Browsing by Author "Vargas, Cristian"
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Item Distribución territorial de las cesáreas realizadas en la Región Metropolitana, de acuerdo a los egresos hospitalarios del año 2015(Universidad del Desarrollo. Facultad de Medicina. Escuela de Enfermería, 2018) Ávalos, Sebastián; Muñoz, Vesna; Salazar, Francisca; Valdivieso, Fernanda; Vargas, Cristian; Ávalos, Sebastián; Muñoz, Vesna; Salazar, Francisca; Valdivieso, Fernanda; Vargas, Cristian; Pedrero Castillo, Víctor; Pedrero Castillo, VíctorLos estudios descriptivos de corte transversal, corresponden a diseños observacionales de base individual, cuyo objetivo es estudiar la frecuencia y distribución de eventos de salud y/o enfermedades. En este caso, se describe la distribución territorial de las cesáreas en las comunas que conforman la RM, considerando las siguientes variables: tipo de establecimiento de salud (público y privado), edad, previsión de salud, Servicio de Salud de Referencia y días de estadía. Esta investigación se realiza por primera vez en Chile, escogiendo como territorio la RM, por concentrar la mayor parte de la población del país, evaluándola a través de sus Servicios de Salud de Referencia y sus comunas. El propósito de esta investigación se orienta principalmente a generar una mejora en la toma de decisiones cuando se debe tomar una decisión sobre el tipo de parto, informándoles sobre los riesgos y beneficios a corto y largo plazo de la cirugía por cesárea, tanto para la madre como para su progenie y con ello, hacia la madre, para generar un impacto positivo en la reducción de cesáreas programadas en la Región Metropolitana y en Chile. Para poder llevar a cabo esta investigación, se realizó búsqueda bibliográfica y literatura gris, referidas al objetivo de este estudio, para luego recopilar información sobre la población objetivo, utilizándose en este caso los egresos hospitalarios por cesárea y parto normal en la RM del año 2015. El análisis de la base da datos secundaria de “Egresos hospitalarios 2015”, rescatada del DEIS, permitió un análisis profundo de la distribución territorial de las cesáreas y partos normales. Posteriormente, se realizó el 79 análisis de la información recopilada, para estudiar las variables consideradas en el estudio y evidenciar la existencia de algún patrón de comportamiento que se repita entre Servicios de Salud de Referencia y las comunas de la RM, generando conclusiones que permitan implementar a futuro un plan de acción para reducir las cesáreas programadas.Item Gender, age and geographical representation over the past 50 years of schizophrenia research(2022) Alliende, Luz María; Czepielewski, Leticia; Aceituno, David; Castañeda, Carmen Paz; Diaz, Camila; Iruretagoyena, Bárbara; Mena, Carlos; Mena, Cristian; Ramírez, Juan Pablo; Tepper, Ángeles; Vásquez, Javiera; Fonseca, Lais; Machado, Viviane; Hernández, Camilo; Vargas, Cristian; Gómez, Gladys; Kobayashi, Luis; Moncada, Tomás; Evans, Sara; Bressan, Rodrigo; Gama, Clarissa; López, Carlos; De la Fuente, Camilo; González, Alfonso; Undurraga, Juan; Gadelha, Ary; Crossley, Nicolás; ANDES NetworkPrevious studies have suggested that subjects participating in schizophrenia research are not representative of the demographics of the global population of people with schizophrenia, particularly in terms of gender and geographical location. We here explored if this has evolved throughout the decades, examining changes in geographical location, gender and age of participants in studies of schizophrenia published in the last 50 years. We examined this using a meta-analytical approach on an existing database including over 3,000 studies collated for another project. We found that the proportion of studies and participants from low-and-middle income countries has significantly increased over time, with considerable input from studies from China. However, it is still low when compared to the global population they represent. Women have been historically under-represented in studies, and still are in high-income countries. However, a significantly higher proportion of female participants have been included in studies over time. The age of participants included has not changed significantly over time. Overall, there have been improvements in the geographical and gender representation of people with schizophrenia. However, there is still a long way to go so research can be representative of the global population of people with schizophrenia, particularly in geographical terms.Publication The enduring gap in educational attainment in schizophrenia according to the past 50 years of published research: a systematic review and meta-analysis(2022) Crossley, Nicolás; Alliende, Luz; Czepielewski, Leticia; Aceituno, David; Castañeda, Carmen; Diaz, Camila; Iruretagoyena, Bárbara; Mena, Carlos; Mena, Cristian; Ramírez, Juan; Tepper, Angeles; Vásquez, Javiera; Fonseca, Lais; Machado, Viviane; Hernández, Camilo; Vargas, Cristian; Gómez, Gladys; Kobayashi, Luis; Moncada, Tomás; Arango, Celso; Barch, Deanna; Carter, Cameron; Correll, Christoph; Freimer, Nelson; McGuire, Philip; Evans, Sara; Undurraga, Eduardo; Bressan, Rodrigo; Gama, Clarissa; López, Carlos; De la Fuente, Camilo; González, Alfonso; Undurraga, Juan; Gadelha, AryBackground: Educational attainment is associated with wellbeing and health, but patients with schizophrenia achieve lower levels of education than people without. Several effective interventions can ameliorate this situation. However, the magnitude of the education gap in schizophrenia and its change over time are unclear. We aimed to reconstruct the trajectories of educational attainment in patients with schizophrenia and, if reported, their healthy comparator controls. Methods: We did a systematic review and meta-analysis including all studies reporting on patients with schizophrenia (of mean age ≥18 years) and describing the number of years of education of the participants, with or without healthy controls. There were no other design constraints on studies. We excluded studies that included only patients with other schizophrenia spectrum disorders and studies that did not specify the number of years of education of the participants. 22 reviewers participated in retrieving data from a search in PubMed and PsycINFO (Jan 1, 1970, to Nov 24, 2020). We estimated the birth date of participants from their mean age and publication date, and meta-analysed these data using random-effects models, focusing on educational attainment, the education gap, and changes over time. The primary outcome was years of education. The protocol was registered on PROSPERO (CRD42020220546). Findings: From 32 593 initial references, we included 3321 studies reporting on 318 632 patients alongside 138 675 healthy controls (170 941 women and 275 821 men from studies describing sex or gender; data on ethnicity were not collected). Patients' educational attainment increased over time, mirroring that of controls. However, patients with schizophrenia in high-income countries had 19 months less education than controls (-1·59 years, 95% CI -1·66 to -1·53; p<0·0001), which is equivalent to a Cohen's d of -0·56 (95% CI -0·58 to -0·54) and implies an odds ratio of 2·58 for not completing 12 years of education (ie, not completing secondary education) for patients compared with controls. This gap remained stable throughout the decades; the rate of change in number of total years of education in time was not significant (annual change: 0·0047 years, 95% CI -0·0005 to 0·0099; p=0·078). For patients in low-income and middle-income countries, the education gap was significantly smaller than in high-income countries (smaller by 0·72 years, 0·85 to 0·59; p<0·0001), yet there was evidence that this gap was widening over the years, approaching that of high-income countries (annual change: -0·024 years, -0·037 to -0·011; p=0·0002). Interpretation: Patients with schizophrenia have faced persistent inequality in educational attainment in the last century, despite advances in psychosocial and pharmacological treatment. Reducing this gap should become a priority to improve their functional outcomes. Funding: Ciencia y Tecnología para el Desarrollo (CYTED) to the Latin American Network for the Study of Early Psychosis (ANDES).