Abstract: Objective: To describe the program offering designed to promote comprehensive early childhood de velopment in Chile. Method: A scoping review was carried out following the Joanna Briggs Institute’s methodological framework. A researcher conducted the review considering as inclusion criteria go vernment programs aimed at the comprehensive development of children under 5 years of age in Chile. The data were organized and synthesized to describe the characteristics of the program and the service(s) it provides. Results: The search identified 2.060 documents and 72 met the inclusion crite ria. 59 current programs are covering early childhood, which are mainly managed by the Ministries of Justice, Education, Health, and Social Development. Most of the programs are aimed at promotion and intervention, focusing on vulnerable populations, are cross-sectoral, and use different strategies for their implementation. Conclusion: The program offering in Chile for early childhood has charac teristics suggested as effective to promote child development.

Resumen: Objetivo: Describir la oferta programática en primera infancia destinada a favorecer el desarrollo infantil integral en Chile. Método: Se realizó una revisión exploratoria siguiendo el marco metodo lógico del Joanna Briggs Institute. La búsqueda fue realizada por un investigador y los criterios de inclusión fueron: programas gubernamentales destinados al desarrollo integral en menores de 5 años en Chile. Los datos fueron organizados y sintetizados para describir características del programa y de la o las prestaciones que entrega. Resultados: La búsqueda identificó 2060 documentos y 72 cumplie ron los criterios de inclusión. Se describen 59 programas vigentes que abarcan la primera infancia, es tando principalmente a cargo de los Ministerio de Justicia, Educación, Salud y Desarrollo Social. Los programas están destinados en su mayoría a la promoción e intervención, se encuentran focalizados en población vulnerable, son intersectoriales y utilizan diversas estrategias para su implementación. Conclusión: La oferta programática en Chile para la primera infancia presenta características sugeri das como efectivas para favorecer el desarrollo infantil.

RESUMO Introdução: Devido à relação entre a identificação precoce das características físicas e antropométricas acima da média populacional em crianças e adolescentes e o êxito nos esportes, a detecção de potenciais talentos esportivos deve ser feita de forma ampla e sistemática como estratégia para a identificação precoce das características físicas favoráveis para o esporte em questão. Entretanto, a maioria dos estudos não utiliza amostras representativas, ou apresenta a detecção de talentos sem a utilização de métodos científicos válidos. O presente estudo comparativo retrospectivo, portanto, apresenta a identificação de potenciais talentos esportivos utilizando a estratégia Z, calculada com os dados das variáveis antropométricas, neuromotoras e de aptidão física. Objetivo: Identificar as habilidades físicas e os valores antropométricos acima dos níveis considerados normais em uma população de alunos do 8° ano de Educação Básica no Chile. Métodos: A amostra foi composta por 9.429 estudantes de escolas públicas e particulares (50,9% sexo masculino). Os dados foram obtidos a partir de um estudo transversal realizado em 2013. Os dados antropométricos e de aptidão física foram recopilados através do Sistema de Medición de la Calidad de Educación - SIMCE de educação física. A “Estratégia Z” foi utilizada para detectar os talentos esportivos ao identificar os valores acima da média da população. Resultados: Em, pelo menos, uma variável, um total de 619 alunos e 623 alunas com um desvio padrão de ≥2 (Z2) foi detectado. Conclusão: A “Estratégia-Z” foi capaz de detectar talentos esportivos de ambos os sexos e em diferentes idades. Nível de evidência III; Estudo retrospectivo comparativo.

ABSTRACT Introduction: Due to the relationship between early identification of physical and anthropometric characteristics above the population mean in children and adolescents, and success in sports, detecting potential sports talents should be broadly and systematically used as a strategy for the early identification of physical characteristics favorable to the sport in question. However, most studies do not use representative samples, or else they present talent detection without using valid scientific methods. This retrospective, comparative study therefore presents the identification of potential sports talents using the Z Strategy, calculated with anthropometric, neuromotor and physical fitness data. Objective: To identify physical abilities and anthropometric values above what are considered the normal ranges in a population of students in the 8th year of basic education, in Chile. Methods: The sample consisted of 9,429 students from public and private schools (50.9% boys). Data were obtained from a cross-sectional study conducted in 2013. Physical fitness and anthropometric data were recompiled through the Educational Quality Measurement System (Sistema de Medición de la Calidad de Educación – SIMCE) of physical education. The “Z Strategy” was used to detect sports talents by identifying values above the population mean. Results: In at least one variable, a total of 619 male and 623 female students with a standard deviation ≥2 (Z2) were detected. Conclusion: “Z Strategy” was able to detect sports talents of both sexes and of different ages. Level of evidence III; Retrospective comparative study.

RESUMEN Introducción: Debido a la relación entre la identificación precoz de las características físicas y antropométricas por encima del promedio poblacional en niños y adolescentes y el éxito en los deportes, la detección de potenciales talentos deportivos debe ser hecha de manera amplia y sistemática como estrategia para la identificación precoz de las características físicas favorables para el deporte en cuestión. Entretanto, la mayoría de los estudios no utiliza muestras representativas, o presenta la detección de talentos sin el uso de métodos científicos válidos. El presente estudio comparativo retrospectivo, por lo tanto, presenta la identificación de potenciales talentos deportivos utilizando la estrategia Z, calculada con los datos de las variables antropométricas, neuromotoras y de aptitud física. Objetivo: Identificar las habilidades físicas y los valores antropométricos por encima de los niveles considerados normales en una población de alumnos de 8° año de Educación Básica en Chile. Métodos: La muestra fue compuesta por 9429 estudiantes de escuelas públicas y privadas (50,9% sexo masculino). Los datos se obtuvieron a partir de un estudio transversal realizado en 2013. Los datos antropométricos y de aptitud física fueron recopilados a través del Sistema de Medición de la Calidad de Educación - SIMCE de educación física. La “Estrategia Z” fue utilizada para detectar los talentos deportivos al identificar los valores por encima del promedio de la población. Resultados: Se detectó en por lo menos una variable, un total de 619 alumnos y 623 alumnas con una desviación estándar de ≥2 (Z2). Conclusión: La “Estrategia-Z” fue capaz de detectar talentos deportivos de ambos sexos y en diferentes edades. Nivel de evidencia III; Estudio retrospectivo comparativo.

ABSTRACT INTRODUCTION Population aging is a worldwide phenomenon. It is estimated that by 2050, one of five persons will be aged ≥60 years. In Chile, 15.8% of the population is now aged ≥60 years, and this figure will reach 30.7% by 2050. In 2006, a national program was implemented to provide assistive devices to older adults aged ≥65 years with limited mobility or difficulty performing activities of daily living. To date, there have been no assessments of the program’s effectiveness. OBJECTIVE Assess the effectiveness of an assistive devices policy in Chile on improving functional capacity of older adults aged ≥65 years, and beneficiaries’ perceptions of the services received, including changes in their quality of life. METHODS This was a before–after longitudinal study. A cohort of 309 persons was recruited, consisting of patients who received care at a public hospital in Santiago, Chile during 2014–2015. They were assessed before delivery of assistive devices, then followed for seven months, with repeated evaluations made in their homes. The following indicators were measured: functional capacity (Tinetti scale and Barthel Index); changes in perceived quality of life related to use of assistive devices; and other sociodemographic, clinical and protocol-compliance variables. A longitudinal analysis of before–after progress was carried out, as well as a description of service delivery and medical followup. RESULTS Sixty-eight percent of those surveyed were women; median age was 74 years, average schooling was 6 years, and 93% had low income (monthly income <US$398). Assistive devices increased independence in activities of daily living, improved mobility and perceived quality of life, and decreased fall risk and pain. One hundred percent felt satisfied with the service received, 91% were trained in use of the device, and delivery deadlines were met in 83% of cases, but only 2% were followed up. One negative aspect is that the program covers only 25% of estimated need. CONCLUSIONS This assistive device program helps improve functional capacity and perceived quality of life in vulnerable patients who are able to access it. It addresses a real need and is highly valued by patients. Although delivery schedules were fulfilled, followup care schedules were not.

The Chilean National Health Survey 2009-10, evidences that 88.6% of the general population does not engage in sports or physical activity in their free time, and this behavior increases with age, low educational levels, and in women. According to evidence, using physical activity for smoking cessation has a weak. However, there is strong evidence that physical activity reduces withdrawal symptoms, craving, and weight gain during smoking cessation. Adults aged 18-64 need to spend at least 150 minutes a week on moderate intensity aerobic physical activity or 75 minutes of vigorous aerobic physical activity each week or an equivalent combination of moderate and vigorous activities to protect thenrselves against mortality from diverse causes.

Resumen En Chile, según la Encuesta Nacional de salud 2009-10, el 88,6% de la población general no realiza deporte o actividad física en su tiempo libre, y esta conducta de inactividad física aumenta con la edad y es mayor en los niveles educacionales bajos y en las mujeres. La evidencia reporta que utilizar la AF para la cesación del tabaquismo es débil, sin embargo, existe fuerte evidencia de que la actividad física reduce los síntomas de abstinencia, el deseo de fumar y el aumento de peso durante el abandono del tabaco. Los adultos de 18 a 64 años necesitan dedicar al menos 150 min semanales a la actividad física aeróbica, de intensidad moderada, o bien 75 min de actividad física aeróbica vigorosa cada semana, o bien una combinación equivalente de actividades moderadas y vigorosas para protegerse de mortalidad por diversas causas.

La autopercepción de aumento de volumen de extremidad superior, puede ser una herramienta eficaz en la pesquisa e intervención temprana del linfedema. El objetivo del estudio fueverificar la asociación entre autopercepción de aumento de volumen de extremidad superior y criterios objetivos de uso común para linfedema en mujeres tratadas por cáncer de mama. Se evaluaron 112 mujeres con cáncer de mama, quienes tenían entre 6 y 18 meses post cirugía. Se realizó el cálculo de volumetría indirecta de extremidades superiores, a través de cuatro criterios diagnósticos basados en diferencia de volumen de extremidades (≥2 cm, ≥ 200 mL, ≥10% ≥20%). La autopercepción de volumen fue evaluada con una pregunta. Para el análisis de datos, se utilizó la prueba de chi cuadrado. La media de edad fue 56,3 años (DE=13,1). La prevalencia observada para el criterio de diferencia de volumen ≥ 200 mL fue de 13,4%, 17% para criterio ≥10%, 6,25% para criterio ≥ 20% y 33% para criterio ≥2 cm. Stemmer fue positivo en 51,8% y fóvea positiva en 17,9% de las mujeres. La autopercepción de aumento de volumen se asoció con los criterios ≥ 200 mL y ≥10% y con la presencia de Stemmer y fóvea (p<0,05). En conclusión, la información entregada por las pacientes respecto de la autopercepción del volumen de su extremidad, se asoció con los criterios diagnósticos de linfedema más conservadores, así como para la presencia de signos de Stemmer y fóvea positiva. Estos se debiera considerar dentro de la evaluación clínica.

Self-perception of upper limbs swelling can be an effective tool in diagnostic and early intervention of lymphedema. The aim of the present paper was to verify the association between self-perception of swelling of upper extremities and objective criteria commonly used for lymphedema diagnostic in women treated for breast cancer. We evaluated 112 women with breast cancer between 6- and 18-months post-surgery. Indirect calculation of the volume of upper extremities through four criteria commonly used was employed (≥2 cm, ≥ 200 mL, ≥10%, ≥20%). The self-perception of swelling was evaluated with a question. The chi square test was used for data analysis. The mean age was 56.3 years (DE=13.1). The prevalence of lymphedema according to limb volume difference ≥ 200 ml criterion was 13.4%; 17% for criterion ≥10 %; 6.25% for criterion ≥ 20%; and 33% for criterion ≥2 cm. Stemmer was positive in 51.8% and 17.9% women presented positive fovea. Self-perception of swelling was associated with the criteria ≥ 200 mL and ≥10 % and the presence of positive Stemmer and fovea (p <0.05). In conclusion, the information provided by the patient about her perception of swelling, is associated with objective diagnostic criteria and the Stemmer and fovea positive signs. Self-perception should be considered in the clinical evaluation.

Abstract: Background: Research in educational centers is a frequent source of social and health related studies. Objective: To determine the knowledge and adherence to the current legal and ethical regulations to research performed on children at educational institutions. Methodology: Cross-sectional study online survey-type. The level of knowledge and adherence to the ethical regulation and legislation in Chile, to conduct research with minors was consulted. Results: 126 educational institutions responded the survey; 69% belonged to urban centers; 60% corresponded to those under the Municipality umbrella and 34% to charter schools. Research was performed in 31,8% of the consulted institutions, 41% of the research was on health issues and 30,8% on education. The 27,5% answered that they had the approval of ethical-scientific committee, 82% answered that they neither received nor had any awareness of regulatory aspects on research. Conclusion: There is low knowledge and adherence to ethical and legal regulation to research performed with children in educational centers. A journey for dissemination of results was performed and a flow chart was created by experts and proposed to the school directors to contribute to the adherence of ethical and regulatory aspects of research in educational centers.

Resumen: Antecedentes: La investigación en centros educacionales es una fuente frecuente de estudios de las áreas sociales y salud. Objetivo: Determinar el conocimiento y la adherencia a la regulación ética y legal vigente de la investigación realizadas con niños en centros educacionales. Metodología: Estudio transversal tipo encuesta online. Se consultó sobre el nivel de conocimiento y adherencia a la regulación ética y legislación vigente en Chile, para realizar investigación con menores de edad. Resultados: 126 centros respondieron la encuesta; 69% de zonas urbanas; 60% son centros municipales y 34% particulares subvencionados. En un 31,8% de los centros se realizó investigación, 41% de salud y 30,8% de educación. El 27,5% informó que la investigación contaba con aprobación del comité ético-científico para su implementación, un 82% señaló no recibir ni tener conocimiento de los aspectos regulatorios sobre la investigación con seres humanos. Conclusión: Existe bajo conocimiento y adherencia a la regulación ética y legal de la investigación con niños en centros educacionales. Se realizó una jornada de difusión de los resultados y se propuso un flujograma generado por expertos orientado a los directores de centros educacionales para contribuir a la adherencia de los aspectos éticos y regulatorios de la investigación en centros educacionales.

Resumo: Antecedentes: A pesquisa em centros educacionais é uma fonte frequente de estudos das áreas sociais e de saúde. Objetivo: determinar o conhecimento e a adesão à regulamentação ética e legal vigente de pesquisa realizada com crianças em centros educacionais. Metodologia: estudo transversal de tipo enquete on-line. Consultou-se sobre o nível de conhecimento e adesão ao regulamento ético e a legislação vigente no Chile, para realizar a pesquisa com menores de idade. Resultados: 126 centros responderam à enquete; 69% em áreas urbanas; 60% são centros municipais e 34% centros particulares subsidiados. Em 31,8% dos centros foram realizadas pesquisas, 41% de saúde e 30,8% de educação. 27,5% relataram que a pesquisa teve aprovação do Comitê de etico-cientifico para a sua execução, 82% disseram não receber ou ter conhecimento dos aspectos regulatórios da pesquisa com seres humanos. Conclusão: Existe pouco conhecimento e adesão ao regulamento ético e legal de pesquisa envolvendo crianças em centros educacionais. Fora realizada uma conferência para a divulgação dos resultados e fora proposto um fluxograma gerado por especialistas, que visam os diretores de centros educacionais para contribuir para a aderência dos aspectos éticos e regulatórios de pesquisa em centros educacionais.

Background: Little is known about the relationship between physical activity (PA) and cardiovascular risk factors in the Chilean population. Aim: To investigate the association between different levels and intensities of PA and the prevalence of cardiovascular (CV) risk factors in Chilean adults. Material and Methods: Data from the National Health Survey 2009-10 including 5157 participants, provided by the Epidemiology Department of the Ministry of Health, was analyzed in this study. The prevalence of type 2 diabetes mellitus, hypertension, metabolic syndrome and dyslipidemia were determined using international criteria. PA levels were determined using the Global Physical Activity Questionnaire (GPAQ v2) and different levels of PA were derived from it (transport-related, moderate and vigorous PA). Quartiles of PA were determined to investigate the association between PA and cardiovascular risk factors. Results: Twenty three percent of women and 17.1% of men did not meet the PA recommendation (≥ 600 METs.min.week-1). When prevalence of CV risk factors were compared between inactive individuals (< 600 METs.min.week-1) and active individuals (≥ 9500 METs.min.week-1) a significantly lower prevalence of diabetes mellitus (6.2% and 10%), hypertension (18.0% and 12.4%) and metabolic syndrome (8.9% and 12.1%) for women and men, respectively, was found in the active participants. Similar results were found for high versus low transport-related PA. Conclusions: Increasing levels of PA are associated with a significantly lower frequency of cardiovascular risk factors in Chilean adults.

Background: During pregnancy and postpartum, women decrease physical activity (PA) levels despite the health benefits reported in the literature for women and the fetus. Aims: To determine PA levels and sedentary behaviour in women during pregnancy and postpartum. Methods: Pregnant and postpartum women between 18 and 40 years old attending to primary care center participated. Sedentary behaviour and PA were measured using the Global Physical Activity Questionnaire (GPAQ). Results: Information was collected from 47 pregnant and 12 postpartum women. Age was P50=25 (range: 18-40 years). 61% were overweight. Daily PA time was P50=154 (range: 0-960 min/day) for pregnant women and P50=190 (range: 24-411 min/day) during postpartum. Leisure time PA was P50=0 (range: 0-540 min/day) for pregnant women and P50=3 (range: 0-86 min/day) during postpartum. Sedentary behaviour was P50=180 min/day (range: 0-720 min/day) for all women. According to WHO criteria, only 20.3% of women are physically active, adjusting by BMI and educational level the reported PA in GPAQ. There was no association between the variables age, nutritional status, educational level, family income and reported level of PA. Conclusion: Leisure time PA could be susceptible to PA promotion interventions. The reported level of PA is higher than those from similar studies in other countries. Validation studies are needed to determine possible overestimation of the results due to measurement bias.

Antecedentes: Durante el embarazo y postparto las mujeres disminuyen el nivel de actividad física (AF). Objetivo: Determinar el nivel de AF y conducta sedentaria en mujeres embarazadas y postparto. Métodos: Participaron mujeres embarazadas y postparto entre 18 y 40 años de edad de un Centro de Salud Familiar. La AF y conducta sedentaria se midió utilizando el Global Physical Activity Questionnaire. Resultados: Se analizó la información de 47 mujeres embarazadas y 12 en postparto. La edad P50=25 años (rango: 18-40 años). El 61% presentó exceso de peso. El tiempo de AF diaria fue P50=154 (rango: 0-960 min/día) en embarazadas y P50=190 (rango: 24-411 min/día) en postparto. La AF en la dimensión tiempo libre en embarazadas fue P50=0 (rango: 0-540 min/día) y P50=3 (rango: 0-86 min/día) en el grupo de postparto. La conducta sedentaria para todo el grupo fue P50=180 (rango: 0-720 min/día). El 20,3% de las mujeres clasifica como suficientemente activo según criterio OMS, al corregir la AF reportada por GPAQ según IMC y nivel educacional. No hubo asociación entre las variables edad, estado nutricional, nivel educacional e ingreso familiar con el nivel de AF reportado. Conclusión: La AF de tiempo libre es una dimensión susceptible a intervenciones de promoción de la AF. El nivel de AF reportado por el grupo es mayor a resultados de estudios similares en otros países. Estudios de validación en esta población son necesarios para determinar la posible sobreestimación de los resultados por un sesgo de medición.