Chile is a middle income country in the process of demographic transition, where mental health problems contribute significantly to the disease burden. In 2001, Chile introduced gradually the Program of Treatment for Depression in Primary Health Care (PTDPHC), which includes a multicomponent care model according to the severity of the medical profile: integral evaluation by a team of professionals, antidepressant drug treatment, individual psychotherapy, psychoeducational group intervention, and monitoring visits. In 10 years of operation, this program has attended more than 1 million adults. We have conducted several evaluations of this program, and our results show that PTDPHC is effective in decreasing depressive symptoms and comorbidity, has positive effects on the patient and their partners, and is independent of the center; the greatest threat to achieving effectiveness is the rate of treatment dropout. In the future, the manager of this policy must meet the following challenges: the continuous training of primary care teams, the incorporation of techniques that have been shown to improve compliance, and the extension of coverage to remote areas, where telepsychiatry could be a good idea. Downloaded by [University of Otago] at 16:55 01 October 2015

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the endoscopic findings, and the type of cystography used. In all, 174 cases were used as training samples for the ANN and 87 to validate it. We calculated the sensitivity, specificity, positive (PPV) and negative predictive values (NPV), and the success rate (%) of the system. RESULTSIn the training group the ANN gave a sensitivity of 86.4%, a specificity of 89.5%, a PPV of 76% and NPV of 94%, with a success rate of 88.6%. In the same training group logistic regression (LR) gave respective values of 68.2%, 58.8%, 39%, 82.7% and 61.4%. In the validation group the respective values for the ANN were 71.4%, 81.6%, 58.8%, 88.6% and 78.9%, and in the same validation group the LR gave 64.4%, 50%, 32.1%, 79.2% and 53.9%. The Wilcoxon test confirmed the independence of both methods ( P < 0.001). CONCLUSIONThe ANN is an effective tool for assisting the urologist in indicating and applying endoscopic treatments for VUR.