĂ&#x201C;O QSJNBSJB PEPOUĂ&#x201C;MPHPT

INCORPORACIÓN DE LOS ODONTÓLOGOS EN LOS PROCESOS DE TRANSFORMACIÓN AL MODELO DE SALUD FAMILIAR DE LA ATENCION PRIMARIA EN CHILE - Jaime Farfán, María Teresa Valenzuela

ABSTRACT Objetive: To describe the inclusion of dentists in the implementation of the family health model in primary health care in Chile. Methodology: We performed a cross-sectional descriptive study, using a survey sent via e-mail to 183 heads of accredited CESFAM (Centro de Salud Familiar) dental programs in the country. Results: 94% of the teams have at least one dentist trained in the model, but only 37% have obtained the Family Health Diploma certification; the rest have been trained through courses or training days at their workplaces. With regards to participation in activities related to the family health model, their perceptions are positive , and decrease with respect to the inclusion of other health professionals in the dental programs or including new features (14% do family counseling, 33% do not practice sectorized care). 83% of the health teams do advocacy and prevention in educational institutions, but they do not take advantage of opportunities for comprehensive care (46% of the program participates in “Chile Crece Contigo” and only 15% in “Vida Sana” community councils). Discussion: There is a high proportion of respondents, which differ according to type and academic load. The high participation in activities offered by the model is not the integration of oral health issues in health teams. Finally, it shows the need for centralized protocols that allow dental teams to schedule and execute new strategies to improve their performance. Keywords: 'BNJMZ )FBMUI 1SJNBSZ $BSF %FOUJTUT

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REVISTA CHILENA DE SALUD PÚBLICA

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INCORPORACIÓN DE LOS ODONTÓLOGOS EN LOS PROCESOS DE TRANSFORMACIÓN AL MODELO DE SALUD FAMILIAR DE LA ATENCION PRIMARIA EN CHILE - Jaime Farfán, María Teresa Valenzuela

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Tabla 1: Grado de capacitación en salud familiar de los equipos odontológicos encuestados. Cantidad de profesionales por equipo

Odontólogos

Asistentes

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INCORPORACIÓN DE LOS ODONTÓLOGOS EN LOS PROCESOS DE TRANSFORMACIÓN AL MODELO DE SALUD FAMILIAR DE LA ATENCION PRIMARIA EN CHILE - Jaime Farfán, María Teresa Valenzuela

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Gráfico 2: Autopercepción en la incorporación de actividades interdisciplinarias de los equipos odontológicos encuestados.

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INCORPORACIÓN DE LOS ODONTÓLOGOS EN LOS PROCESOS DE TRANSFORMACIÓN AL MODELO DE SALUD FAMILIAR DE LA ATENCION PRIMARIA EN CHILE - Jaime Farfán, María Teresa Valenzuela

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ARTĂ?CULOS ORIGINALES Rev Chil Salud PĂşblica 2014; Vol 18 (1): 81-86

PREVALENCIA DE RETINOPATĂ?A DIABĂ&#x2030;TICA Y EDEMA MACULAR EN POBLACIĂ&#x201C;N DIABĂ&#x2030;TICA DEL CESFAM CORDILLERA ANDINA DE LOS ANDES PREVALENCE OF DIABETIC RETINOPATHY AND MACULAR EDEMA IN THE DIABETIC POPULATION OF THE CORDILLERA ANDINA DE LOS ANDES FAMILY HEALTH CENTER (CESFAM)

RESUMEN

SERGIO ABUAUAD Interno VII Medicina Facultad de Medicina Universidad de Chile. sergio.abuauad@gmail.com

PABLO GUZMĂ N Interno VII Medicina Facultad de Medicina Universidad de Chile.

CRISTHIAN URZĂ&#x161;A OftalmĂłlogo Hospital del Salvador Hospital ClĂnico Universidad de Chile.

IntroducciĂłn: La retinopatĂa diabĂŠtica(RD) es una microangiopatĂa progresiva a nivel retinal que aparece como complicaciĂłn de la diabetes y es una de las principales causas de ceguera en el mundo. En los diabĂŠticos la principal causa de pĂŠrdida visual es el edema macular diabĂŠtico (EMD). Presentamos un trabajo cuyo objetivo es describir la prevalencia de RD y subtipos y EMD en una poblaciĂłn de pacientes diabĂŠticos en un centro de atenciĂłn primaria del paĂs. Materiales y mĂŠtodos: Estudio transversal descriptivo realizado en un grupo de 468 pacientes diabĂŠticos del CESFAM Cordillera Andina de Los Andes, sometidos a examen anual de fondo de ojo. Los parĂĄmetros analizados en este estudio fueron: sexo, edad, aĂąos de diagnĂłstico de diabetes mellitus(DM), presencia de RD y subtipos y EMD. Resultados: Se encontrĂł una prevalencia de RD de 24,78%. El grupo etario entre los 50-70 aĂąos presentĂł la mayor prevalencia de RD mientras que el 51,7% de pacientes con RD tenĂa 10 o mĂĄs aĂąos de diagnĂłstico de DM2. El subtipo mĂĄs frecuente fue la RD no proliferativa (RDNP) leve (37,1%). La prevalencia de EMD fue 3,8%. Conclusiones: Se aportan nuevos datos a la escasa literatura nacional disponible, destacando la mediciĂłn de prevalencia de EMD. Palabras clave: 3FUJOPQBUĂ&#x17D;B EJBCĂ&#x160;UJDB FEFNB NBDVMBS EJBCĂ&#x160;UJDP EJBCFUFT NFMMJUVT ABSTRACT Introduction: Diabetic retinopathy (DR) is a progressive microangiopathy at the retinal level which appears as a complication of diabetes and is a major

REVISTA CHILENA DE SALUD PĂ&#x161;BLICA

cause of blindness in the world. In diabetics, the leading cause of visual loss is diabetic macular edema (DME). We present a study which aims to determine the prevalence of DR and subtypes and DME in a population of diabetic patients in a primary care center of the country. Materials and Methods: Transversal descriptive study carried out in a group of 468 diabetic patients of Cordillera Andina from Los Andes Family Health Center (CESFAM), who underwent an annual fundoscopy. The factors analyzed in this study were: sex, age, years of diagnosis of diabetes, presence of DR and subtypes and DME. Results: We found a prevalence of DR of 24.78%.The most frequent subtype was mild non-proliferative diabetic retinopathy (NPDR)(37.1%). The age group between 50-70 years old showed the biggest prevalence, while 51.7% of patients with DR had ten or more years of diagnosis of diabetes. DME prevalence was 3.8%. Conclusions: This study provides new data to add to the limited available national literature, highlighting the prevalence of DME measurement. Key words: %JBCFUJD SFUJOPQBUIZ EJBCFUJD NBDVMBS FEFNB EJBCFUFT NFMMJUVT

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PREVALENCIA DE RETINOPATÍA DIABÉTICA Y EDEMA MACULAR EN POBLACIÓN DIABÉTICA DEL CESFAM CORDILLERA ANDINA DE LOS ANDES - Sergio Abuauad, Pablo Guzmán, Cristhian Urzúa

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REVISTA CHILENA DE SALUD PÚBLICA

4F EFDJEJFSPO FTUBT EJWJTJPOFT EF BDVFSEP B MP FYQVFTUP FO MB MJUFSBUVSB JOUFSOBDJPOBM

Tabla 1. Descripción de la población en estudio según edad y sexo (n=468 pts.). Sexo

RESULTADOS -BT DBSBDUFSÎTUJDBT EF MB QPCMBDJÓO FTUVEJBEB DPSSFTQPOEJFOUF B QBDJFOUFT EJBCÊUJDPT UJQP EFM $&4'". $PSEJMMFSB "OEJOB TF FODVFOUSBO FO MB 5BCMB -B NBZPSÎB EF MPT QBDJFOUFT QSFTFOUÓ VOB FYQMPSBDJÓO WJUSFPSSFUJOBM OPSNBM 6O QSFTFOUÓ IBMMB[HPT DPNQBUJCMFT DPO PUSBT FOGFSNFEBEFT SFUJOBMFT "M BOBMJ[BS FM QPSDFOUBKF EF DBEB EFTDSJQDJÓO EJBHOÓTUJDB FODPOUSBEB 5BCMB EFTUBDB RVF FM EF MPT QBDJFOUFT UJFOF VO FYBNFO DPNQBUJCMF DPO 3% %FOUSP EFM HSVQP EF QBDJFOUFT DPO 3% FO DBTPT TF QFTRVJTÓ &.% DMÎOJDBNFOUF TJHOJàDBUJWP DPSSFTQPOEJFOUF BM EFOUSP EF FTF TVCHSVQP Z B VO EFM UPUBM EF QBDJFOUFT FYBNJOBEPT "M BOBMJ[BS MB QSFWBMFODJB EF TVCUJQPT EF 3% TFHÙO TFWFSJEBE 5BCMB FODPOUSBNPT RVF MB HSBO NBZPSÎB DPSSFTQPOEF B 3%/1 Z RVF FM TVCUJQP NÃT GSFDVFOUF FT MB 3%/1 MFWF VO EFM UPUBM EF DBTPT NJFOUSBT RVF FM UJFOF IBMMB[HPT DPNQBUJCMFT DPO 3%1 %F MPT QBDJFOUFT DPO 3% BM TFS EJTUSJCVJEPT QPS SBOHP FUBSJP 5BCMB WFNPT VO QSFEPNJOJP EFM SBOHP FOUSF Z BÒPT DPSSFTQPOEJFOEP BM EF MPT QBDJFOUFT DPO 3% TFHVJEP QPS FM SBOHP NBZPS B BÒPT "M FWBMVBS MB EJTUSJCVDJÓO EF MPT QBDJFOUFT QPSUBEPSFT EF 3% TFHÙO MB BOUJHÛFEBE EF %. 5BCMB TF PCTFSWÓ RVF QBDJFOUFT QSFTFOUBSPO VOB EBUB EF EJBHOÓTUJDP EF %. NFOPS B MPT BÒPT NJFOUSBT RVF QBDJFOUFT GVFSPO EJBHOPTUJDBEPT EF 3% UFOJFOEP P NÃT BÒPT EF FOGFSNFEBE DISCUSIÓN -PT SFTVMUBEPT PCUFOJEPT FO OVFTUSP FTUVEJP SFTQFDUP B MB QSFWBMFODJB EF 3% Z &.% DMÎOJDBNFOUF TJHOJàDBUJWP TPO DPNQBSBCMFT BM FTUVEJP EF 7FSEBHVFS FO $IJMF RVF JODMVZÓ QBDJFOUFT Z DPOTUJUVZF MB QSJODJQBM SFGFSFODJB B

Porcentaje

.BTDVMJOP

'FNFOJOP

Edad (años) BÒPT

BÒPT

Tabla 2. Distribución según descripción diagnóstica de la población estudiada (n=468 pts.). Descripción diagnóstica

Porcentaje

%FOUSP SBOHP OPSNBM

116

*EMCS 0USBT BMUFSBDJPOFT

3,8

3% 3FUJOPQBUÎB %JBCÊUJDB &.$4 &EFNB NBDVMBS DMÎOJDBNFOUF TJHOJàDBUJWP 5PEPT MPT QUT DPO &.$4 FTUBCBO EFOUSP EFM HSVQP DPO 3%

Tabla 3. Distribución de la población con RD según clasificación EDTRS (n=116 pts.). Tipos de RD

Porcentaje

.JOJNB

-FWF

.PEFSBEB

3%/1

4FWFSB 3%1

3% 3FUJOPQBUÎB %JBCÊUJDB 3%/1 3FUJOPQBUÎB %JBCÊUJDB OP QSPMJGFSBUJWB 3%1 3FUJOPQBUÎB %JBCÊUJDB QSPMJGFSBUJWB

Tabla 4. Distribución de RD según rango etario y antigüedad de diagnóstico de DM2 (116 pts.). Edad

Porcentaje

BÒPT

Antigüedad DM2 (2años)

3% 3FUJOPQBUÎB %JBCÊUJDB %. %JBCFUFT UJQP

PREVALENCIA DE RETINOPATÍA DIABÉTICA Y EDEMA MACULAR EN POBLACIÓN DIABÉTICA DEL CESFAM CORDILLERA ANDINA DE LOS ANDES - Sergio Abuauad, Pablo Guzmán, Cristhian Urzúa

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REVISTA CHILENA DE SALUD PÚBLICA

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ARTĂ?CULOS ORIGINALES Rev Chil Salud PĂşblica 2014; Vol 18 (1): 87-94

NIVEL DE CONOCIMIENTO EN SALUD ORAL DEL EQUIPO DE SALUD EN CENTROS DE ATENCIĂ&#x201C;N PRIMARIA DE LA REGIĂ&#x201C;N DE VALPARAĂ?SO LEVEL OF ORAL HEALTH KNOWLEDGE OF THE HEALTHCARE TEAM IN PRIMARY HEALTH CARE CENTERS IN THE VALPARAISO REGION

RESUMEN

CRISTĂ&#x201C;BAL PIZARRO Facultad de OdontologĂa Universidad de ValparaĂso. cpizarrovallejos@gmail.com

DANIELA VALENZUELA Facultad de OdontologĂa Universidad de ValparaĂso.

IntroducciĂłn: En el modelo actual de Salud Familiar, el equipo de salud debe poseer conocimientos transversales respecto de las primeras etapas del ciclo vital con el control de embarazadas y posteriormente control de niĂąo sano, los que se encuentran estandarizados en el documento Pauta de evaluaciĂłn buco-dentaria establecida por Minsal en 2007. Objetivo: Evaluar el nivel de conocimiento en salud oral del equipo de salud en los centros de atenciĂłn primaria de la quinta regiĂłn. Materiales y mĂŠtodos: El diseĂąo de este estudio es de corte transversal. La muestra se obtuvo de todos los centros de salud que ejercen atenciĂłn primaria en la quinta regiĂłn. De un total de 77 consultorios, se seleccionaron aleatoriamente 35 de manera proporcional entre las tres redes asistenciales, de los cuales 14 corresponden al Servicio de Salud ValparaĂso - San Antonio (SSVSA), 17 al Servicio de Salud ViĂąa del Mar - Quillota (SSVQ) y cuatro al Servicio de Salud Aconcagua (SSA). Cada centro contempla un equipo de salud compuesto por un mĂŠdico, enfermero(a), matrĂłn(a) , nutricionista y tĂŠcnico paramĂŠdico, a los cuales se les aplicĂł un cuestionario para la obtenciĂłn de la informaciĂłn. Resultados: Se evidenciĂł que el equipo de salud de los centros de atenciĂłn primaria de la quinta regiĂłn presenta un 49% de respuestas afirmativas y/o correctas. DiscusiĂłn: El nivel de conocimiento de salud oral del equipo de salud de los centros de atenciĂłn primaria de la quinta regiĂłn es insuficiente. Palabras clave: FRVJQP EF TBMVE BUFODJĂ&#x201C;O QSJNBSJB TBMVE GBNJMJBS

REVISTA CHILENA DE SALUD PĂ&#x161;BLICA

ABSTRACT Introduction: In the current model of family health, the healthcare team must possess comprehensive knowledge regarding the early stages of the life cycle, care of pregnant women, and subsequently, healthy children, which are standardized in the in the oral health evaluation guidelines of 2007, by the Ministry of Health. Objective: Assess the level of oral health knowledge of the healthcare team in public primary healthcare centers in the fifth region, Valparaiso. Materials and Methods: The design of this study is cross-sectional. The sample was obtained from all health centers offering primary care in the fifth region. From a total of 77 clinics, 35 were randomly selected in equal proportions from 3 health services, of which 14 belong to the Valparaiso - San Antonio Health Service (SSVSA), 17 to the ViĂąa del Mar - Quillota Health Service (SSVQ) and 4 to the Aconcagua Health Service (SSA). Each center has a healthcare team consisting of a doctor, nurse, midwife, nutritionist and paramedic, and a questionnaire was filled out by each to obtain the data for this study. Results: It was shown that the healthcare team of the primary health care centers in the fifth region had 49% affirmative or positive answers. Discussion: The level of oral health knowledge of the healthcare team in public primary health care centers in the fifth region is insufficient. Key words: IFBMUIDBSF UFBN QSJNBSZ IFBMUI DBSF GBNJMZ IFBMUI

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NIVEL DE CONOCIMIENTO EN SALUD ORAL DEL EQUIPO DE SALUD EN CENTROS DE ATENCIÓN PRIMARIA DE LA REGIÓN DE VALPARAÍSO - Cristóbal Pizarro, Daniela Valenzuela

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REVISTA CHILENA DE SALUD PÚBLICA

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Tabla 1. Distribución (%) de respuestas correctas referentes a ‘anatomía dentaria’ por estamento.

Ítem de Anatomía

Estamento .ÊEJDP

&OGFSNFSP B

.BUSÓO B

/VUSJDJPOJTUB

5&/4

$BOUJEBE EJFOUFT UFNQPSBMFT

&EBE FSVQDJÓO QSJNFS EJFOUF

5JQP EF EJFOUF

1SPNFEJP

Tabla 2. Distribución (%) de respuestas correctas correspondientes a ‘higiene bucal’ y ‘uso de flúor’ por estamento.

Ítem de Higiene

Estamento .ÊEJDP

&OGFSNFSP B

.BUSÓO B

/VUSJDJPOJTUB

5&/4

)JHJFOF BOUFT NFTFT

*OTUSVNFOUP IJHJFOF BOUFT NFTFT

.BUFSJBMFT EF IJHJFOF FO OJÒPT

5ÊDOJDB EF 'POFT

6TP QBTUB FO OJÒPT

&EBE DPNJFO[P VTP QBTUB

$BOUJEBE EF QBTUB

.PNFOUP EF DFQJMMBEP

2VJÊO EFCF DFQJMMBS

$PODFOUSBDJÓO EF áÙPS

1SPNFEJP

NIVEL DE CONOCIMIENTO EN SALUD ORAL DEL EQUIPO DE SALUD EN CENTROS DE ATENCIÓN PRIMARIA DE LA REGIÓN DE VALPARAÍSO - Cristóbal Pizarro, Daniela Valenzuela

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Tabla 3. Distribución (%) de respuestas correctas referentes a ‘alimentación’ por estamento.

Ítem de Alimentación

Estamento .BUSÓO B

/VUSJDJPOJTUB

6TP B[ÙDBS FO FM CJCFSÓO

.ÊEJDP

&OGFSNFSP B

5&/4

5ÊSNJOP MBDUBODJB NBUFSOB FYDMVTJWB

3FUJSP CJCFSÓO OPDUVSOP

&EBE VTP EF MÎRVJEPT FO WBTP

%FàOJDJÓO EJFUB DBSJPHÊOJDB

$POTVNP BMJNFOUPT TÓMJEPT

1SPNFEJP

Tabla 4. Distribución (%) de respuestas correctas referentes a ‘patología’, ‘malos hábitos’ y ‘TDA’ por estamento

Variables de Patología, Malos Hábitos y TDA

Estamento .ÊEJDP

&OGFSNFSP B

.BUSÓO B

/VUSJDJPOJTUB

5&/4

3FDPOPDJNJFOUP EF NBM IÃCJUP

3FDPOPDJNJFOUP EF QBUPMPHÎB PSBM

$POTFDVFODJB EF 5%"

$POEVDUB GSFOUF B 5%"

1SPNFEJP

REVISTA CHILENA DE SALUD PÚBLICA

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Tabla 5. Distribución (%) de respuestas correctas referentes a ‘reconocimiento de imágenes’ por estamento Ítem de Reconocimiento %JTDSJNJOBDJÓO JNBHFO

Estamento .ÊEJDP

&OGFSNFSP B

.BUSÓO B

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2VF SFDPOPDF JNBHFO

%JTDSJNJOBDJÓO JNBHFO

2VF SFDPOPDF JNBHFO

%JTDSJNJOBDJÓO JNBHFO

2VF SFDPOPDF JNBHFO

%JTDSJNJOBDJÓO JNBHFO

2VF SFDPOPDF JNBHFO

%JTDSJNJOBDJÓO JNBHFO

5&/4

2VF SFDPOPDF JNBHFO

1SPNFEJP

NIVEL DE CONOCIMIENTO EN SALUD ORAL DEL EQUIPO DE SALUD EN CENTROS DE ATENCIÓN PRIMARIA DE LA REGIÓN DE VALPARAÍSO - Cristóbal Pizarro, Daniela Valenzuela

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4 años que asisten a la educación preescolar $IJMF .*/4"- 4PUP - 5BQJB 3 +BSB ( 3PESÎHVF[ ( Diagnóstico Nacional de Salud Bucal del Niño de 6 años. $IJMF .*/4"- $IJMF Ministerio de Salud. Pauta de evaluación buco-dentaria FEJDJÓO $IJMF %JWJTJÓO EF 1SFWFODJÓO Z $POUSPM EF &OGFSNFEBEFT %FQBSUBNFOUP EF 4BMVE #VDBM Q $IJMF .JOJTUFSJP EF 4BMVE Pauta de evaluación buco-dentaria FEJDJÓO $IJMF %JWJTJÓO EF 1SFWFODJÓO Z $POUSPM EF &OGFSNFEBEFT %FQBSUBNFOUP EF 4BMVE #VDBM Q $IJMF .JOJTUFSJP EF 4BMVE Guía de alimentación del niño(a) menor de dos años. Guía de alimentación hasta la adolescencia: anexo 25 $IJMF %FQBSUBNFOUP OVUSJDJÓO Z DJDMP WJUBM

ENTREVISTA Rev Chil Salud Pública 2014; Vol 18 (1): 95-99

Luc Delannoy, director del Instituto de Neuroartes, Tijuana, México

-VD %FMBOOPZ OBDJÓ FO #ÊMHJDB FT àMÓTPGP EF GPSNBDJÓO Z BDUVBM EJSFDUPS EFM *OTUJUVUP EF /FVSPBSUFT VOB SFE JOUFSOBDJPOBM EF BSUJTUBT àMÓTPGPT DJFOUÎàDPT Z QSPGFTJPOBMFT EF MB TBMVE NFOUBM DPO TFEF FO .ÊYJDP DVZP QSPQÓTJUP FT EFTBSSPMMBS QSPHSBNBT GPSNBUJWPT Z QSFWFOUJWPT EF TBMVE NFOUBM 6OB MBSHB USBZFDUPSJB DPNP JOWFTUJHBEPS Z QSPGFTPS JOWJUBEP FO WBSJBT VOJWFSTJEBEFT EFM NVOEP MP IBO MMFWBEP B JOEBHBS QSPGVOEBNFOUF FO MB NFOUF Z MB DPODJFODJB IVNBOB 4F USBUB EF VO USBCBKP EPOEF QSPHSFTJWBNFOUF IB JEP UPNBOEP QSPUBHPOJTNP FM UFNB EF MB BVUPOPNÎB FO QBDJFOUFT RVF QBEFDFO USBTUPSOPT OFVSPMÓHJDPT Z NFOUBMFT QSJODJQBMNFOUF "M[IFJNFS %F FTUF NPEP %FMBOOPZ IB QPEJEP SPNQFS MBT CBSSFSBT EJTDJQMJOBSJBT Z DPNCJOBS FO VO NJTNP QBJTBKF MPT BQPSUFT EF MB OFVSPMPHÎB Z MB àMPTPGÎB EF MB NFOUF DPO VOB QFSTQFDUJWB QBSUJDVMBS EF MB FTUÊUJDB EPOEF MP BSUÎTUJDP UJFOF VO SPM WJUBM Tuillang Yuing: Cuéntenos un poco los motivos de su visita a Chile. -% 7JBKÊ B $IJMF FM BÒP QBSB PGSFDFS VOB TFSJF EF DPOGFSFODJBT FO EJTUJOUBT VOJWFSTJEBEFT EFM QBÎT *OBVHVSÊ FM BÒP BDBEÊNJDP FO MB 6OJWFSTJEBE EF $IJMF IJDF VO UBMMFS EF JOWFTUJHBDJÓO EPDFOUF FO 6OJWFSTJEBE "SDJT MB 6OJWFSTJEBE "MCFSUP )VSUBEP Z MB 6OJWFSTJEBE EF $PODFQDJÓO NF JOWJUBSPO B QSFTFOUBS NJ MJCSP Convergencias &O FTF DPOUFYUP GVJ JOWJUBEP QPS FM %S "EPMGP 7FSB EF MB 6OJWFSTJEBE EF 7BMQBSBÎTP QBSB QSFTFOUBS VOP EF NJT MJCSPT BRVÎ FO 7BMQBSBÎTP EF EPOEF TVSHJÓ MB JEFB EF WPMWFS FTUF BÒP )F WVFMUP FOUPODFT QBSB IBDFS VO DVSTP EF WFSBOP FO FM QSPHSBNB EF QPTHSBEP EF MJUFSBUVSB IJTQÃOJDB FO MB 6OJWFSTJEBE EF $PODFQDJÓO Z VO DVSTP UFÓSJDP QSÃDUJDP TPCSF /FVSPBSUFT FO FM )PTQJUBM 1TJRVJÃUSJDP EFQFOEJFOUF EF MB 'BDVMUBE EF .FEJDJOB EF MB NJTNB VOJWFSTJEBE DPO UFSBQFVUBT FOGFSNFSBT QTJRVJBUSBT Z QSPGFTJPOBMFT EF MB TBMVE JANA STOJANOVA Coordinación Editorial Revista Chilena de Salud Pública jana.stojanova@gmail. com

TUILLANG YUING Posdoctorando Instituto de Estudios Avanzados (IDEA) Universidad de Santiago tuillang@yahoo.com

Jana Stojanova: Un curso tipo práctico… -% 4Î MB JEFB FSB FYQMJDBS MPT GVOEBNFOUPT EF /FVSPBSUFT Z FYQMJDBS DÓNP FTUBNPT USBCBKBOEP QSJODJQBMNFOUF FO DVFTUJPOFT EF TBMVE NFOUBM FT EFDJS MB SFMBDJÓO RVF QVFEB UFOFS FM BSUF DPO MB GPSNBDJÓO QSFWFODJÓO Z UFSBQJB EF MB TBMVE NFOUBM &TUP GVF FO $PODFQDJÓO "RVÎ FO 7BMQBSBÎTP TF USBUB EF VO DVSTP EF JOUSPEVDDJÓO B /FVSPBSUFT QFSP RVF "EPMGP MMBNÓ /FVSPFTUÊUJDB QBSB GBDJMJUBS MB DPNQSFOTJÓO EFM DPODFQUP &M DVSTP GVF VO ÊYJUP

REVISTA CHILENA DE SALUD PÚBLICA

JS: ¿Es un curso dirigido a los estudiantes de filosofía? -% /P OFDFTBSJBNFOUF &M %S 7FSB BSNÓ VO HSVQP CBTUBOUF EJWFSTP Z EF NVZ BMUP OJWFM -MFHBSPO NÙTJDPT HFOUF EF MJUFSBUVSB QTJDÓMPHPT HFOUF EF UFBUSP &TUVWJNPT USBCBKBOEP VOB CSFWF JOUSPEVDDJÓO B /FVSPBSUFT QSJODJQBMNFOUF UFNBT TPCSF MB QFSDFQDJÓO IVNBOB DPO FM FKF QVFTUP FO FM BSUF WJTVBM &TUF FT FM QSJNFS QBTP EF NVDIBT BDUJWJEBEFT RVF WBNPT B SFBMJ[BS BRVÎ FO $IJMF TY: De seguro esto merece un desarrollo muy extendido, pero la noción de Neuroartes no está muy difundida, y me imagino que más de alguna vez ha tenido que explicarla, porque la parte “neuro” de la palabra suena a laboratorio, a una cuestión biomédica, lo que comúnmente contrasta con el vocablo “arte”. Cuéntenos cómo llega a desarrollar esta noción. -% 5JFOFO NVDIB SB[ÓO DVBOEP EJDFO RVF MB QBMBCSB iOFVSPu OPT SFNJUF B MPT MBCPSBUPSJPT %F IFDIP IBZ VO UFYUP RVF UFOFNPT RVF FT VOB JOUSPEVDDJÓO B /FVSPBSUFT RVF TF MMBNB i6O MBCPSBUPSJP EF JEFBTu "IPSB MB JEFB EF /FVSPBSUFT DPNP MBCPSBUPSJP EF JEFBT BMVEF B VO MBCPSBUPSJP FO MB DBMMF FO MB TPDJFEBE /P FT VOB TFSJF EF FYQFSJNFOUPT FO VO MBCPSBUPSJP QPSRVF MB WJEB FT NÃT RVF VO MBCPSBUPSJP EF VOJWFSTJEBE )BZ NVDIPT FYQFSJNFOUPT RVF TF IBDFO FO VO MBCPSBUPSJP RVF OP TF QVFEFO SFQSPEVDJS FO MB DBMMF FOUPODFT FGFDUJWBNFOUF OPTPUSPT FTUBNPT IBDJFOEP VO MBCPSBUPSJP EF JEFBT QFSP JEFBT RVF SFBMNFOUF TF JNQMFNFOUBO FO MB WJEB DPUJEJBOB FO EJGFSFOUFT DPNVOJEBEFT "IPSB CJFO MB JEFB EF /FVSPBSUFT TVSHJÓ EF VOB JORVJFUVE NÎB EF IBDF NVDIPT BÒPT EF MB QSFHVOUB QPS MB SFMBDJÓO FOUSF MB QFSDFQDJÓO IVNBOB Z FM BSUF yRVÊ FTUÃ QBTBOEP FO FM DFSFCSP EF BMHVJFO RVF QBEFDF EF VOB QBSÃMJTJT DFSFCSBM QSPGVOEB DVBOEP FTUÃ FO QSFTFODJB EF NÙTJDB %F BIÎ TVSHF MB JORVJFUVE EF CVTDBS MPT TVTUSBUPT CJPMÓHJDPT EF MPT QSPDFTPT DSFBUJWPT UBOUP EFM BSUJTUB DPNP EFM QÙCMJDP -P NJTNP B OJWFM EF MBT MMBNBEBT AFOGFSNFEBEFT NFOUBMFT MP RVF EF QBTP JNQMJDB QPOFS FO EVEB FM UÊSNJOP EF AFOGFSNFEBE NFOUBM

SFQFOTBS FM NVOEP EF MB QTJRVJBUSÎB FT EFDJS QFOTBS MB QTJRVJBUSÎB Z QFOTBS MB FOGFSNFEBE NFOUBM QPS NFEJP EF MBT BSUFT 4VSHJÓ BTÎ VOB TFSJF EF QSPQVFTUBT USBOTEJTDJQMJOBSJBT RVF MFWBOUBO VO QVFOUF FOUSF àMPTPGÎB QTJDPMPHÎB DJFODJB FNQÎSJDB Z BSUFT DPO FM BGÃO EF FOUFOEFS NFKPS MBT DVFTUJPOFT EF TBMVE NFOUBM "IÎ TVSHJÓ VOB TFSJF EF QSFHVOUBT RVF JNQMJDBO VOB SFJOUFSQSFUBDJÓO EFM DPOPDJNJFOUP EF MB TBCJEVSÎB EF MB FOTFÒBO[B EF MB TBMVE Z NVDIBT PUSBT DPTBT 'JOBMNFOUF TF QVFEF MMFHBS B VOB QSPQVFTUB EF TPDJFEBE JS: A mí me interesan en términos prácticos dos cosas: primero, ¿cómo son los estudios que se realizan en su centro? ¿Con pacientes? En definitiva, ¿qué tipo de estudios hacen? -% 7JWJNPT FO VO NVOEP RVF UJFOF MB UFOEFODJB B RVFSFS DVBOUJàDBS UPEP "IPSB CJFO FT UBO HSBWF FM QSPCMFNB EF MB DVBOUJàDBDJÓO RVF JODMVTP IBDF EPT BÒPT MMFHÓ B .ÊYJDP VO HSVQP EF DJFOUÎàDPT Z àMÓTPGPT JOHMFTFT QBSB FOTFÒBS B MPT NFYJDBOPT DPNP DVBOUJàDBS FM CJFOFTUBS &OUPODFT OPTPUSPT FTUBNPT VO QPDP JORVJFUPT VO QPDP DPNP iyRVÊ POEB DPO FTUP u )BZ DPTBT RVF OP TF UJFOFO RVF DVBOUJàDBS TJ OP DBFNPT EF OVFWP FO MB MPDVSB EF %FTDBSUFT RVF MPHSÓ SFMBUJWJ[BS TV TVCKFUJWJEBE QBSB EFNPTUSBS MB FYJTUFODJB EF %JPT /PTPUSPT FTUBNPT VO QPDP BM NBSHFO EF UPEP FTP Z FOUPODFT OPTPUSPT OP DVBOUJàDBNPT -B GPSNB EF NFEJDJÓO EF OVFTUSP QSPHSBNB FT FM EJTFÒP EF NBQBT /PTPUSPT EJTFÒBNPT NBQBT 5PEPT OVFTUSPT QSPHSBNBT TPO NBQBT B USBWÊT EF MPT DVBMFT WFNPT TJ VO JOEJWJEVP QVFEF MMFHBS EF VO QVOUP B PUSP 4J QVFEF TFS GVODJPOBM TJ QVFEF TFS BVUÓOPNP TJ QVFEF WJWJS DPO EJHOJEBE &TUP OPT QFSNJUF WFS QPS EÓOEF WB FM JOEJWJEVP FO MVHBS EF MB NFEJDJÓO EF MB DJFODJB EVSB /FVSPBSUFT OP PQFSB VTBOEP FM NÊUPEP MMBNBEP IJQPUÊUJDP EFEVDUJWP BTÎ QBSB NVDIPT MBT QSPQVFTUBT EF /FVSPBSUFT OP TPO DJFOUÎàDBT "EPQUBNPT MB NFUÃGPSB EFM àMÓTPGP EF MB DJFODJB 3POBME (JFSF /FVSPBSUFT FT DPNP VOB TFSJF EF NBQBT QPOFS B QSVFCB VO NBQB OP TJHOJàDB WFSJàDBS EF GPSNB BSCJUSBSJB QVOUPT BM B[BS TJOP NÃT CJFO WFS TJ B JOEJWJEVPT VTBOEP FM NBQB MFT BZVEB B MMFHBS EPOEF RVJFSFO MMFHBS $POUFTUBS

ENTREVISTA A LUC DELANNOY, DIRECTOR DEL INSTITUTO DE NEUROARTES, TIJUANA, MÉXICO - Jana Stojanova, Tuillang Yuing

QSFHVOUBT DVBOUJUBUJWBT TPCSF MPT FGFDUPT EF MBT DBNQBÒBT EF /FVSPBSUFT OP SFRVJFSF SBTUSFBS BàSNBDJPOFT UFÓSJDBT TJOP VOB BUFODJÓO DVJEBEPTB FO MB JOGPSNBDJÓO SFDPQJMBEB -PT SFTVMUBEPT EF MPT QSPHSBNBT EF /FVSPBSUFT OP TPO JONFEJBUPT OJ UBNQPDP DBOKFBCMFT -P GVOEBNFOUBM FT QFSNBOFDFS FO FM DBNJOP EF MB EJHOJEBE Z QFOTBS EFM IVNBOP JS: Como la pregunta por los índices de normal y no-normal… -% /PTPUSPT OP USBCBKBNPT BTÎ 4PO QSPDFTPT CBTUBOUF MFOUPT QFSP QFSTPOBT JOEFQFOEJFOUFT EFM *OTUJUVUP EF /FVSPBSUFT RVF FTUÃO FO FM TFDUPS EF MB TBMVE QÙCMJDB OPT IBO EJDIP mZ IBO EJDIP QÙCMJDBNFOUFm RVF MPT QSPHSBNBT EF /FVSPBSUFT QFSNJUFO mQBSUJDVMBSNFOUF FO QFSTPOBT EF MB UFSDFS FEBEm CBKBS MBT EPTJT EF NFEJDBNFOUPT BMDBO[BS DJFSUB USBORVJMJEBE Z FTUBCJMJEBE FNPDJPOBM EJTNJOVJS MB DBOUJEBE EF EÎBT EF IPTQJUBMJ[BDJÓO 0 TFB FT BMHP BTÎ DPNP VO DPNQMFNFOUP RVF MPT NÊEJDPT WFO Z EFM DVBM TF BEWJFSUFO TVT SFTVMUBEPTw %F EJGFSFOUFT EFQBSUBNFOUPT EF HFSJBUSBT OPT QSFHVOUBO iyDÓNP MP FTUÃO IBDJFOEP u &TUP FT TJ TF RVJFSF VOB GPSNB EF NFEJDJÓO QFSP OP FT VOB NFEJDJÓO EVSB 5SBCBKBNPT TPCSF MPT QSPDFTPT $POTJEFSBNPT RVF MB TVCKFUJWJEBE OP FT BMHP RVF TF QVFEB NFEJS "RVFMMP OP FT OVFTUSP àO TJ CJFO TPO SFTVMUBEPT DPODSFUPT RVF PCTFSWBO UFSDFSPT RVF TPO EF MB QSPGFTJÓO NÊEJDB EVSB 1BSB OPTPUSPT FT VOB SFUSPBMJNFOUBDJÓO RVF OPT BZVEB ZB TFB B IBDFS NPEJàDBDJPOFT B OVFTUSPT QSPHSBNBT P CJFO B TFHVJS MB MÎOFB /PT EB NVDIP BMJFOUP TY: Claro, no va con el enfoque clínico tradicional, de superar metas, de asignar el proceso terapéutico únicamente al individuo, como si fuese solo el individuo ‘el enfermo’, etcétera. Me parece que hay un compromiso cultural mayor. Digamos que “lo médico”, “lo anormal”, “lo enfermo” son nociones que responden siempre a una red social que las permite, una red que me parece que aquí se pone en cuestión. Ya no sería un enfoque desde lo científico, sería un enfoque desde otro lado, desde el arte…

-% 5PEP FM QSPHSBNB EF /FVSPBSUFT UJFOF GVOEBNFOUP àMPTÓàDP /PTPUSPT DPOTJEFSBNPT RVF MB àMPTPGÎB FT MB CBTF EF UPEP Z RVF TF UJFOF RVF BQMJDBS FO MB WJEB DPUJEJBOB RVF MB àMPTPGÎB OP FT OBEB BCTUSBDUP TJOP RVF FT BMHP NVZ DPODSFUP %JDIP FTP QFOTBNPT RVF FM USBCBKP RVF IBDFNPT FT USBUBS EF BQPZBS BM JOEJWJEVP QBSB RVF EFTBSSPMMF TV QSPQJB TVCKFUJWJEBE Z OP USBOTGPSNBSMP FO BMHP RVF OP FT &TUP QBSB OPTPUSPT FT GVOEBNFOUBM $POTJEFSBNPT RVF UFOFNPT MB SFTQPOTBCJMJEBE EF GSFOBS MB QBUPMPHJ[BDJÓO EF MB OBUVSBMF[B IVNBOB Z FTUP JNQMJDB VO DPNQSPNJTP QBSB FWJUBS RVF MPT MBCPSBUPSJPT GBSNBDÊVUJDPT TJHBO DPMPOJ[BOEP MB TVCKFUJWJEBE EF MPT JOEJWJEVPT &OUPODFT IBZ UBNCJÊO VO DPNQSPNJTP TPDJBM mZ WBNPT B EFDJS UBNCJÊO QPMÎUJDPm GVFSUÎTJNP -P UFOFNPT CJFO DMBSP IBZ RVF GSFOBS MB QBUPMPHJ[BDJÓO EF MB OBUVSBMF[B IVNBOB OP QFSNJUJS RVF MPT MBCPSBUPSJPT GBSNBDÊVUJDPT TJHBO NPMEFBOEP F JOWBEJFOEP MB TVCKFUJWJEBE EF MPT JOEJWJEVPT EF BDVFSEP B TVT QSPQJPT JOUFSFTFT FDPOÓNJDPT &TUP FT QBSB OPTPUSPT VO DPNQSPNJTP GVOEBNFOUBM %F BIÎ RVF DVBOEP IBZ EFQBSUBNFOUPT FOUFSPT EF IPTQJUBMFT FO .ÊYJDP RVF OPT EJDFO iIFNPT CBKBEP MB DBOUJEBE EF NFEJDJOBu P iMBT QFSTPOBT UJFOFO DPNQPSUBNJFOUPT EJTUJOUPTu QVFT OPT QBSFDF RVF OP FTUBNPT UBO FRVJWPDBEPT "TÎ TVSHF MB QSPQVFTUB EF VO OVFWP DPOUSBUP TPDJBM QPSRVF FM DPOUSBUP TPDJBM RVF UFOFNPT EFTEF TJHMP 97*** IB GSBDBTBEP Z FOUPODFT IBZ RVF CVTDBS PUSBT WÎBT JS: La segunda parte de mi pregunta es, ¿cómo practican su meta los neuroartistas? ¿Cómo se forman y cómo es su profesionalización? -% /PTPUSPT UFOFNPT VOB QSPQVFTUB BDBEÊNJDB P NFKPS EJDIP QBSB BDBEÊNJDB QBSB OP FOUSBS FO MB iUJUVMJUJT BHVEBu 5FOFNPT VOB QBSUF QBSB BDBEÊNJDB RVF FT VOB TFSJF EF DVSTPT EJQMPNBEPT Z TFNJOBSJPT JOUFS HFOFSBDJPOBMFT QPSRVF UFOFNPT HFOUF EF B BÒPT RVF WJFOF B TFHVJS MPT DVSTPT 0GSFDFNPT UBNCJÊO FM EJQMPNBEP Neuroartes y tercera edad $POUBNPT DPO VOB QMBOUB EPDFOUF JOUFSOBDJPOBM Z USBCBKBNPT QBSB TFOTJCJMJ[BS B MBT QFSTPOBT BDFSDB EF MB DVFTUJÓO EF MB UFSDFSB FEBE %FOUSP EFM EJQMPNBEP TF GPSNBO FRVJQPT EF

REVISTA CHILENA DE SALUD PÚBLICA

USBCBKP Z DBEB FRVJQP UJFOF RVF EFTBSSPMMBS VOPT QSPZFDUPT FO TVT DPNVOJEBEFT QBSB RVF SFBMNFOUF IBZB VOB QSÃDUJDB JONFEJBUB EF MP BQSFOEJEP 1PS FKFNQMP FM BÒP QBTBEP TF MPHSÓ IBDFS VO NVSBM EPOEF VO HSVQP EF BEVMUPT NBZPSFT FO TJMMB EF SVFEBT TBMJÓ B MB DBMMF Z TF BQPEFSÓ EF VOB QBSFE QBSB IBDFS VO NVSBM &O FM QBÎT EF MPT NVSBMFT Z MPT NVSBMJTUBT FT MB QSJNFSB WF[ FO MB IJTUPSJB EF .ÊYJDP RVF VO HSVQP EF BEVMUPT NBZPSFT JOWBEFO MB DBMMF FO TJMMB EF SVFEBT Z IBDFO VO NVSBM -VFHP IFNPT MPHSBEP RVF VO HSVQP EF BEVMUPT NBZPSFT BCSB VOB FNQSFTB DIJRVJUB RVF WFOEF QSPEVDUPT BHSÎDPMBT &O àO FT VOB GPSNB EF FNQPEFSBNJFOUP EF MPT BEVMUPT NBZPSFT RVJFOFT FO TV NBZPSÎB FTUÃO BCBOEPOBEPT QPS TVT GBNJMJBT Z UJFOFO EFNFODJB P QSPCMFNBT NPUPSFT RVF MFT JNQJEFO TFS BVUÓOPNPT 6OB TFÒPSB RVF IJ[P BMHP EF OVUSJDJÓO Z BIPSB FTUÃ IBDJFOEP DPOGFSFODJBT EF OVUSJDJÓO QBSB FYQMJDBS TV FYQFSJFODJB 4PO DPTBT RVF SFBMNFOUF JNQBDUBO QVFT TPO GPSNBT EF FNQPEFSBS BM BEVMUP NBZPS QBSB RVF UFOHB VO QBQFM BDUJWP FO TV DPNVOJEBE OP TPMBNFOUF B OJWFM BSUÎTUJDP TJOP QPMÎUJDP Z TPDJBM 0USB QBSUF TPO MPT UBMMFSFT "MMÎ OPTPUSPT WBNPT IBDJB MBT DPNVOJEBEFT EF BEVMUPT NBZPSFT Z BIÎ WB VO UBMMFSJTUB Z IBDF VO UBMMFS EPT P USFT WFDFT B MB TFNBOB )BZ FOUPODFT VOB SPUBDJÓO QPS EJGFSFOUFT BTJMPT MPT BTJMPT RVF BDFQUBO SFDJCJSOPT QVFTUP RVF UBNCJÊO IBZ MVHBSFT RVF OP QFSNJUFO MB FOUSBEB QPSRVF IBZ BCVTPT EF UPEP UJQP 1VFT FOUPODFT DVBOEP FT QPTJCMF USBUBNPT EF PSJFOUBS B MPT EJSFDUJWPT EF MPT BTJMPT QBSB IBDFS MB WJEB NÃT BNBCMF QBSB MPT BEVMUPT NBZPSFT 1PS FKFNQMP TJ BMHVJFO RVJFSF IBDFS VO UBMMFS UJFOF RVF IBDFS Z QSFQBSBS VOB QSPQVFTUB 5PEPT MPT UBMMFSJTUBT UJFOFO RVF DBQBDJUBSTF DPO OPTPUSPT mTPCSF àMPTPGÎB FO NVDIPT DBTPTm FOUPODFT BZVEBNPT B MB QFSTPOB B PSJFOUBS TV UBMMFS MB NFUPEPMPHÎB Z MB QSFQBSBDJÓO EF UBMMFS -VFHP UBNCJÊO IBDFNPT SFHVMBSNFOUF SFVOJPOFT EF UBMMFSJTUBT QBSB DPNQBSUJS FYQFSJFODJBT "EFNÃT USBCBKBNPT DPO BEVMUPT NBZPSFT FO MBT DÃSDFMFT TY: Me gustaría que nos contara brevemente sobre la relación de este trabajo con su interés por la música, específicamente con el latín

jazz, que yo sé que ha trabajado largamente. ¿Qué nos puede decir sobre este vínculo? -% 5VWF MB GPSUVOB EF OBDFS FO VOB GBNJMJB EPOEF IBCÎB VOB BCVFMB QJBOJTUB %JHBNPT RVF ZB FTUBCB NFUJEP EFTEF DBTJ MB DVOB FO MB NÙTJDB &MMB NF JOUSPEVKP BM QJBOP " NJ QBESF MF FODBOUBCB FM KB[[ &O MB DBTB NJ NBESF TJFNQSF FTUBCB FTDVDIBOEP NÙTJDB DMÃTJDB &OUPODFT IBCÎB VOB WBSJFEBE EF NÙTJDB FO MB GBNJMJB $BEB VOP UPNBCB TV UVSOP QBSB FTDVDIBS NÙTJDB FTP FSB NVZ EJWFSUJEP 1FSP BEFNÃT UFOÎB VO WFDJOP mVO BNJHP NÎPm RVF UFOÎB QBSÃMJTJT DFSFCSBM QSPGVOEB $VBOEP WFOÎB B DBTB DPO TVT QBESFT ÊM TF RVFEBCB FO DBTB "TÎ DSFDJÓ VO UJQP EF SFMBDJÓO NVZ FYUSBÒB DPO FTUF NVDIBDIP QVFT B WFDFT OP FOUFOEÎB TJFNQSF NF RVFEBCB BTÎ DPNP iyFTUBSÃ FTDVDIBOEP MB NÙTJDB DPNP ZP u : CVFOP EVSBOUF MB BEPMFTDFODJB FNQJF[BT B SFáFYJPOBS TPCSF MBT QSFHVOUBT RVF UF IJDJTUF EF OJÒP Z FTUP FNQF[Ó B HFOFSBS UBNCJÊO FTUB DVFTUJÓO 1VFT CJFO Z DPO FM KB[[ ZP FTUBCB NFUJEP EFTEF IBDF NVDIPT BÒPT %FTEF MB QSFBEPMFTDFODJB Z TJFNQSF NF IB JOUFSFTBEP MB JNQSPWJTBDJÓO FO FM KB[[w TY: Claro, justamente, el jazz latino caracterizado por esto de “la descarga”, de romper los patrones, por la posibilidad de que en una experiencia colectiva acontezca algo que no estaba escrito –como en la experiencia musical europea, occidental: pauteada, de partitura. En el jazz latino hay una cuestión más ritual, hay la incorporación de elementos con raíz afro que parecieran también poner en cuestión el parámetro musical académico. -% &O FGFDUP FM MBEP BGSP MBUJOP FT GVOEBNFOUBM JOUSPEVDJÊOEPNF FO MB JNQSPWJTBDJÓO Z FNQF[BOEP B IBDFS FTUVEJPT EF àMPTPGÎB EF OFVSPDJFODJBT TF BEWJFSUF VOB SFMBDJÓO FTUSFDIB FOUSF FM DPODFQUP EF JNQSPWJTBDJÓO FO FM KB[[ mZ FO MB NÙTJDB FO HFOFSBMm Z FM GVODJPOBNJFOUP EFM DFSFCSP &M DFSFCSP JNQSPWJTB mEJSÎBNPTm TJNVMB TFMFDDJPOB BOUJDJQB /PTPUSPT UFOFNPT RVF JNQSPWJTBS EF GPSNB DPOTUBOUF : QPS FTP UFOFNPT UBOUP NJFEP QPS FTP OFDFTJUBNPT UFOFS UBOUB TFHVSJEBE QPS FTP OFDFTJUBNPT B WFDFT TJTUFNBT QPMÎUJ-

ENTREVISTA A LUC DELANNOY, DIRECTOR DEL INSTITUTO DE NEUROARTES, TIJUANA, MÉXICO - Jana Stojanova, Tuillang Yuing

DPT SFQSFTJWPT QPSRVF UFOFNPT NJFEP EF MB JNQSPWJTBDJÓO 1FSP OVFTUSP DFSFCSP FTUÃ FO VO FTUBEP EF JNQSPWJTBDJÓO DPOTUBOUF Z MPT TJTUFNBT QPMÎUJDPT FO HFOFSBM USBUBO EF JNQFEJS FTUB GVODJÓO EF JNQSPWJTBDJÓO EFM DFSFCSP QBSB FODBNJOBS B MPT JOEJWJEVPT IBDJB NFUBT ZB QSFFTUBCMFDJEBT &OUPODFT MVDIBOEP QPS VO MBEP QBSB GBWPSFDFS MB JNQSPWJTBDJÓO NVTJDBM mRVF FT VOB NFUÃGPSB QFSGFDUB EF MB JNQSPWJTBDJÓO DFSFCSBMm RVF SFBMNFOUF WB QFSGFDUP QBSB MVDIBS DPOUSB NJ Abête noire RVF FT MB TJOHVMBSJEBE PCKFUJWB QSFFYJTUFOUF VOB TJOHVMBSJEBE QÙCMJDB Z DPNQBSUJEB QPS UPEPT 1VFT WB UPEP EF MB NBOP : UPEP QBSUF EF MB NÙTJDB 5PEP QBSUF EF MB NÙTJDB Z EF MB JNQSPWJTBDJÓO EF UPEPT MPT SJFTHPT RVF UJFOFT RVF DPSSFS DPO MB JNQSPWJTBDJÓO MB BWFOUVSB RVF IBZ RVF WJWJS EFTBSSPMMBS UV TVCKFUJWJEBE FO GVODJÓO EF UVT IBCJMJEBEFT EF JNQSPWJTBDJÓO : FTUP TF DPOTJHVF QPS NFEJP EF MBT UÊDOJDBT RVF BQSFOEFT DPNP NÙTJDP DPO FM DPOUBDUP DPO FM PUSP Z UV TVCKFUJWJEBE RVF TF EFTBSSPMMB DPO MB JNQSPWJTBDJÓO 4F IBDF QPS NFEJP EFM BSUF Z FMMP QFSNJUF NBOUFOFS P EFTBSSPMMBS VOB TBMVE NFOUBM FRVJMJCSBEB FNQÃUJDB &OUPODFT FM EFTBSSPMMP EF IBCJMJEBEFT QBSB JNQSPWJTBS FT MB QSFWFODJÓO QBSB UFOFS VOB TPDJFEBE FRVJMJCSBEB TPTUFOJCMF TY: Es una apuesta estética en contra de la “anestesia” que cotidianamente se trata de imponer como mejoría. La pastilla es eso: adormecer la sensibilidad, y al contrario, aquí justamente por medio de la estimulación se busca recuperar un poco la salud… -% &YBDUBNFOUF UPEP FTUÃ NVZ SFMBDJPOBEP : MB NÙTJDB Z FM KB[[ FO QBSUJDVMBS FT VOB NFUÃGPSB QFSGFDUB EF MB IBCJMJEBE RVF QVFEF UFOFS FM IVNBOP EF JNQSPWJTBS &T FTUP MP RVF B OPTPUSPT OPT JOUFSFTB MPT SJFTHPT RVF JNQMJDBO VO BDUP EF GF FO FM PUSP /P VOB GF EJWJOB TJOP MB GF DPNP VO BDUP EF SJFTHP MB GF FT VO BDUP EF BQFSUVSB BM PUSP &TP FT MP RVF B OPTPUSPT OPT JNQPSUB TY: Me imagino que en el caso del jazz se trata también de un contexto cultural que tiene que ver con la discriminación racial y por tanto también con la liberación…

-% &GFDUJWBNFOUF ZP TJFNQSF IF DPOTJEFSBEP FM KB[[ DPNP VOB NÙTJDB EF SFTJTUFODJB &TUB SFTJTUFODJB MB UFOFNPT RVF FODBSOBS OPTPUSPT -B SFTJTUFODJB FT VOB GPSNB EF FNQPEFSBNJFOUP VOB NBOJGFTUBDJÓO EFM FNQPEFSBNJFOUP RVF OFDFTJUBNPT UPEPT "IPSB WBNPT B FNQF[BS B USBCBKBS DPO OJÒPT FO FM FTUBEP EF $IJBQBT RVF FT VO FTUBEP CBTUBOUF QPCSF EF .ÊYJDP EPOEF IBZ NVDIB QPCMBDJÓO JOEÎHFOB Z IBZ UBNCJÊO BEVMUPT NBZPSFT 5SBCBKBSFNPT DPO FMFNFOUPT DVMUVSBMFT QSPQJPT EF TVT WJEBT %JHP FTUP QPSRVF MB UFSBQJB OP FT USBOTGPSNBS B BMHVJFO FO MP RVF OP FT MP RVF VTVBMNFOUF QBTB QPSRVF FM UFSBQFVUB UJFOF TVT FYQFDUBUJWBT NJEF BM JOEJWJEVP DPNP VO PCKFUP FUDÊUFSB JS: ¿Qué lugar tiene el Instituto dentro de la salud pública en México?, porque parece que en este momento sigue como un experimento que depende de las comunidades que permiten su ingreso. -% 5FOFNPT VO àOBODJBNJFOUP EFM HPCJFSOP 5SBCBKBNPT DPO GPOEPT QÙCMJDPT $PO FTF EJOFSP QBHBNPT B UPEBT MBT QFSTPOBT RVF JOUFSWJFOFO 4PNPT QFSTPOBT USBCBKBOEP $PNP BEFNÃT FT VOB GVFOUF EF USBCBKP FOUPODFT JODPSQPSBNPT BSUJTUBT EF EJGFSFOUFT EJTDJQMJOBT : FM QSPZFDUP FT BCSJS VO JOTUJUVUP EF /FVSPBSUFT FO $IJMF $SFP RVF FO TFQUJFNCSF UFOESFNPT MPT QBQFMFT FO PSEFO QBSB DPOTUJUVJS VOB 0/( DPO USBCBKP FO 4BOUJBHP $PODFQDJÓO Z 7BMQBSBÎTP "RVÎ WBNPT B DPOTUJUVJS VO HSVQP EF USBCBKP PSJFOUBEP BM EFTBSSPMMP EF BDUJWJEBEFT BDBEÊNJDBT QPS NFEJP EF MB 6OJWFSTJEBE EF 7BMQBSBÎTP %F IFDIP WBNPT B àSNBS VO DPOWFOJP EF DPMBCPSBDJÓO QBSB FM *OJDJBMNFOUF WB B TFS VO EJQMPNBEP QFSP UBNCJÊO CVTDBNPT EFTBSSPMMBS BDUJWJEBEFT DPO BEVMUPT NBZPSFT $SFP RVF WB B TFS VO QPDP EJTUJOUP BM QSPHSBNB EF .ÊYJDP QPSRVF MB JEFB FT DBQUVSBS MBT JORVJFUVEFT MPDBMFT -B QSJNFSB FUBQB BRVÎ FO $IJMF mMB QBSUF BDBEÊNJDBm WB B TFS VOB GPSNB EF TFOTJCJMJ[BDJÓO 1FSP MB QBSUF DPODSFUB TFSÎB FM USBCBKP DPO BEVMUPT NBZPSFT FO EJGFSFOUFT DPNVOJEBEFT EFM QBÎT

REVISTA DE LIBROS Y REVISTAS Rev Chil Salud Pública 2014; Vol 18 (1): 100-111

NUSSBAUM M. NOT FOR PROFIT. WHY DEMOCRACY NEEDS THE HUMANITIES. NEW JERSEY, WOODSTOCK, PRINCETON UNIVERSITY PRESS, 2012.

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AGENDA 2014 Marzo 3-7 marzo | II Congreso Latinoamericano de EpidemiologĂa Universidad de Antioquia, MedellĂn, Colombia UVDBOPT VEFB FEV DP DNT DPOHSFTPFQJ 4-7 marzo | International Conference on Urban Health .BODIFTUFS 3FJOP 6OJEP IUUQT XXX JDVI DPN 14 de marzo | V Jornada de PrevenciĂłn y Control del Tabaquismo del ComitĂŠ Nacional para la PrevenciĂłn del Tabaquismo (CNPT) .BESJE &TQBĂ&#x2019;B IUUQT JOUSBOFU QBDJĂ DP NFFUJOHT DPN (FT$P'PSN DGH 14-15 marzo | IV Congreso Internacional de Humanidades MĂŠdicas 7BODPVWFS $BOBEĂ&#x192; IUUQ IVNBOJEBEFTNFEJDBT DPN DPOHSFTP 19-21 marzo | XVIII Jornadas de NutriciĂłn PrĂĄctica y IX Congreso Internacional de NutriciĂłn, AlimentaciĂłn y DietĂŠtica .BESJE &TQBĂ&#x2019;B IUUQ XXX OVUSJDJPOQSBDUJDB PSH Abril 10-12 abril | EUPHA 5th European Conference on Migrant and Ethnic Minority Health (SBOBEB &TQBĂ&#x2019;B IUUQ XXX FVQIB NJHSBOUIFBMUIDPOGFSFODF DPN 23-25 de abril | 22nd International Health Promoting Hospitals and Health Services (HPH) Conference #BSDFMPOB &TQBĂ&#x2019;B IUUQ XXX IQIDPOGFSFODFT PSH CBSDFMPOB IUNM 24-25 abril | XIV Jornadas nacionales sobre avances en medicina preventiva .VSDJB &TQBĂ&#x2019;B IUUQ XXX KPSOBEBTQSFWFOUJWB DPN Mayo 12-16 de mayo | I Jornadas Virtuales de EstadĂstica en Salud IUUQ KWFT BFTBXFC FT

Julio 23-25 de julio | III Congreso Chileno de Salud Pública y V Congreso Chileno de Epidemiología “Salud pública en todas las políticas” 4BOUJBHP $IJMF -B &TDVFMB EF 4BMVE 1ÙCMJDB EF MB 6 EF $IJMF FO DPOKVOUP DPO MB 4PDJFEBE $IJMFOB EF 4BMVCSJEBE MB 4PDJFEBE $IJMFOB EF &QJEFNJPMPHÎB Z MB 3FE $IJMFOB EF *OTUJUVDJPOFT 'PSNBEPSBT FO 4BMVE 1ÙCMJDB JOWJUBO BM *** $POHSFTP $IJMFOP EF 4BMVE 1ÙCMJDB Z 7 $POHSFTP $IJMFOP EF &QJEFNJPMPHÎB i4BMVE QÙCMJDB FO UPEBT MBT QPMÎUJDBTu RVF TF SFBMJ[BSÃ EFTEF FM BM EF KVMJP EF FO FM )PUFM 4IFSBUPO 4BOUJBHP

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