Ethics in Mental Health Research with Haitian Migrants: Lessons from a Community-Based Study in Santiago, Chile.

Migration research poses several unique challenges and opportunities. Conducting ethical global health practice, especially when studying migrant mental health, is of particular concern. This article explores seven challenges and lessons learned in our mixed-methods study conducted to assess the impact of the migration experience on Haitian migrants' mental health in Santiago, Chile. The primary challenges were recruiting in a highly mobile population, building trust and community participation, overcoming language barriers, safety considerations during the Covid-19 pandemic, mitigating potential negative impacts of research on the community, providing psychological support, and finding meaningful ways to benefit the community. We propose moving toward a better and more ethical migrant research practice by ensuring language accessibility, hiring community members for the study team, working with local institutions and nongovernmental organizations, and maintaining sustainable connections.

The Impact of Long COVID on Cognitive Performance and Sleep Quality: An Analysis of the Rancagua Chilean Study (RACHIS).

Background Infection with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can lead to prolonged symptoms post-recovery, commonly known as long-term coronavirus disease 2019 (COVID-19) or "long COVID." Neuropsychiatric consequences of long COVID include cognitive dysfunction and sleep disturbances, which significantly impair daily living. This study aimed to explore the impact of long COVID on cognitive performance and sleep quality in patients receiving outpatient care. Material and methods This study involved a random sample of 138 of 363 patients, corresponding to 38% of the cohort, who tested positive for SARS-CoV-2 via polymerase chain reaction (PCR) between May 2020 and April 2021. These unvaccinated, non-hospitalized individuals, predominantly exhibiting mild disease symptoms, were prospectively assessed 11 months post-positive PCR test. After informed consent, demographic data, memory, and concentration impairment levels were collected through interviews. Participants reporting cognitive symptoms underwent the Mini-Mental State Examination (MMSE), the Montreal Cognitive Assessment (MOCA), and the Pittsburgh Sleep Quality Index. Statistical analyses were conducted, including Student's t-test, Chi-square, Fisher's test, Kruskal-Wallis test, and Pearson correlation coefficient, with a significance threshold set at p<0.05. Results Of the 138 participants, 76 (55.1%) were female and 62 (44.9%) were male. The mean age was 45.9 years (± 13.0), with an average educational attainment of 10.4 years (± 3.7). Roughly 50% of the patients reported significant memory and concentration issues (p<0.001). Thirty-three participants underwent detailed cognitive assessments, revealing a 2:1 female-to-male ratio and a significantly higher prevalence of depression in female participants. Cognitive deficits were diagnosed in five (15.2%) participants via the MMSE and in 26 (78.8%) via the MOCA test, with notable deficits in visuospatial/executive functions, language repeat, and deferred recall (p<0.001). A lower educational level was correlated with higher cognitive deficits (p=0.03). Conclusion The study findings reveal that cognitive impairments, as a consequence of COVID-19, can persist up to 11 months post-infection. The MOCA test proved more effective in diagnosing these deficits and requires adjustments based on educational background. Sleep parameters remained largely unaffected in this cohort, likely attributed to the mild nature of the initial symptoms and the outpatient management of the disease.

Marine litter pollution in a subantarctic beach of the Strait of Magellan, Punta Arenas, Chile.

This study assessed the presence of marine litter along the beach of the city of Punta Arenas, Chile. The sampling period coincided with the COVID-19 pandemic. A total of 239 plastic waste items were identified out of a total of 638 litter items. The Clean Coast Index reported within this study ranged from Clean (CCI 2-5) to Extremely dirty (CCI >20), especially near the port. The majority of litter items has been classified as originating from varied origins, as it is not possible to pinpoint a precise origin in most items. The results indicate that the predominant plastic litter in Punta Arenas is PVC. The results are discussed in relation to the sources and composition of the residues, the morpho dynamics of the coast, and the CCI is compared with other locations around the globe.

Feasibility of a capacity building organizational intervention for worker safety and well-being in the transportation industry: Pivoting to address the COVID-19 pandemic and social and political unrest in Chile.

OBJECTIVE: This study developed, implemented, and evaluated the feasibility of executing an organizational capacity building intervention to improve bus driver safety and well-being in a Chilean transportation company. METHOD: Through an implementation science lens and using a pre-experimental mixed methods study design, we assessed the feasibility of implementing a participatory organizational intervention designed to build organizational capacity. RESULT: We identified contextual factors that influenced the intervention mechanisms and intervention implementation and describe how the company adapted the approach for unexpected external factors during the COVID-19 pandemic and social and political unrest experienced in Chile. CONCLUSIONS: The intervention enabled the organization to create an agile organizational infrastructure that provided the organization's leadership with new ways to be nimbler and more responsive to workers' safety and well-being needs and was robust in responding to strong external forces that were undermining worker safety and well-being.

Transdisciplinary research before, during and after COVID-19 vaccination in Chile: a virtuoso collaboration with future perspectives.

The COVID-19 pandemic presented numerous challenges that required immediate attention to mitigate its devastating consequences on a local and global scale. In March 2020, the Chilean government, along with health and science authorities, implemented a strategy aimed at generating relevant evidence to inform effective public health decisions. One of the key strengths of this strategy was the active involvement of the scientific community, employing transdisciplinary approaches to address critical questions and support political decision-making. The strategy promoted collaborations between the government, public and private institutions, and transdisciplinary academic groups throughout each phase of the pandemic. By focusing on pressing problems and questions, this approach formed the foundation of this report which reflects the collaborative effort throughout the pandemic of individuals from the Instituto de Sistemas Complejos de Ingeniería (ISCI), the Faculty of Medicine of the University of Chile, government authorities and industry. Early in the pandemic, it became crucial to gather evidence on how to minimize the impact of infection and disease while awaiting the availability of vaccines. This included studying the dynamics of SARS-CoV-2 infection in children, assessing the impact of quarantines on people's mobility, implementing strategies for widespread SARS-CoV-2 polymerase chain reaction (PCR) testing, and exploring pool testing for large populations. The urgent need to reduce disease severity and transmission posed a significant challenge, as it was essential to prevent overwhelming healthcare systems. Studies were conducted to predict ICU bed requirements at the local level using mathematical models. Additionally, novel approaches, such as using cellphone mobility-based technology to actively identify infected individuals, and to optimize population sampling, were explored following the first wave of the pandemic. Chile took early action in addressing vaccination through a high-level scientific board, before vaccines became available. Studies conducted during this period included population-based immunologic evaluations of different vaccines, which helped build confidence in the population and supported the need for booster doses and potential vaccination of children. These studies and collaborations, which will be discussed here, have provided valuable insights and will inform future approaches in a post-pandemic world. Importantly, highly conservative estimates indicate that 3,000 lives and more than 300 million USD were saved by this academic-public-private collaborative effort.

The impact of COVID-19 on deaths from dementia and Alzheimer's disease in Chile: an analysis of panel data for 16 regions, 2017-2022.

Background: Although several studies have documented the detrimental impacts of global COVID-19 containment measures on individuals with Alzheimer's disease and dementia, a comprehensive analysis of mortality rates for these conditions within the Chilean population is notably lacking. This study aimed to analyze the impact of COVID-19 on mortality rates among individuals with dementia and Alzheimer's disease in Chile. Methods: A retrospective longitudinal cross-sectional study was conducted, considering mortality data for specific mental health conditions during the pre-pandemic and pandemic contexts of COVID-19 in Chile. Quantile regression techniques were employed to analyze the existence of differences between the two periods, while non-observable heterogeneity models for panel data methods were used to evaluate the effect of COVID-19 mortality on crude mortality rates. Findings: Statistically significant differences were observed in the number of deaths from dementia and Alzheimer's disease between the pre-pandemic and COVID-19 pandemic periods. Specifically, crude mortality rates decreased by 10% (-0.10 [95% CI: -0.16, -0.05]) during the pandemic period. Furthermore, the number of deaths from COVID-19 during the pandemic period has a very weak incidence of deaths from mental health conditions such as dementia and Alzheimer's. Specifically, a unit percentage increase in confirmed cases from COVID-19 would result in a 7% (-0.07 [95% CI: -0.13, -0.001]) decrease in the number of deaths from dementia and Alzheimer's. These findings are supported by the application of panel regression with one-way random effects models. Interpretation: The study findings indicate a reduction in mortality rates attributed to dementia and Alzheimer's disease during the COVID-19 pandemic in Chile. This decline could be attributed to the potential underreporting of mental illness as the cause of death during the pandemic period. Several studies have highlighted that approximately 30% of death certificates fail to document the presence of a dementia syndrome. Moreover, the cause of death recorded for individuals with mental health conditions may be influenced by the physician's familiarity with the patient or reflect the prevailing approach to managing end-stage dementia patients. Funding: This work received no funding.

A retrospective study suggests 55 days of persistence of SARS-CoV-2 during the first wave of the pandemic in Santiago de Chile.

Background: As the COVID-19 pandemic persists, infections continue to surge globally. Presently, the most effective strategies to curb the disease and prevent outbreaks involve fostering immunity, promptly identifying positive cases, and ensuring their timely isolation. Notably, there are instances where the SARS-CoV-2 virus remains infectious even after patients have completed their quarantine. Objective: Understanding viral persistence post-quarantine is crucial as it could account for localized infection outbreaks. Therefore, studying and documenting such instances is vital for shaping future public health policies. Design: This study delves into a unique case of SARS-CoV-2 persistence in a 60-year-old female healthcare worker with a medical history of hypertension and hypothyroidism. The research spans 55 days, marking the duration between her initial and subsequent diagnosis during Chile's first COVID-19 wave, with the analysis conducted using RT-qPCR. Results: Genomic sequencing-based phylogenetic analysis revealed that the SARS-CoV-2 detected in both Nasopharyngeal swab samples (NPSs) was consistent with the 20B clade of the Nextstrain classification, even after a 55-day interval. Conclusion: This research underscores the need for heightened vigilance concerning cases of viral persistence. Such instances, albeit rare, might be pivotal in understanding sporadic infection outbreaks that occur post-quarantine.

Changes in Televisit Modalities Due to the COVID Pandemic in Chile: A Comparison of Patient Satisfaction.

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has impacted healthcare guidelines and modalities of patient consultation worldwide. The frequent cycles of quarantine confinement in Chile have caused mobility restrictions for patients and physicians, forcing the Hospital Las Higueras de Talcahuano (HHT) to replace the assisted televisit modality with a more classic televisit program. Here we have described if this change in televisit modality and type of outpatient may have impacted patients' satisfaction. METHODS: The patient's perception of satisfaction was evaluated through self-administered survey questionnaires previously validated in Spanish. Cohorts were grouped according to the following two relational models: (i) assisted televisit, 503 neurology patients from 2018 to 2019, and (ii) televisit, 831 patients from different specialties treated during 2020. Perception of satisfaction was compared by gender, age, and type of televisit, and internal consistency (Cronbach alpha) and reliability (factorial analysis of principal components) were assessed. Finally, we compared the patient satisfaction of both modalities. RESULTS: Questionnaires showed excellent internal consistency; all items showed point biserial correlations greater than 0.30. Assisted televisit and televisit cohorts comprised 64.2% and 67.6% females, respectively, and patients under the age of 65 years were 62.2% and 75%, respectively. Assisted televisit patients showed very high 94.4% (n=475) and high 5.2% (n=26) satisfaction levels, while televisit patients showed very high 22.3% (n=185), high 63.9% (n=531), and moderate 13.1% (n=109) satisfaction levels; this difference was statistically significant at p<0.001. CONCLUSION: Lower perception of satisfaction due to the change in televisit relational modality underscores the importance of primary care professionals who support the specialist in the assisted televisit model. However, the televisit modality showed high patient satisfaction and suggested that this modality can be a plausible alternative according to each location's reality. The results of this study indicate that both assisted televisit and televisit contribute to delivering an integrative solution that helps to alleviate the system's fragmentation.

Emergency preparedness and response sensitive of migrant populations in Chile: post-pandemic perspectives. / Preparación y respuesta ante emergencias sensibles a poblaciones migrantes en Chile: perspectivas postpandémicas.

On August 31, 2023, the Chilean government ended the health alert for COVID-19. This milestone invites us to reflect on lessons learned in emergency preparedness and response regarding migrant populations in the country. In this context, three perspectives are presented. The first focuses on avoiding pointing to individual responsibility for non-compliance with prevention measures, as this approach ignores structural and historical inequities. Emergency recommendations should be constructed considering a collective approach and diverse sociocultural and political contexts. The second perspective calls for considering and addressing migration as a social determinant of health. During the pandemic, changes in the governance of migration around the world made migration processes more precarious, with risks to the physical and mental health of migrants, which needs better planning and evidence-based decision-making in future pandemics. The third perspective focuses on promoting intercultural health, as effective communication of contagion risks and preventive measures were hampered among migrant populations with diverse worldviews and interpretations of health and disease processes. Responding to the needs of historically marginalized communities requires establishing ways of life that respect diversity in narratives and everyday practices. Governments and health systems must incorporate migration into their emergency preparedness and response strategies, creating the conditions for optimal compliance.

El 31 de agosto de 2023, el Gobierno de Chile puso fin a la alerta sanitaria por COVID-19. Este hito invita a reflexionar sobre lecciones aprendidas respecto a la preparación y respuesta ante emergencias, que sean sensibles e informadas sobre la experiencia de la población migrante de nuestro país. En este marco, se presentan tres perspectivas. La primera se centra en evitar la responsabilización individual en el incumplimiento de las medidas de prevención del contagio, ya que este enfoque ignora las inequidades estructurales e históricas. Las recomendaciones de emergencia se deben construir bajo un abordaje colectivo y con la consideración de los diversos contextos socioculturales y políticos. La segunda perspectiva llama a tomar en cuenta y abordar la migración como determinante social de la salud de la población en la preparación y respuesta ante emergencias. Durante la pandemia, los cambios en la gobernanza de la migración en todo el mundo precarizaron los procesos migratorios, con riesgos para la salud física y mental de las personas que migran. Esto requiere una mejor planificación y decisiones informadas en evidencia científica para futuras pandemias. La tercera perspectiva se enfoca en promover la interculturalidad, dado que la comunicación de los riesgos de contagio y de las medidas preventivas se vio dificultada entre poblaciones migrantes con diversas cosmovisiones e interpretaciones de los procesos de salud y enfermedad. Asimismo, el responder a las necesidades de aquellas comunidades históricamente marginadas, requiere establecer modos de vida que respeten la diversidad en las narrativas y las prácticas cotidianas. Los gobiernos y sistemas sanitarios deben incorporar la migración a sus estrategias de preparación y respuesta ante emergencias, con la construcción de las condiciones para su cumplimiento óptimo.

Surveillance of the recurrence time of the effectiveness of national and region-level quarantines of COVID-19 pandemic in Chile.

The World Health Organization has recommended a range of social and health measures to mitigate the spread of coronavirus disease 2019 (COVID-19), including strategies such as quarantines, border closures, social distancing, and mask usage, among others. Specifically, the Chilean authorities implemented the "step-by-step" plan, built on the concept of dynamic quarantine. Numerous studies have examined the effectiveness of these quarantines in Chile during the pandemic, utilizing data published by the Chilean Ministry of Health. This study's primary aim was to enhance our understanding of quarantine effectiveness in Chile during the pandemic. We accomplished this by analyzing the distributional behavior of the time until the COVID-19 pandemic was deemed under control or not. In our study, we defined an event with two potential outcomes related to the instantaneous reproductive number (Rt), which signifies the time until a change in the event outcome occurs. Importantly, we did not predefine a specific temporal observation unit. These findings allowed us to complement the concept of effective quarantine by considering the dynamics generated by the protocols, such as phase 1 of the quarantine, in achieving natural herd immunity in response to the number of COVID-19 cases and Rt. We assessed the behavior of the mean and median residual lifetime until the initiation of controlled/uncontrolled episodes of the COVID-19 pandemic based on Rt in all regions of Chile. Despite variations in the distribution of residual times for controlled/uncontrolled episodes in different regions, there was a similar observation during the period considered (between March 2020 and March 2021): the mitigation measures did not produce a clear positive effect for controlling the epidemic. The residual times of episodes with Rr,t > 1 were not different from those episodes with Rr,t ≤ 1.

Impact of the Pandemic Time on the Mental Health of People with Dementia and Their Family Caregivers in Brazil and Chile: One-Year Follow-Up.

Background: Previous studies reported the negative impact of social isolation on mental health in people with dementia (PwD) and their caregivers, butlongitudinal studies seem scarcer. Objective: To describe a one-year follow-up impact of the COVID-19 pandemic on PwD and their caregivers in both Brazil and Chile. Methods: This study analyzed the impact of the pandemic on the psychological and physical health of PwD and their family caregivers after one year of follow-up in three outpatient clinics in Brazil (n = 68) and Chile (n = 61). Results: In both countries, PwD reduced their functional capacity after one year of follow-up (p = 0.017 and p = 0.009; respectively) and caregivers reported worse physical and mental health (p = 0.028 and p = 0.039). Only in Chile, caregivers reported more sadness associated with care (p = 0.001), and reduced time sleeping (p = 0.07). Conclusions: In conclusion, the COVID-19 pandemic appears to have had a long-lasting impact on PwD and their caregivers. However, it is essential to acknowledge that the inherent progression of dementia itself may also influence changes observed over a year.

Calidad de vida de las personas con enfermedad de Parkinson durante el confinamiento por la pandemia por covid-19 / Quality of life of people with Parkinson's disease during confinement due to the covid-19 pandemic

Introducción: El estudio tuvo como objetivo explorar la calidad de vida de las personas con enfermedad de Parkinson durante el confinamiento por la pandemia de coronavirus de 2019 (covid-19). Material y métodos: El estudio fue de carácter cuantitativo, descriptivo y correlacional. La muestra fue de 51 personas con enfermedad de Parkinson de la región de Magallanes y Antártica Chilena, y cuya información fue recogida desde la base de datos de la Corporación de Rehabilitación Club de Leones Cruz del Sur, a la cual pertenecen. Resultados: Los principales resultados muestran que el 51,6% de las personas manifiestan una calidad de vida «buena y muy buena» y que los principales dominios del Parkinson's Disease Questionnaire (PDQ-39) afectados son: malestar corporal, movilidad y bienestar emocional. Según el análisis de los rangos cualitativos del PDQ-39, las dimensiones que se mostraron más comprometidas durante el confinamiento por la pandemia por covid-19 fueron: comunicación, estigma y bienestar emocional. Además, las mujeres presentaron peor calidad de vida que los hombres. Por último, se demostró que la progresión de síntomas afecta la calidad de vida de las personas con enfermedad de Parkinson. Conclusiones: Durante el confinamiento por la pandemia por covid-19 las personas con enfermedad de Parkinson aumentaron los síntomas y presentaron una menor calidad de vida, sobre todo las de sexo femenino.(AU)

Introduction: The study was aimed to explore the quality of life of people with Parkinson's disease during confinement due to the coronavirus infectious disease 2019 (covid-19) pandemic. Material and methods: The study was quantitative, descriptive and correlational. The sample was 51 people with Parkinson's disease, from the region of Magallanes and Chilean Antarctica, and whose information was collected from the database of the Rehabilitation Corporation Club de Leones Cruz del Sur, to which they belong. Results: The main results show that 51.6% of people with Parkinson's disease report a «good and very good» quality of life and that the main domains of the Parkinson's Disease Questionnaire (PDQ-39) affected are: body discomfort, mobility and emotional well-being. According to the analysis of the qualitative ranges of the PDQ-39, the dimensions that were most compromised during the confinement by the covid-19 pandemic were: communication, stigma and emotional well-being. In addition, women had a poorer quality of life than men. Finally, it was shown that the progression of symptoms affects the quality of life of people with Parkinson's disease. Conclusions: In conclusion, during the confinement due to the covid-19 pandemic people with Parkinson's disease increased symptoms and presented a lower quality of life, especially women.(AU)

The challenges of mental health in Chilean university students.

Mental health is a crucial issue in Chile and worldwide, gaining even more relevance following social events in Chile in 2019, including the sociopolitical crisis and the COVID-19 pandemic. In Chile, over 20% of adolescents experience mental health problems such as anxiety, depression, and stress, with many going untreated due to limited access or the stigma associated with these issues. The COVID-19 pandemic has exacerbated this situation, with a 25% increase in the prevalence of anxiety and depression. The university population is particularly vulnerable to mental health challenges due to the unique pressures of the academic environment, including increased academic demands and the acquisition of university-related behaviors that can negatively impact physical and mental health, with notable gender differences. Effectively addressing these issues is essential for ensuring the emotional and psychological well-being of university students. Specific policies and programs are needed to address the mental health needs of university adolescents and ensure that they have access to mental health services required to navigate the challenges of daily life. A methodology reflective of the essayistic approach guides this exploration, which is characterized by critical reflection and structured argumentation.

Impact of the COVID-19 pandemic on training and technology use among Chilean amateur athletes.

Introduction: The COVID-19 pandemic was a health problem which affected the entire world. Sports were strongly affected, especially outdoors. The purpose of this study was to evaluate the impact of COVID-19 pandemic on training and technology use among Chilean amateur athletes. Method: An observational descriptive cross-sectional study, carried out during the 2021-2. Nonprobabilistic convenience sample of people over 18 years. Data were obtained via online survey and analyzed with Stata 16.0 statistical program for runners, triathletes, cyclists. Results: The sample was 179 athletes, average age was 42.5 years ±10.2; males were 58.6%. 22.65% of the sample were triathletes, 58% runners, and 18.2% cyclists. Training habits were measured during Pre-Pandemic (PP), Pandemic With Quarantine (PWQ), and Pandemic Without Quarantine (PWOQ). In total sample, a decrease was observed in variables of average training frequency of 1.28 sessions per week (p = 0.001; d = 0.648); weekly average training time of 189.63 min (p = 0.005; d = 0.293); days per week with high and medium intensity training of 0.95 (p = 0.001; d = 0.833) and 0.37 (p = 0.001; d = 0.327) respectively; and days per week with cardio training of 1.01 (p = 0.001; d = 0.678), comparing the PP and PWQ periods. When comparing PWQ and PWOQ, an increase was observed in the same variables mentioned above of 1,57 sessions per week (p = 0.001; d = 0.513); 162.68 min per week (p = 0.020; d = -0.245); days per week with high of 0.82 (p = 0.001; d = -0.714) and medium intensity training of 0.46 (p = 0.001; d = -0.412); days per week with cardio training of 1.14 (p = 0.001; d = -0.730); and included strength training of 0.42 (p = 0.012; d = -0.312). For technology incorporation, over 78% (p = 0.023) claimed to used devices to measure training, with the watch being the preferred device in over 72% (p = 0.002) during the three timeframes. Highlighted the rise in use of training software during and after the lockdown period of more than 23% (p < 0.001). Discussion: All variables related with training habits decreased comparing PP and PWQ and all variables rose between PWQ and PWOQ; however, comparing PP and PWOQ, there are small differences, which do not always favor the PWOQ, reflecting how athletes have not yet been able to recover their training rhythms. Finally, we should note that the use of technology increased, in all periods.

Impacto de la edad, las comorbilidades y las complicaciones en pacientes con COVID-19 con síndrome de dificultad respiratoria aguda en la ventilación mecánica invasiva. Estudio multicéntrico observacional / Impact of Age, Comorbidities and Complications in COVID-19 Patients with Acute Respiratory Distress Syndrome on Invasive Mechanical Ventilation. An Observational Multicenter Study

Objetivos: Millones de pacientes con COVID-19 fueron internados en terapia intensiva en el mundo, la mitad desarrollaron síndrome de dificultad respiratoria aguda (SDRA) y recibieron ventilación mecánica invasiva (VMI), con una mortalidad del 50%. Analiza-mos cómo edad, comorbilidades y complicaciones, en pacientes con COVID-19 y SDRA que recibieron VMI, se asociaron con el riesgo de morir durante su hospitalización.Métodos: Estudio de cohorte observacional, retrospectivo y multicéntrico realizado en 5 hospitales (tres privados y dos públicos universitarios) de Argentina y Chile, durante el segundo semestre de 2020.Se incluyeron pacientes >18 años con infección por SARS-CoV-2 confirmada RT-PCR, que desarrollaron SDRA y fueron asistidos con VMI durante >48 horas, durante el se-gundo semestre de 2020. Se analizaron los antecedentes, las comorbilidades más fre-cuentes (obesidad, diabetes e hipertensión), y las complicaciones shock, insuficiencia renal aguda (IRA) y neumonía asociada a la ventilación mecánica (NAV), por un lado, y las alteraciones de parámetros clínicos y de laboratorio registrados.Resultados: El 69% era varón. La incidencia de comorbilidades difirió para los diferentes grupos de edad. La mortalidad aumentó significativamente con la edad (p<0,00001). Las comorbilidades, hipertensión y diabetes, y las complicaciones de IRA y shock se asociaron significativamente con la mortalidad. En el análisis multivariado, sólo la edad mayor de 60 años, la IRA y el shock permanecieron asociados con la mortalidad. Conclusiones: El SDRA en COVID-19 es más común entre los mayores. Solo la edad >60 años, el shock y la IRA se asociaron a la mortalidad en el análisis multivariado.

Objectives: Millions of patients with COVID-19 were admitted to intensive care world-wide, half developed acute respiratory distress syndrome (ARDS) and received invasive mechanical ventilation (IMV), with a mortality of 50%. We analyzed how age, comor-bidities and complications in patients with COVID-19 and ARDS who received IMV were associated with the risk of dying during their hospitalization.Methods: Observational, retrospective and multicenter cohort study carried out in 5 hospitals (three private and two public university hospitals) in Argentina and Chile, during the second half of 2020.Patients >18 years of age with SARS-CoV-2 infection confirmed by RT-PCR, who devel-oped ARDS and were assisted with IMV for >48 hours, during the second half of 2020, were included. History, the most frequent comorbidities (obesity, diabetes and hyper-tension) and the complications of shock, acute renal failure (AKI) and pneumonia as-sociated with mechanical ventilation (VAP), on the one hand, and the alterations of re-corded clinical and laboratory parameters, were analyzed.Results: 69% were men. The incidence of comorbidities differed for different age groups. Mortality increased significantly with age (p<0.00001). Comorbidities, hyper-tension and diabetes, and complications of ARF and shock were significantly associat-ed with mortality. In the multivariate analysis, only age over 60 years, ARF and shock remained associated with mortality.Conclusions: ARDS in COVID-19 is more common among the elderly. Only age >60 years, shock and ARF were associated with mortality in the multivariate analysis

Preparación y respuesta ante emergencias sensibles a poblaciones migrantes en Chile: perspectivas postpandémicas / Emergency preparedness and response sensitive of migrant populations in Chile: post-pandemic perspectives

El 31 de agosto de 2023, el Gobierno de Chile puso fin a la alerta sanitaria por COVID-19. Este hito invita a reflexionar sobre lecciones aprendidas respecto a la preparación y respuesta ante emergencias, que sean sensibles e informadas sobre la experiencia de la población migrante de nuestro país. En este marco, se presentan tres perspectivas. La primera se centra en evitar la responsabilización individual en el incumplimiento de las medidas de prevención del contagio, ya que este enfoque ignora las inequidades estructurales e históricas. Las recomendaciones de emergencia se deben construir bajo un abordaje colectivo y con la consideración de los diversos contextos socioculturales y políticos. La segunda perspectiva llama a tomar en cuenta y abordar la migración como determinante social de la salud de la población en la preparación y respuesta ante emergencias. Durante la pandemia, los cambios en la gobernanza de la migración en todo el mundo precarizaron los procesos migratorios, con riesgos para la salud física y mental de las personas que migran. Esto requiere una mejor planificación y decisiones informadas en evidencia científica para futuras pandemias. La tercera perspectiva se enfoca en promover la interculturalidad, dado que la comunicación de los riesgos de contagio y de las medidas preventivas se vio dificultada entre poblaciones migrantes con diversas cosmovisiones e interpretaciones de los procesos de salud y enfermedad. Asimismo, el responder a las necesidades de aquellas comunidades históricamente marginadas, requiere establecer modos de vida que respeten la diversidad en las narrativas y las prácticas cotidianas. Los gobiernos y sistemas sanitarios deben incorporar la migración a sus estrategias de preparación y respuesta ante emergencias, con la construcción de las condiciones para su cumplimiento óptimo.

On August 31, 2023, the Chilean government ended the health alert for COVID-19. This milestone invites us to reflect on lessons learned in emergency preparedness and response regarding migrant populations in the country. In this context, three perspectives are presented. The first focuses on avoiding pointing to individual responsibility for non-compliance with prevention measures, as this approach ignores structural and historical inequities. Emergency recommendations should be constructed considering a collective approach and diverse sociocultural and political contexts. The second perspective calls for considering and addressing migration as a social determinant of health. During the pandemic, changes in the governance of migration around the world made migration processes more precarious, with risks to the physical and mental health of migrants, which needs better planning and evidence-based decision-making in future pandemics. The third perspective focuses on promoting intercultural health, as effective communication of contagion risks and preventive measures were hampered among migrant populations with diverse worldviews and interpretations of health and disease processes. Responding to the needs of historically marginalized communities requires establishing ways of life that respect diversity in narratives and everyday practices. Governments and health systems must incorporate migration into their emergency preparedness and response strategies, creating the conditions for optimal compliance.

Acompañar una doble hospitalización en pandemia: la experiencia de padres con bebés hospitalizados mientras las madres se encuentran hospitalizadas por COVID-19 / Supporting a double hospitalization during the pandemic: The experience of fathers whose infants were hospitalized while their mothers were also hospitalized due to COVID-19

Introducción. La hospitalización de un hijo en la unidad de pacientes críticos neonatal puede ser altamente estresante para padres y madres, lo cual se intensificó en el contexto de la pandemia por COVID-19. A la fecha, no se han encontrado estudios que describan la experiencia de padres que vivieron la doble hospitalización simultánea de su pareja y de su hijo/a al nacer, durante la pandemia por COVID-19. Objetivos. Explorar la vivencia de los padres de tener a sus hijos/as hospitalizados en Neonatología mientras su pareja se encontraba hospitalizada por agravamiento de COVID-19. Población y método. Cuatro entrevistas semiestructuradas fueron realizadas y analizadas mediante un análisis interpretativo fenomenológico. Resultados. Se identificaron cuatro momentos cuando surgieron emociones específicas: a) inicio del contagio, b) hospitalización de la pareja, c) nacimiento del bebé y d) hospitalización del bebé. Culpa, miedo, angustia de muerte, soledad e incertidumbre aparecen muy tempranamente y luego se combinan con emociones como felicidad y empoderamiento, entre otras. La falta de contacto físico con sus parejas e hijos, y las fallas en la comunicación con los equipos de salud se destacan como factores que obstaculizan el ejercicio del rol paternal, mientras que una comunicación fluida con el equipo y una participación activa en los cuidados del bebé son factores protectores. Los padres cumplen una multiplicidad de roles, en la que prima el rol protector. Conclusiones. La comunicación y la atención centrada en la familia, y la participación activa en los cuidados de los bebés tienen el potencial de proteger contra el impacto de esta experiencia compleja de doble hospitalización.

Introduction. The hospitalization of a baby in the neonatal intensive care unit may be highly stressful for both mothers and fathers, and this was even more intense in the context of the COVID-19 pandemic.To date, no studies have been found that describe the experience of fathers who underwent the simultaneous hospitalization of their partner and newborn infant during the COVID-19 pandemic. Objectives. To explore the experience of fathers who had their babies hospitalized in the Neonatal Unit while their partner were hospitalized due to worsening of COVID-19. Population and method. Four semi-structured interviews were conducted and analyzed using an interpretative phenomenological analysis. Results. Four moments were identified when specific emotions arose: a) onset of infection, b) partner hospitalization, c) baby birth, and d) baby hospitalization. Guilt, fear, death anxiety, loneliness, and uncertainty appear very early and are later combined with emotions such as happiness and empowerment, among others. The lack of physical contact with their partners and babies and failures in communication with the health care team stand out as factors that hinder the exercise of the paternal role, while an effective communication with the health care team and active participation in the baby's care are protective factors. Fathers fulfill multiple roles, the most important of which is their role as protectors. Conclusions. Family-centered communication and care and active involvement in baby care may potentially protect against the impact of this complex experience of double hospitalization.

Cultural adaptation and psychometric properties of the online learning climate scale for Chilean university students.

Introduction: The COVID-19 pandemic has profoundly changed university teaching and learning formats, leading to a significant increase in online learning. Consequently, the crisis has facilitated the potential development of this educational modality. However, researchers need adapted and validated instruments to assess the online learning climate in universities. Aim: This study aimed to adapt and psychometrically validate the Online Learning Climate Scale (OLCS) for Chilean university students. Method: Quantitative research was conducted with a non-experimental and cross-sectional, design executed in two phases: the first was oriented to the cultural adaptation of the instrument, and the second was focused on analyzing its psychometric properties in a sample of 491 university students. Results: A translated and culturally adapted version was obtained, composed of 15 items distributed in a factorial structure composed of four dimensions that showed excellent adjustment to the data [χ2 (84) = 189.628; p < 0.001; CFI = 0.979; TLI = 0.973; RMSEA = 0.051 (IC90% 0.044-0.059); SRMR = 0.028]; internal consistency was estimated through Cronbach's alpha and ranged between 0.892 and 0.955, and strict invariance between men and women was achieved. Discussion: The Online Learning Climate Scale (OLCS) is a valid and reliable measure for measuring the online learning climate within the Chilean higher education context so that it can be used both in research and in monitoring management programs in educational environments.

Resiliencia en estudiantes universitarios de ciencias de la salud chilenos en el contexto de la telesimulación / Resilience in Chilean university health science students in the context of telesimulation

Introducción: El presente trabajo tuvo como propósito conocer el nivel de resiliencia en contexto pandémico en una muestra de estudiantes de pregrado de ciencias de la salud y cómo ésta se comporta en escenarios de telesimulación. Sujetos y métodos: El estudio tuvo un enfoque cuantitativo, con diseño observacional y temporalidad transversal. Se incluyó a 192 estudiantes pertenecientes a cinco carreras de las ciencias de la salud, cuyas edades oscilaron entre los 20 y los 49 años. Para medir la variable de interés se utilizó el cuestionario de resiliencia adaptado a 44 ítems con respuestas en escalamiento de tipo Likert. Resultados: Los resultados muestran niveles altos de resiliencia en carreras con programas de estudio que incluyen la telesimulación y las diferencias entre cada una de estas carreras. Conclusiones: Se sugiere la ampliación de la línea de investigación en otros contextos situacionales e intervención de metodologías de enseñanza-aprendizaje, con el fin de potenciar los procesos de adaptación de los estudiantes de salud y evaluar competencias esperadas del perfil de egreso, directamente relacionadas con su desempeño en su quehacer profesional.(AU)

Introduction: The purpose of this work was to know the level of resilience in a pandemic context in a sample of undergraduate students of health sciences, and how it behaves in tele-simulation scenarios. The study had a quantitative approach, with observational design, cross-sectional temporality and prospective.Subjects and methods: We included 192 students belonging to 5 careers in health sciences, whose ages ranged between 20 and 49 years. To measure the variable of interest, the resilience questionnaire adapted to 44 items with Likert-type scaling responses was used. Results: The results show high levels of resilience in careers with study programs that include tele-simulation and the differences between each of these careers. Conclusions: It is suggested to expand the line of research in other situational contexts and intervention of teachinglearning methodologies, to enhance the adaptation processes of health students and evaluate expected competencies of the graduation profile, directly related to their performance in their professional work.(AU)

Social isolation consequences: lessons from COVID-19 pandemic in a context of dynamic lock-down in Chile.

BACKGROUND: Chile did not adopt general and unified lockdowns for the whole nation but organized itself with dynamic and sometimes irregular lockdowns. These dynamics and consequences of social isolation could be generalized to other contexts of isolation such as those affecting minorities such as immigrants, prisoners, refugees. METHODS: In this study, we investigated the physical and mental health symptoms associated with lifestyle changes due to lockdown among university students in Chile. We examined psychopathological variations in relation to mental health problems in a healthy young population. Our goal was to develop interventions to address these new psychosocial problems in potentially comparable post-pandemic contexts. From May 10th 2021 to June 2th 2021, 420 University students took part in an anonymous survey asking for information on habits and symptoms that emerged during the lockdown in response to the COVID-19 pandemic. Three health outcomes were assessed: digestive disorders; headache; fear of COVID-19. Covariates including conditions and lifestyle during the pandemic, SARS-CoV-2 infections in the family, financial situation and productivity were considered in the analysis. RESULTS: Participants experienced headache and fear of COVID-19 quite frequently during the lockdown period. More than half of the sample also experienced social isolation. Female gender, sleep quality, memory difficulties, and a change in eating habits resulted associated with an increased risk of health outcomes such as headaches and digestive disorders. CONCLUSIONS: The results of this study fit within an original pandemic context: The results of this study can help identify needs and promote solutions applicable to different contexts. Future interventions should focus on the promotion and implementation of healthy habits focused on sleep hygiene, psychoeducation on the use of mobile devices and gender medicine with the support of healthcare organizations and University.