Insects associated to ephemeral pools in Huentelauquén (29ºS Coquimbo Region, Chile) / Insetos associados a lagoas temporárias em Huentelauquén (29ºS Região de Coquimbo, Chile)

Abstract In northern central Chile, ephemeral pools constitute shallow isolated water bodies with a favourable habitat for fauna adapted to seasonal changes. Based on the limited knowledge about the fauna—particularly insects—associated to these ecosystems, the objective of this study was to characterize the richness, composition, structure and similarity of the insect communities associated with ephemeral pools in Huentelauquén (29º S, Coquimbo Region, Chile). By using pitfall traps, 10,762 individuals were captured, represented by 7 orders, 27 families, and 51 species. Coleoptera and Hymenoptera were the best represented orders, with Neuroptera, Orthoptera and Plecoptera being poorly represented groups. The non-parametric estimators evaluated showed wealth values above those observed for all the studied pools, and their accumulation curves suggest the existence of an incomplete species inventory in the studied community. Additionally, the hierarchical and ordering analysis showed groupings of pools located in the northwest and southeast of Huentelauquén. Preliminarily we found a negative correlation between the area of the pools and the richness (species) and abundance of insects. Additional studies (on other arthropod groups and other seasons of the year) could provide a better understanding of the local processes of extinction and colonization of the species inhabiting these fragile coastal environments.

Resumo No norte central do Chile, lagoas efêmeras constituem corpos de água isolados e pouco profundos, com um habitat favorável para a fauna adaptada as mudanças sazonais que as zonas úmidas estão sujeitas. Com relação a estes ecossistemas, sabe-se pouco sobre sua fauna, principalmente a de insetos. O objetivo do presente estudo foi caracterizar a riqueza, composição, estrutura e similaridade das comunidades de insetos que habitam as lagoas temporárias de Huentelauquén (29º S, Região de Coquimbo, Chile). Usando armadilhas de interceptação, se capturou um total de 10.762 indivíduos, pertencentes a 7 ordens, 27 famílias e 51 espécies. Coleoptera e Hymenoptera foram as ordens mais representativas, enquanto Neuroptera, Orthoptera e Plecoptera foram grupos pouco representativos. Os estimadores não paramétricos avaliados mostraram valores de riqueza superiores ao observados para todas as lagoas estudadas, e suas curvas de acumulação parecem indicar que o inventario da comunidade estudada está incompleto. A análise hierárquica e de ordenamento revelou agrupamentos de lagoas correspondentes a zona nordeste e sudeste de Huentelauquén. Preliminarmente encontramos uma correlação negativa entre a área de lagoas efêmeras e a riqueza (espécies) e abundância de insetos. É necessário realizar estudos adicionais (sobre outros grupos de artrópodes e em outras estações do ano) para melhor compreensão dos processos locais de extinção e colonização das espécies que habitam estes frágeis ambientes costeiros estudados.

Evidence of plastic pollution from offshore oceanic sources in southern Chilean Patagonian fjords.

The Chilean Patagonian fjords are globally renowned as one of the few remaining pristine environments on Earth; however, their ecosystems are under significant threat from climatic and anthropogenic pressures. Of particular concern is the lack of research into the impact of plastic pollution on the waters and biodiversity of these fjords. In this study, the marine environment of a secluded and sparsely populated fjord system in southern Patagonia was sampled to assess microplastics in seawater, beaches, bottom sediment, and zooplankton. Microplastics were found to be widespread across the water surface of the fjord, but with low abundances of 0.01 ± 0.01 particles m-3 (mean ± SD). The presence of microplastics in sedimentary environments (e.g., beaches and bottom sediments, 15.6 ± 15.3 and 9.8 ± 24 particles kg of dry sediment-1, respectively) provided additional evidence of plastic debris accumulation within the fjord system. Furthermore, microplastics were already bioavailable to key zooplankton species of the Patagonian food web (0.01 ± 0.02 particles individual-1), suggesting bioaccumulation. A comprehensive examination of potential microplastic inputs originating from coastal runoff, coupled with distribution of water masses, suggested minimal local contribution of microplastics to the fjord, strongly indicating that plastic litter is likely entering the area through oceanic currents. The composition and type of microplastics, primarily consisting of polyester fibers (approx. 60 %), provided further support for the proposed distant origin and transportation into the fjord by oceanographic drivers. These results raise significant concern as reveal that despite a lack of nearby population, industrial or agricultural activity, remote Patagonian fjords are still impacted by plastic pollution originating from distant sources. Prioritizing monitoring efforts is crucial for effectively assessing the future trends and ecological impact of plastic pollution in these once so-called pristine ecosystems.

Internet use by informal caregivers in Chile: An analysis including age and gender perspectives.

OBJECTIVES: This study explored the relationship between Internet use and informal caregivers' characteristics. METHODS: We used the Chilean Sociodemographic Characterization Survey. A total of 86,172 informal caregivers were identified. We conducted a weighted χ2 to test differences in 10 types of Internet use and weighted logistic regressions with caregivers' characteristics as predictors of Internet use. RESULTS: Younger caregivers engaged in more types of use than the older ones. Education level was positively associated with all types of use, such as searching for information (OR = 3.52, CI 95% [2.34, 5.29]). Age was negatively related to Internet use. Women used the Internet more to communicate via social networks. Being single reduced the likelihood of performing certain types of use, such as information seeking. The number of people living in households has increased entertainment. CONCLUSIONS: Older caregivers with lower education levels are at greater risk of digital exclusion. The same occurred in some types of use with single caregivers, where fewer people lived in the household. CLINICAL IMPLICATIONS: The Internet can be a tool for coping with caregiving tasks and their negative consequences. Interventions should consider these characteristics when promoting online tools and performing online interventions to reach the broadest possible audience.

Nivel de actividad física de una población privada de libertad masculina medida a través del cuestionario IPAQ / Level of physical activity of a male prison population measured with the IPAQ questionnaire

Objetivos: Describir el nivel de actividad física (AF) de una población privada de libertad masculina a través del Cuestionario Internacional de Actividad Física (IPAQ, International Physical Activity Questionnaire), correlacionando años de condena y rango etario. Material y método: Estudio no experimental transversal y de corte descriptivo en el que se recogieron datos de nivel de AF a través de la versión breve del cuestionario IPAQ. La información se analizó a través de datos estadísticos descriptivos, como media y desviación estándar, además se realizó un análisis inferencial, con p ≥0,05. Resultados: se aplica el cuestionario a una muestra de 100 hombres privados de libertad de la ciudad de Talca, en Chile, agrupados, en una primera instancia, por años de condena y, en una segunda instancia, por rango de edad, donde se obtiene que las personas estudiadas presentan, a pesar del contexto de limitación de movimiento por encarcelamiento, un nivel de AF moderada, siendo la caminata la actividad que genera más unidades de medida del índice metabólico (MET) entre la muestra. No existen diferencias significativas entre los grupos de la muestra estudiados. Discusión: Los evaluados presentan un nivel de AF menor en comparación con personas de la misma condición en otros países, si muestran un mejor nivel al compararse con la población chilena no recluida. La caminata, que a diario realizan los privados de libertad en los patios de cada módulo y los espacios compartidos en el interior del penal, se observa como factor protector ante enfermedades crónicas no transmisibles (ECNT). (AU)

Objectives: To describe the level of physical activity of a male prison population measured with the International Physical Activity Questionnaire (IPAQ), correlating years of sentence and age range. Material and method: Non-experimental cross-sectional and descriptive study. The data was collected through the short version IPAQ questionnaire. The data was analyzed through descriptive statistics such as mean and standard deviation, and an inferential analysis was carried out, with a P ≥ 0.05. Results: The questionnaire was applied to a sample of 100 male prisoners from the city of Talca, Chile. They were grouped firstly into years of sentence and then by age range, obtaining a result from the evaluated population that shows moderate level of physical activity despite the context of confinement, in which walking is the activity that generates more MET’s among the sample. There are no significant differences between the evaluated groups. Discussion: The evaluated population shows a lower level of physical activity than a similar group in other countries, although they show better levels of physical activity when they are compared to the Chilean general public. Walking, which prisoners do every day in the modules and shared spaces in prison, is found to be a protective factor against chronic noncommunicable diseases. (AU)

Reasignación vocal: relación entre autopercepción de la voz, parámetros acústicos y función vocal en mujeres trans / Vocal reassignment: Relationship between voice self-perception, acoustic parameters and vocal function in trans women

Objetivo: Determinar aspectos anatómicos, acústicos y socioemocionales de la voz en mujeres trans.Método: Corresponde a una investigación de tipo cuantitativa con diseño observacional, análisis descriptivo de tipo transversal retrospectivo, en el que participan 10 mujeres trans que forman parte del programa de género del HSJD. Resultados: Destaca el inicio tardío del proceso de evaluación médica, terapia hormonal y acompañamiento multidisciplinario durante la transición de género. La mayor parte de las participantes perciben su voz dentro de rangos masculinos o neutros. Según los datos obtenidos en este estudio con relación a los parámetros acústicos, todas las participantes se encuentran dentro de rangos normales en la medida de Jitter, sin embargo, 2 de ellas presentan alteración en Shimmer y NHR. Además, el 70% de las participantes presentan características de disfonía músculo tensional. Conclusión: Se debe mencionar que el acompañamiento fonoaudiológico, la valoración de la voz, el estudio anatómico y la posible intervención quirúrgica por parte del especialista otorrinolaringólogo/a, son un eje fundamental a considerar en el proceso de salud global de las personas trans.(AU)

Objective: To determine anatomical, acoustic and socio-emotional aspects of the voice in trans women. Method: It corresponds to a quantitative investigation with an observational design, descriptive analysis of a retrospective cross-sectional type, in which 10 trans women who are part of the gender program of the HSJD. Results: The late start of the process of medical evaluation, hormonal therapy and multidisciplinary accompaniment during the gender transition stands out. Most of the participants perceived their voice to be within the masculine or neutral ranges. According to the data obtained in this study in relation to the acoustic parameters, all the participants are within normal ranges in the Jitter measurement, however two of them present presentations in Shimmer and NHR. In addition, 70% of the participants presented characteristics of tension muscle dysphonia. Conclusion: It should be mentioned that speech therapy monitoring, voice assessment, anatomical study and possible surgical intervention by the otorhinolaryngologist specialist are a fundamental axis to consider in the global health process of trans people.(AU)

Increased academic stress is associated with decreased plasma BDNF in Chilean college students.

Introduction: Academic stress (AS) is a prevalent challenge faced by university students, potentially affecting molecular indicators such as brain-derived neurotrophic factor (BDNF) and global DNA methylation (G-DNA-M). These indicators could illuminate the physiological ramifications of academic stress. Study Design and Methods: This research followed a quantitative, non-experimental, longitudinal panel design spanning two academic semesters, observing phenomena in their natural context. Students from the Medical Technology program at Universidad de Concepción, Chile were involved, with assessments at the beginning and during heightened academic stress periods. Sample: Of the total participants, 63.0% were females, with an average age of 21.14 years at baseline, and 36.92% were males, averaging 21.36 years. By the study's conclusion, female participants averaged 21.95 years, and males 22.13 years. Results: Significant differences were observed between initial and final assessments for the SISCO-II Inventory of Academic Stress and Beck Depression Inventory-II, notably in stressor scores, and physical, and psychological reactions. Gender differences emerged in the final physical and psychological reactions. No significant changes were detected between the two assessments in plasma BDNF or G-DNA-M values. A refined predictive model showcased that, on average, there was a 3.56% decrease in females' plasma BDNF at the final assessment and a 17.14% decrease in males. In the sample, the G-DNA-M percentage at the final assessment increased by 15.06% from the baseline for females and 18.96% for males. Conclusions: The study underscores the physiological impact of academic stress on university students, evidenced by changes in markers like BDNF and G-DNA-M. These findings offer an in-depth understanding of the intricate mechanisms regulating academic stress responses and highlight the need for interventions tailored to mitigate its physiological and psychological effects.

Abundance and associated factors of Amblyomma tigrinum (Acari: Ixodidae) infesting wild foxes in north-central Chile.

The tick Amblyomma tigrinum inhabits areas with diverse climatic conditions, with adult stages parasitizing wild canids, such as chilla (Lycalopex griseus) and culpeo (Lycalopex culpaeus) foxes. We described the infestation loads in wild foxes captured at three sites (periurban, rural and wild) through an anthropization gradient in north-central Chile. We tested whether local-scale environmental and/or individual host factors can predict tick abundance by using negative binomial models. During 2018-2020 (spring and summer), we captured 116 foxes (44 chillas and 72 culpeos), and 102 of them were infested with ticks (87.9%, CI=80.6-93.2%). We collected 996 A. tigrinum adult ticks, estimating a total mean abundance of 8.6±0.8 ticks/host. Periurban and rural foxes harbored greater tick loads than foxes from the wild site (2.34 and 1.71 greater, respectively) while tick abundance in summer decreased by up to 57% compared to spring. Tempered, more humid climate conditions of the periurban site could favor the development and survival of adults A. tigrinum; and ticks may have adopted a quiescent stage or similar survival mechanisms to cope with summer temperature increases related to the ongoing megadrought. Further studies are warranted to understand the underlying factors determining the life cycle of A. tigrinum at larger spatiotemporal scales.

Sociodemographic, biological, and developmental characteristics of preschool children born full-term and preterm. / Desarrollo, antecedentes biológicos y características sociodemográficas en preescolares con y sin antecedentes de prematuridad.

In Chile, preterm birth is the main cause of infant mortality and morbidity. However, there is little information on the particular characteristics of preterm-born preschool children. OBJECTIVE: To describe the sociodemographic, biological, and developmental characteristics of Chilean preschool children born full-term and preterm. SUBJECTS AND METHOD: A secondary analysis of the databases of the 2010 Longitudinal Survey of Early Childhood (ELPI) was conducted. Children between 2 and 4 years of age with information on gestational age at birth were selected. Late-term infants were excluded. The sample included 8,571 children, of whom 9.78% were preterm newborns. Variables related to sociodemographic characteristics, biological risk factors, and psychomotor development were considered. A descriptive and association analysis (Chi-square) was performed to establish whether the differences between the compared groups were significant. RESULTS: No differences were observed regarding the proportion of sex, geographic area of residence, and health prognosis. Most premature infants reside in urban areas and they have higher biological risk factors. In addition, they have lower average scores than those born at term in all development areas. CONCLUSIONS: The information presented raises the need to analyze the interaction of prematurity with social risk in the development of preterm infants of different gestational ages.

Adherence to the Mediterranean diet and depression, anxiety, and stress symptoms in Chilean university students: a cross-sectional study.

This study aims to determine the association of adherence to the Mediterranean diet and its food groups with depressive symptoms in Chilean university students. The study design was cross-sectional. A total of 934 first-year students at a Chilean public university completed a self-report questionnaire. To assess adherence to Mediterranean diet, an index validated in Chile (Chilean-MDI) was used, and depression, anxiety, and stress symptoms were assessed using the Depression Anxiety and Stress Scale (DASS-21). Logistic regression models were used to analyze the association of adherence to Mediterranean diet and its food groups with depression, anxiety, and stress symptoms adjusted for the main confounders. Students with moderate and high adherence to Mediterranean diet showed lower odds of depression [DASS-21 > 5, odds ratio (OR) = 0.64; 95% confidence interval (95%CI): 0.47-0.88] than those with low adherence to Mediterranean diet. The consumption of 1-2 servings/day of vegetables (OR = 0.63; 95%CI: 0.43-0.92), > 2 servings/week of nuts (OR = 0.41; 95%CI: 0.21-0.80), 1-2 servings/day of fruits (OR = 0.60; 95%CI: 0.42-0.85), 1-2 servings/week of fish and seafood (OR = 0.67; 95%CI: 0.48-0.94), and 1/2-3 units/week of avocado (OR = 0.67; 95%CI: 0.48-0.93) showed low odds of depressive symptoms. The consumption of whole grains and cereals (> 2 servings/day) (OR = 1.63; 95%CI: 1.02-2.61) showed the opposite association. Adherence to Mediterranean diet and consumption of fruits, vegetables, nuts, avocado, fish, and seafood are associated with a lower likelihood of depression in Chilean university students. New policies and educational strategies are recommended to improve diet quality and the mental health of the entire university community.

Evaluation of patients´ perspective on a multimorbidity patient-centered care model piloted in the chilean public health system.

BACKGROUND: The progressive multimorbidity explosion has challenged Chile's health systems and worldwide. The Centro de Innovación en Salud ANCORA UC implemented a new Multimorbidity Patient-Centered Care Model in Chile. OBJECTIVE: Evaluate the perspective of high-risk patients about the core elements of the model. METHODOLOGY: We conducted a cross sectional telephone-based survey that considered the application of a 13 items questionnaire. Of them, nine were Likert scale questions with scores from 1 to 7, one dichotomic question, and three open-ended questions. 231 high-risk patients who received care through the model at primary care centers participated in the study. Quantitative data were encoded, consolidated, and analyzed with the SPSS software. We performed descriptive and analytic statistics techniques to assess different variables and their potential associations. Thematic analysis was conducted for qualitative data. RESULTS: The overall score was 5.84 (range: 1 to 7), with a standard deviation of 1.25. Questions with the best scores were those related with personalized care and the primary care teams. The lowest scored was for the item regarding the continuity of care between primary nurses and inpatient care at the hospital. There was a difference in patient outcomes depending on their health center. Regarding sociodemographic characteristics, age did not significantly affect the results. CONCLUSIONS: The study reveals the perceptions about a complex multimorbidity intervention from the patient's perspective. It complements the impact on health services utilization evaluation that supports decision-makers currently scaling up a similar strategy in our country and could be considered in other countries dealing with non-communicable diseases.

Establishing the health and wellbeing needs of mining host community in Brazil, Chile and Peru: a mixed-method approach to identify priority areas for action to help communities meet their SDG3 targets.

BACKGROUND: The global mining industry is an important partner in advancing the 2030 Agenda for Sustainable Development. In 2018, Anglo American plc published their Sustainable Mining Plan, containing a goal for improving health and wellbeing aligned with the Sustainable Development Goal 3 (SDG3) targets. Having formed an independent multidisciplinary research consortium, we designed and implemented a mixed-methods approach to attain a deeper understanding of SDG3 priorities within the local context of communities hosting Anglo American mining operations located in Latin America. METHODS: In 2019, within the host communities of three mining operations in Chile, three in Brazil, and one in Peru, we conducted a qualitative study which included stakeholder workshops and key informant interviews. We also quantitatively appraised existing health data. Findings emerging from the qualitative and quantitative assessments were compared to identify health and wellbeing priority areas for action relevant to each community. RESULTS: Across the three countries, 120 people took part in workshops and 35 in interviews. In these workshops and interviews, non-communicable diseases (SDG3.4), harmful alcohol consumption (SDG3.5), and pollution, particularly air pollution (SDG3.9), were consistently identified as areas for priority action. There were similarities in the reporting of individual, interpersonal, community, societal, and structural factors underlying these priority areas across the different communities. The availability of quantitative data was generally good at the state level, becoming increasing sparse as we focused on smaller geographies. The priorities identified in the quantitative assessments generally aligned with those highlighted in the qualitative data. CONCLUSIONS: We highlight the importance of engaging with local populations to understand and address health needs. To address the priorities identified, intervention packages tailored to the specific needs of host communities, that tackle associated upstream societal level factors, are required. To facilitate this, appropriate monitoring systems and epidemiological investigations should be implemented to better understand the local context and quantify health issues. In the host communities, it is essential for the mining sector to be a key health partner in promoting integrated programmes that contribute to achieving the priority objectives and targets aligned with the SDG3 agenda.

Social participation in Chile's healthcare system: Reflective contributions from bioethics. / Participación social en el sistema de salud de Chile: aportes reflexivos desde la bioética.

Social participation in health is related to the ability of collectives to intervene in the healthcare system. From a bioethical perspective, the relevance of social participation in health has been emphasized due to its positive effects at the level of social groups, the healthcare structure, and democratic political systems. To ensure social participation in health, bioethics advocates for the incorporation of deliberation as a tool for making binding decisions. The aim of this essay is to reflect on social participation in the history of Chile's healthcare system from a bioethical perspective. The main reflections indicate that participation is consultative in nature, lacking deliberation and, therefore, the distribution of power. Additionally, social participation has been redefined under the label of "citizen," promoting an instrumental, individual, and client-oriented character in healthcare. To subvert this situation, it is necessary to incorporate bioethical reflections into the healthcare structure to enable communities to consistently influence the healthcare system.

La participación social en salud se relaciona con la capacidad de intervención de los colectivos en el sistema sanitario. Desde la bioética, se ha enfatizado en la relevancia de la participación social en salud debido a los efectos positivos a nivel de los grupos sociales, de la estructura sanitaria y de los sistemas políticos democráticos. Para asegurar la participación social en salud, la bioética aboga por la incorporación de la deliberación como herramienta para la toma de decisiones vinculantes. El objetivo del presente ensayo es reflexionar sobre la participación social en la historia del sistema de salud de Chile desde la óptica de la bioética. Las principales reflexiones indican que la participación es de tipo consultiva, sin deliberación y, por tanto, sin distribución de poder. Asimismo, la participación social fue resignificada por la etiqueta de "ciudadana", potenciando el carácter instrumental, individual y clientelar en salud. Para subvertir esta situación, se requiere incluir reflexiones bioéticas en la estructura sanitaria con el propósito que las comunidades puedan incidir de manera consistente en el sistema de salud.

Association of Germline Variation in Driver Genes with Breast Cancer Risk in Chilean Population.

Cancer is a genomic disease, with driver mutations contributing to tumorigenesis. These potentially heritable variants influence risk and underlie familial breast cancer (BC). This study evaluated associations between BC risk and 13 SNPs in driver genes MAP3K1, SF3B1, SMAD4, ARID2, ATR, KMT2C, MAP3K13, NCOR1, and TBX3, in BRCA1/2-negative Chilean families. SNPs were genotyped using TaqMan Assay in 492 cases and 1285 controls. There were no associations between rs75704921:C>T (ARID2); rs2229032:A>C (ATR); rs3735156:C>G (KMT2C); rs2276738:G>C, rs2293906:C>T, rs4075943T:>A, rs13091808:C>T (MAP3K13); rs178831:G>A (NCOR1); or rs3759173:C>A (TBX3) and risk. The MAP3K1 rs832583 A allele (C/A+A/A) showed a protective effect in families with moderate BC history (OR = 0.7 [95% CI 0.5-0.9] p = 0.01). SF3B1 rs16865677-T (G/T+T/T) increased risk in sporadic early-onset BC (OR = 1.4 [95% CI 1.0-2.0] p = 0.01). SMAD4 rs3819122-C (A/C+C/C) increased risk in cases with moderate family history (OR = 2.0 [95% CI 1.3-2.9] p ≤ 0.0001) and sporadic cases diagnosed ≤50 years (OR = 1.6 [95% CI 1.1-2.2] p = 0.006). SMAD4 rs12456284:A>G increased BC risk in G-allele carriers (A/G + G/G) in cases with ≥2 BC/OC cases and early-onset cases (OR = 1.2 [95% CI 1.0-1.6] p = 0.04 and OR = 1.4 [95% CI 1.0-1.9] p = 0.03, respectively). Our study suggests that specific germline variants in driver genes MAP3K1, SF3B1, and SMAD4 contribute to BC risk in Chilean population.

Cardiometabolic risk factors in South American children: A systematic review and meta-analysis.

BACKGROUND: Cardiometabolic risk factors (impaired fasting glucose, abdominal obesity, high blood pressure, dyslipidemia) cluster in children, may predict adult disease burden, and are inadequately characterized in South American children. OBJECTIVES: To quantify the burden of cardiometabolic risk factors in South American children (0-21 years) and identify knowledge gaps. METHODS: We systematically searched PubMed, Google Scholar, and the Latin American and Caribbean Health Sciences Literature via Virtual Health Library from 2000-2021 in any language. Two independent reviewers screened and extracted all data. RESULTS: 179 studies of 2,181 screened were included representing 10 countries (n = 2,975,261). 12.2% of South American children experienced obesity, 21.9% elevated waist circumference, 3.0% elevated fasting glucose, 18.1% high triglycerides, 29.6% low HDL cholesterol, and 8.6% high blood pressure. Cardiometabolic risk factor definitions varied widely. Chile exhibited the highest prevalence of obesity/overweight, low HDL, and impaired fasting glucose. Ecuador exhibited the highest prevalence of elevated blood pressure. Rural setting (vs. urban or mixed) and indigenous origin protected against most cardiometabolic risk factors. CONCLUSIONS: South American children experience high rates of obesity, overweight, and dyslipidemia. International consensus on cardiometabolic risk factor definitions for children will lead to improved diagnosis of cardiometabolic risk factors in this population, and future research should ensure inclusion of unreported countries and increased representation of indigenous populations.

Evaluation of ALBA device for upper extremity motor function in adults with subacute and chronic acquired brain injury: a randomised controlled trial protocol in a tertiary clinic of the metropolitan region of Chile.

INTRODUCTION: Stroke is a significant worldwide cause of death and a prevalent contributor to long-term disability among adults. Survivors commonly encounter a wide array of motor, sensory and cognitive impairments. Rehabilitation interventions, mainly targeting the upper extremities, include a wide array of components, although the evidence indicates that the intensity of practice and task-specific training play crucial roles in facilitating effective results. Assisted therapy with electronic devices designed for the affected upper extremity could be employed to enable partial or total control of this limb, while simultaneously incorporating the aforementioned characteristics in the rehabilitation process. METHODS AND ANALYSIS: 32 adults who had a subacute or chronic stroke, aged over 18 years old, will be included for this randomised controlled trial aiming to determine the non-inferiority effect of the inclusion of a robotic device (ALBA) to regular treatment against only regular rehabilitation. Participants will be assessed before and after 4 weeks of intervention and at 3 months of follow-up. The primary outcome will be the Fugl-Meyer assessment for upper extremities; secondary outcomes will include the questionnaires Functional Independence Measure, Medical Outcomes Study 36-item Short-Form Health Survey as well as the System Usability Scale. ETHICS AND DISSEMINATION: Full ethical approval was obtained for this study from the scientific and ethical review board Servicio de Salud Metropolitano Oriente of Santiago (approval number: SSMOriente030522), and the recommendations of the Chilean law no 20120 of 7 September 2006, concerning scientific research in the human being, its genome and human cloning, will be followed. Ahead of inclusion, potential participants will read and sign a written informed consent form. Future findings will be presented and published in conferences and peer-reviewed journals. TRIAL REGISTRATION NUMBER: International ClinicalTrials.gov Registry (NCT05824416; https://clinicaltrials.gov/ct2/show/NCT05824416?term=uMOV&draw=2&rank=1).

A Spatial-Spectral Classification Method Based on Deep Learning for Controlling Pelagic Fish Landings in Chile.

Fishing has provided mankind with a protein-rich source of food and labor, allowing for the development of an important industry, which has led to the overexploitation of most targeted fish species. The sustainable management of these natural resources requires effective control of fish landings and, therefore, an accurate calculation of fishing quotas. This work proposes a deep learning-based spatial-spectral method to classify five pelagic species of interest for the Chilean fishing industry, including the targeted Engraulis ringens, Merluccius gayi, and Strangomera bentincki and non-targeted Normanichthtys crockeri and Stromateus stellatus fish species. This proof-of-concept method is composed of two channels of a convolutional neural network (CNN) architecture that processes the Red-Green-Blue (RGB) images and the visible and near-infrared (VIS-NIR) reflectance spectra of each species. The classification results of the CNN model achieved over 94% in all performance metrics, outperforming other state-of-the-art techniques. These results support the potential use of the proposed method to automatically monitor fish landings and, therefore, ensure compliance with the established fishing quotas.

[Coercion in psychiatric hospitalizations in Chile: madness and suffering in the 21st century]. / Coerción en las hospitalizaciones psiquiátricas en Chile: El sufrimiento de la locura en el siglo XXI.

This article reflects on the problem of coercion in Chilean psychiatric hospitalizations from the perspective of users who participate in mental health treatment programs in the public healthcare system. Qualitative research from a hermeneutical epistemic approach was carried out between 2019 and 2020, which included 25 interviews with individuals of both sexes (15 men and 10 women) who had a psychiatric diagnosis. The purpose of this research was to analyze their narratives and critically reframe intervention practices implemented in psychiatric hospitalizations in Chile, which constitute an important space for public health in the country as well as the rights of people with mental health problems. One of the principal findings of the study was that coercive practices still persist in Chile, despite being detrimental to the recovery of mental health care users, representing a negative impact on the quality of life and citizen freedoms of individuals with mental health problems.

Este artículo aborda el problema de la coerción en las hospitalizaciones psiquiátricas chilenas desde la perspectiva de personas usuarias que participan en un tratamiento en salud mental en la red pública de atención. Entre 2019 y 2020 se realizó un estudio cualitativo con enfoque epistémico hermenéutico, en el que se entrevistaron 25 personas de ambos sexos (15 hombres y 10 mujeres) con diagnóstico psiquiátrico, con el fin de analizar sus relatos y repensar críticamente las prácticas de intervención que se desarrollan al interior de las hospitalizaciones psiquiátricas en Chile, las cuales se constituyen como un espacio de importancia para la salud pública chilena y los derechos de las personas con problemas de salud mental. Uno de los principales hallazgos es que, en desmedro de la recuperación de las personas usuarias, las prácticas coercitivas siguen manteniéndose en Chile, lo que implica un impacto negativo en la calidad de vida y en la libertad ciudadana de las personas con problemas de salud mental.

Iron, folic acid, and vitamin D supplementation during pregnancy: Did pregnant Chilean women meet the recommendations during the COVID pandemic?

BACKGROUND: Antenatal micronutrient supplementation has been defined as a priority for Low-and Middle-income Countries (LMICs). However, it is also relevant to assess its performance in middle-high income countries, such as Chile, particularly given the post-pandemic food insecurity context. AIM: To assess the use (frequency and doses) of daily recommended supplementation (iron (15-30 mg), folic acid (FA) (400-800 µg/day), and vitamin (VD) (400 IU)) in a sample of Chilean pregnant women. METHODS: In 1, 507 pregnant women selected from public health care registries of the Southeast area of Santiago-Chile, we collected maternal, supplement use, sociodemographic, and nutritional information at the first (<15 weeks), second (24-28 weeks), and third trimesters (32-36 weeks) of gestation by using a researcher administer online questionnaire. RESULTS: The median (IQR) age of women was 29 (25-33) years. Pre-conceptional supplementation was rare (24%), but it reached >93% in the first trimester; thereafter supplement use decreased to 79% in the second and 84% in the third trimesters, particularly in women with lower income (p<0.05), lower education (p<0.05), and with excess weight (p<0.05). Use of iron supplements in the first trimester was rare (<21%) as well as the use of VD supplements across pregnancy (<31%). Most FA (70%) and iron (80%) supplement users, exceeded the recommended daily dose while ~40% of VD users took less than the recommended dose. CONCLUSIONS: In this sample of Chilean women, timely initiation of FA, iron, and VD supplementation was low and doses were not aligned with the recommendations. Strengthening adherence and quality of micronutrient supplementation programs delivered through public primary care could benefit particularly the most vulnerable women.

[Sociodemographic characterization of adolescents who accessed to services related to voluntary termination of pregnancy due to rape. Chile: 2018 - 2020]. / Caracterización sociodemográfica de adolescentes que tuvieron acceso a las prestaciones vinculadas con la interrupción voluntaria del embarazo por violación. Chile: 2018 - 2020.

Ground N°3 of Law 21,030 allows for the termination of a pregnancy due to rape, with the woman's consent, establishing a gestational age limit of 14 weeks for adolescents under 14 years of age and 12 weeks for those over 14 years of age. OBJECTIVE: To describe, between the period 2018-2020, the main sociodemographic and other variables linked to ground N°3 in minors under 14 years, adolescents aged 14 years or older and under 18 years, and women aged 18 years or older. PATIENTS AND METHOD: Cross-sectional, descriptive, and population-based design. National data was obtained from the official registry of the Ministry of Health and through the Transparency Law. Measures of central tendency (median), dispersion (interquartile range), absolute frequencies, and percentages were used. RESULTS: 31.6% of the women with rape-related pregnancies were under 18 years of age. Women under 14 lived mainly in the regions of the country, had a higher gestational age at the time of the ground factor, and 31.2% decided to continue the pregnancy. Adolescents aged 14 or older and under 18, had a higher multidimensional poverty index. Women aged 18 or older were most frequently foreigners, lived mainly in the Metropolitan Region, and decided to terminate the pregnancy. 57.4% of those who reported the rape and 11.1% who failed to establish the ground were under 18. CONCLUSIONS: Sexual violence is a public health problem. Pregnancy due to rape in adolescents is a social reality. There should be permanent evaluation and monitoring of the implementation of Law 21,030, guaranteeing timely, efficient, and nondiscriminatory access to benefits.

Trends in mortality from cardiovascular diseases in Chile, 2000–2020 / Tendencias de la mortalidad por enfermedades cardiovasculares en Chile, 2000-2020 / Tendências de mortalidade por doenças cardiovasculares no Chile, 2000-2020

[ABSTRACT]. Objective. To analyze trends in mortality caused by cardiovascular diseases (CVD) in Chile during the period 2000–2020. Methods. Data on age-adjusted mortality rates (AAMR) from CVD per 100 000 population in Chile for 2000– 2020 were extracted from the World Health Organization Mortality Database. Joinpoint regression was used to analyze the trends and compute the average annual percent change (AAPC) in Chile. In addition, analyses were conducted by sex and type of CVD. Results. Between 2000 and 2020, the AAMR from CVD decreased in Chile from 159.5 to 94.6 per 100 000 population, with a statistically significant decrease in the AAPC of 2.6% (95% CI [–2.8, –2.4]). No joinpoints were identified. The AAMR from CVD decreased annually by 2.6% (95% CI [–2.8, –2.4]) and 2.8% (95% CI [–3.5, –2.6]) in men and women, respectively. The AAMR from ischemic heart disease reduced annually by 3.6% (95% CI [–4.6, –2.7]) with two joinpoints in 2011 and 2015. In the case of stroke, the mortality rate decreased annually by 3.7% (95% CI [–4.5, –3.0]), with two joinpoints in 2008 and 2011. Conclusions. Cardiovascular disease mortality rates have decreased significantly in Chile, in both sexes, especially in women. This decrease could be explained mainly by a significant reduction in the case fatality in recent decades. These results could be a reference for developing primary prevention and acute management of CVD policies focused on populations with higher mortality.

[RESUMEN]. Objetivo. Analizar las tendencias de la mortalidad por enfermedades cardiovasculares (ECV) en Chile durante el período 2000-2020. Métodos. Los datos sobre la tasa de mortalidad ajustada por la edad (TMAE) por ECV por 100 000 habitantes en Chile durante el período 2000-2020 se extrajeron de la base de datos de mortalidad de la Organización Mundial de la Salud. Se utilizó la regresión de tipo joinpoint (punto de cambio) para analizar las tendencias y calcular el cambio porcentual anual promedio (CPAP) en Chile. Además, se realizaron análisis por sexo y por tipo de ECV. Resultados. Entre el 2000 y el 2020, la TMAE por ECV disminuyó en Chile de 159,5 a 94,6 por 100 000 habi- tantes, con una disminución del CPAP estadísticamente significativa del 2,6% (IC del 95% [-2,8 a -2,4]). No se detectó ningún punto de cambio (joinpoint). La TMAE por ECV disminuyó anualmente un 2,6% (IC del 95% [-2,8 a -2,4]) en los hombres y un 2,8% (IC del 95% [-3,5 a -2,6]) en las mujeres. La TMAE por cardiopatía isquémica se redujo anualmente en un 3,6 % (IC del 95 % [-4,6 a -2,7]), encontrándose dos puntos de cambio en el 2011 y el 2015. En el caso de los ataques cerebrovasculares, la tasa de mortalidad disminuyó anual- mente un 3,7% (IC del 95% [-4,5 a -3,0]), encontrándose dos puntos de cambio en el 2008 y el 2011. Conclusiones. La tasa de mortalidad por ECV ha disminuido significativamente en Chile en ambos sexos, pero en especial en las mujeres. Este descenso podría explicarse principalmente por la reducción significa- tiva de la letalidad observada en las últimas décadas. Estos resultados podrían constituir una referencia para la elaboración de políticas de prevención primaria y manejo de casos agudos de ECV que estén centradas en aquellos grupos poblacionales donde la mortalidad es más alta.

[RESUMO]. Objetivo. Analisar as tendências de mortalidade causada por doenças cardiovasculares (DCV) no Chile no período de 2000 a 2020. Métodos. Taxas de mortalidade por DCV ajustadas por idade no Chile referentes ao período de 2000 a 2020 foram extraídas do Banco de Dados de Mortalidade da Organização Mundial da Saúde. Foi usado um modelo de regressão linear segmentada (joinpoint) para analisar tendências e calcular a variação percentual média anual no Chile. Além disso, foram realizadas análises por sexo e tipo de DCV. Resultados. No Chile, entre 2000 e 2020, a taxa de mortalidade por DCV ajustada por idade caiu de 159,5 para 94,6 por 100 mil habitantes, com uma redução estatisticamente significante da variação percentual média anual de 2,6% (IC de 95% [-2,8; -2,4]). Não foram identificados pontos de inflexão. Anualmente, a taxa de mortalidade por DCV ajustada por idade caiu 2,6% (IC 95% [-2,8; -2,4]) e 2,8% (IC 95% [-3,5; -2,6]) entre homens e mulheres, respectivamente. A taxa de mortalidade por doença cardíaca isquêmica ajustada por idade caiu 3,6% (95% CI [-4,6; -2,7]) por ano, com dois pontos de inflexão (em 2011 e 2015). No caso do acidente vascular cerebral, a taxa de mortalidade diminuiu 3,7% (IC de 95% [-4,5; -3,0]) por ano, com dois pontos de inflexão (em 2008 e 2011). Conclusões. As taxas de mortalidade por doenças cardiovasculares diminuíram significativamente no Chile em ambos os sexos, especialmente nas mulheres. Essa queda pode ser explicada principalmente por uma redução significativa na letalidade observada nas últimas décadas. Esses resultados podem ser uma referên- cia para o desenvolvimento de políticas de prevenção primária e manejo de casos agudos de DCV voltadas para populações com maiores taxas de mortalidade.