Browsing by Author "Zavala, Cynthia"
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Item Priority setting for mental health research in Chile(BioMed Central, 2017) Zitko, Pedro; Borghero, Francesca; Zavala, Cynthia; Markkula, Niina; Santelices, Emilio; Libuy, Nicolás; Pemjean, AlfredoBackground: Scientifc knowledge is a fundamental tool for making informed health policy decisions, but the link between health research and public policy decision-making is often missing. This study aims to identify and prioritize a national set of research gaps in mental health. Methods: A multi-approach method to identify gaps in knowledge was developed, including (1) document analysis and identifcation of possible research questions, (2) interviews to Ministry of Health key informants, (3) focus groups with diferent stakeholders, and (4) a web consultation addressed to academics. The identifed gaps were translated to a standardized format of research questions. Criteria for prioritization were extracted from interviews and focus groups. Then, a team of various professionals applied them for scoring each question research. Findings: Fifty-four people participated in the knowledge gaps identifcation process through an online consultation (n = 23) and focus groups (n = 18). Prioritization criteria identifed were: extent of the knowledge gap, size of the objective population, potential beneft, vulnerability, urgency and applicability. 155 research questions were prioritized, of which 44% were related to evaluation of systems and/or health programs, and 26% to evaluation of interventions, including questions related to cost-efectiveness. 30% of the research questions came from the online consultation, and 36% from key informants. Users groups contributed with 10% of total research questions. Conclusion: A fnal priority setting for mental health research was reached, making available for authorities and research agencies a list of 155 research questions ordered by relevance. The experience documented here could serve to other countries interested in developing a similar process.Item The incidence of non-affective psychotic disorders in Chile between 2005 and 2018: results from a national register of over 30 000 cases(2020-08) González-Valderrama, Alfonso; Jongsma, Hannah E.; Mena, Cristián; Castañeda, Carmen Paz; Nachar, Rubén; Undurraga, Juan; Crossley, Nicolás; Aceituno, David; Iruretagoyena, Bárbara; Gallardo, Carlos; Mondaca, Pilar; Monje, Matías; Irarrazaval, Matías; Zavala, Cynthia; Valmaggia, Lucia; Kirkbride, James B.Background. Evidence suggests the incidence of non-affective psychotic disorders (NAPDs) varies across persons and places, but data from the Global South is scarce. We aimed to estimate the treated incidence of NAPD in Chile, and variance by person, place and time. Methods. We used national register data from Chile including all people, 10–65 years, with the first episode of NAPD (International Classification of Diseases, Tenth Revision: F20– F29) between 1 January 2005 and 29 August 2018. Denominators were estimated from Chilean National Census data. Our main outcome was treated incidence of NAPD and age group, sex, calendar year and regional-level population density, multidimensional poverty and latitude were exposures of interest. Results. We identified 32358 NAPD cases [12136 (39.5%) women; median age-at-first- contact: 24 years (interquartile range 18–39 years)] during 171.1 million person-years [crude incidence: 18.9 per 100 000 person-years; 95% confidence interval (CI) 18.7–19.1]. Multilevel Poisson regression identified a strong age–sex interaction in incidence, with rates peaking in men (57.6 per 100 000 person-years; 95% CI 56.0–59.2) and women (29.5 per 100 000 person-years; 95% CI 28.4–30.7) between 15 and 19 years old. Rates also decreased (non-linearly) over time for women, but not men. We observed a non-linear association with multidimensional poverty and latitude, with the highest rates in the poorest regions and those immediately south of Santiago; no association with regional population density was observed. Conclusion. Our findings inform the aetiology of NAPDs, replicating typical associations with age, sex and multidimensional poverty in a Global South context. The absence of asso- ciation with population density suggests this risk may be context-dependent.