Chilean Context Research Articles

Latent class analyses of multimorbidity and all-cause mortality: A prospective study in Chilean adults.

Multimorbidity patterns can lead to differential risks for all-cause mortality. Within the Chilean context, research on morbidity and mortality predominantly emphasizes individual diseases or combinations thereof, rather than specific disease clusters. This study aimed to identify multimorbidity patterns, along with their associations with mortality, within a representative sample of the Chilean population. 3,701 participants aged ≥18 from the Chilean National Health Survey 2009-2010 were included in this prospective study. Multimorbidity patterns were identified from 16 chronic conditions and then classified using latent class analyses. All-cause mortality data were extracted from the Chilean Civil Registry. The association of classes with all-cause mortality was carried out using Cox proportional regression models, adjusting by sociodemographic and lifestyle variables. Three classes were identified: a) Class 1, the healthiest (72.1%); b) Class 2, the depression/cardiovascular disease/cancer class (17.5%); and c) Class 3, hypertension/chronic kidney disease class (10.4%). Classes 2 and 3 showed higher mortality risk than the healthiest class. After adjusting, Class 2 showed 45% higher mortality risk, and Class 3 98% higher mortality risk, compared with the healthiest class. Hypertension appeared to be a critical underlying factor of all-cause morbidity. Particular combinations of chronic diseases have a higher excess risk of mortality than others.

The Evolution of Hemodialysis in Chile: Is Hemodiafiltration the Next Step?

Hemodialysis began in Chile during the latter half of the 20th century, primarily targeting individuals with acute renal failure. With time, dialysis facilities emerged across diverse regions of the nation, covering hospitals and private centers. This expansion widened dialysis access to chronic patients, culminating in universal coverage through the AUGE plan. Ongoing technological improvements and the integration of pharmaceutical interventions for chronic kidney disease-related complications have notably enhanced survival rates. Nonetheless, dialysis recipients continue to confront significantly elevated mortality risks in comparison to the general population. Despite advancements, complications linked to dialysis persist, significantly affecting patients' overall quality of life. Heightened rates of hospitalization and mortality are, in part, ascribed to the inherent technical limitations of hemodialysis in efficiently clearing uremic toxins. Therefore, superior purification modalities such as high-volume hemodiafiltration need to be progressively adopted to effectively address the persistent clinical needs in the care of dialysis patients within the Chilean context.

Drivers of business-to-business sales success and the role of digitalization after COVID-19 disruptions

PurposeThe purpose of this study is to investigate the drivers of business-to-business (B2B) sales success and the role of digitalization, in a selling and sales management landscape being disrupted by COVID-19.Design/methodology/approachThe methodology follows a discovery-oriented grounded theory approach, which consists of a two-stage qualitative study with sales professionals in Chile, and a fuzzy-set qualitative comparative analysis (fsQCA).FindingsThis research shows that interfunctional coordination, agility in the selling process and business customer engagement are critical determinants of B2B sales success, whereas digitalization moderates these relationships.Originality/valueThis research responds to a call for more research on the impact of digitalization on business relationships in different contexts and perspectives. The authors study the Chilean context, through a two-stage qualitative study, and a fsQCA analysis, which constitutes a novel combination in this stream of research.

Psychometric Properties of the Social Media Addiction Scale (SMAS) on Chilean University Students

Background: The use and abuse of social networks are harming the mental health of university students. Objective: To adapt and validate the Social Media Addiction Scale (SMAS) for the Chilean context to have a reliable instrument to measure addiction to social networks. The sample comprised 686 university students (mean age = 28.04, SD = 8.4), 71.1% female, 28.4% male, and 0.5% other genders. Methods: Confirmatory factor analysis (CFA) using the weighted least squares means and variances method (WLSMV) was used for this study. Results: Reliability was Cronbach's alpha (α) 0.841. The SMAS yielded two factors that explained 53.433% of the variance. The CFA yielded very good fit indicators such as CFI = .959, TLI = .949, and RMSEA .060.Conclusions: Based on the results described above, we can affirm that the SMAS is a good instrument to measure social network addiction in college students.

Evaluation of a Transitional Care Strategy Implemented in Adults With High-Risk and Multimorbidity in Chile

ObjectivesFragmentation of continuity of care impacts the health system's efficiency and increases inequity. It severely affects high-risk patients with multimorbidity, requiring coordinated care to avoid preventable complications. The Centro de Innovación en Salud ANCORA UC, together with the Servicio de Salud Metropolitano Sur Oriente, and the National Health Fund, implemented a transitional care strategy for high-risk adults with multimorbidity at 3 hospitals in the southeast of Santiago. The study aimed to evaluate the impact on length of hospital stay, consultations with primary care physicians and contacts after discharge, and also to describe the implementation process of the transition nurse activities. MethodsA cohort study was performed between 2017 and 2019, with 137 hospitalizations from exposed patients and 167 hospitalizations from unexposed patients. The results of the study showed a significant decrease in the length of hospital stays and an increase in consultations with physicians. ResultsThe results of the implementation process showed that the transition nurse followed-up in a mean of 24 hospitalizations monthly, and 91% of the discharged patients were contacted via the telephone within 7 days. The implementation process showed that the transition nurse’s tasks merged with the daily clinical activities in which training on case management, transition care, and continuous support were key aspects of success. ConclusionWe conclude that transitional care intervention has a strong potential in addressing fragmentation of care and is feasible to install and sustain over time in the Chilean context. Finally, this study provides a detailed description of the intervention strategy contributing to its spread and scale-up.

Co-Active Coping Inventory: Development and Validation for the Chilean Population.

Co-active coping is a fundamental construct in organizational and work environments as it allows for the exploration of individual and group behaviors within organizations. The aim of this study was to develop a new scale called the Co-Active Coping Inventory in the Chilean context. The sample was comprised of 1,442 workers with an average age of 30.48 years (SD = 11.13). 55% were public-sector workers, 34.5% were workers in private commercial organizations, and 10.5% belonged to non-profit private organizations. Different exploratory factor analyses were performed, and the best exploratory model was verified with a confirmatory factor analysis. In addition, multiple linear regressions were used to analyze which dimensions of co-active coping helped predict workers' burnout (emotional exhaustion, affective hardening, and personal fulfillment) and symptomatology (psychological and somatic). Based on the exploratory and confirmatory approach, the Co-Active Coping Inventory showed a good fit to a structure of five correlated factors (Reflective Action, Rash Action, Search for Spiritual Support, Search for Affective Support and Evasion), demonstrating measurement invariance in terms of sex and type of organization. The different domains of co-active coping explain between 20% (emotional exhaustion) and 41% (affective hardening) of occupational burnout and around 3-5% of workers' symptomatology, with reflective action being the most important variable. These results indicate that the new scale has suitable psychometric properties; it can assess coping strategies in the Chilean organizational context in a reliable and valid way. These coping strategies have demonstrated certain importance in relation to organizational and clinical variables.

Transitioning from industry to teaching in VET: profiles of VET teachers in Chile

PurposeSituated in the Chilean context, this study investigates how Vocational Education and Training (VET) teacher profiles, based on their perceptions of prior work experience in industry, relate to their current motivation and perception of teaching in VET. By doing so, the authors seek to provide valuable evidence to inform the development of policies to attract and maintain well-qualified teachers from industry in Chile and other countries facing similar changes.Design/methodology/approachThe authors used a descriptive cross-sectional design to collect data from 660 VET teachers using a two-scale instrument: Perception of Prior Occupation (PPO) and adapted FIT-Choice scales. By adopting a typological approach, the authors constructed profiles of VET teachers based on their perception of past industry experience. The authors then analyzed how these profiles vary regarding individual teacher characteristics, motivation and perception of teaching in VET.FindingsThe authors found a significant degree of heterogeneity among VET teachers' prior industry experiences, leading them to identify three distinct VET teacher profiles: “High Perception of Prior Occupation,” “Learning and Teaching-Oriented” and “Low Perception of Prior Occupation.” Notably, the most distinguishing characteristics across these profiles were age, VET teaching area, holding a job outside of teaching and years of prior industry experience. Furthermore, the authors found that motivation and perceptions of teaching varied significantly across these VET teacher profiles.Originality/valueThere needs to be more research on the factors that attract and retain industry workers as VET teachers in high schools. This study is among the first to address this topic in a non-European context.

Adaptation and validation of the Perceived Nutrition Environment Measures Survey for the Chilean context (NEMS-P-Ch)

Adaptation and validation of the Perceived Nutrition Environment Measures Survey for the Chilean context (NEMS-P-Ch)

Inclusive learning practices: a multiple case study in early childhood education

This study is framed in the Chilean context, where inclusion in early childhood education has been gradually incorporated into public policies through decrees and curricular guidelines that seek to meet the challenge of advancing the right to a more egalitarian education, eliminating all forms of discrimination, both in access to learning and in the development of all learners. The objective of the study is to describe inclusive learning practices developed by early education teachers for transitional levels (ages 4 to 6). For this purpose, a qualitative methodology with an interpretative approach was used, based on a multiple case study. Three early childhood education teachers participated in a semi-structured interview involving 18 classroom scenarios. The data were analyzed through content analysis and descriptive interpretations based on classroom observation. The results indicate that the teachers implement inclusive practices which largely favor organizing play and learning as well as resource mobilization in the classroom. On the other hand, the dimension of diversified teaching is identified with less presence. The scarce modalities used by teachers in their pedagogical practice to favor representation, expression and motivation for learning are discussed, which are essential principles for the development of learning. The study also reveals the importance of learning for the timely acquisition of knowledge and feedback of concepts in early childhood students.

Profiles of University Students Who Graduate on Time: A Cohort Study from the Chilean Context.

Graduating from higher education on time is an important topic, given its relation to students' academic success and the efficiency of the institutions. However, a low percentage of university students finish their studies on time, which poses a challenge that requires the identification of the factors that account for this phenomenon. This study aimed to identify and characterize profiles of students who graduate on time. The population is 514 university students (45% men, 55% women), with an average age of 19.5 years (SD= 1.9) studying business at a university in Chile who belong to four cohorts entering between 2011 and 2014. The results obtained from the Classification and Regression Tree (CART) technique demonstrate eight student profiles constructed considering different variables at the pre-university, transition-motivation, and university levels. As the primary outcome, the profile of the student who graduates on time is characterized by a good performance in the first year of university, enters university right after high school, and takes advantage of institutional support by participating in academic tutoring. These findings suggest that institutions can implement specific strategies from the beginning of the university journey to promote on-time graduation.

Reinforcing the STEM pipeline in vocational-technical high schools: The effect of female teachers

Although secondary Vocational-Technical Education (VTE) is highly prevalent in low-income settings in the developing world, this sector remains understudied in the Economics of Education literature. Situated in the Chilean context, this study examines the effect of exposure to a female VTE teacher on STEM pipeline persistence from secondary to post-secondary level. We find that having at least one female teacher in secondary STEM-VTE programs increases overall enrollment in STEM higher education programs by 2.1 percentage points, primarily driven by women choosing postsecondary VTE diplomas in STEM fields. The effect of female VTE teachers in enrollment in these diplomas reaches 4.0 percentage points, equivalent to an 18% reduction in the observed gender gap. We argue that female VTE teachers, acting as role models, have the potential to mitigate the traditional barriers that young women encounter to persist in the STEM pipeline, thereby contributing to closing the STEM gender gap.

Developmental trajectories of aggression, hyperactivity/inattention, and anxious depressed mood: co-occurring problems within a chilean context

AbstractThe current study examined multi-trajectories of aggression, hyperactivity/inattention and anxious/depressed problems, along with associated risk factors for trajectory group membership, using a person-centred approach. The sample included 2,857 children (50.1% males) enrolled in the Chilean Encuesta Longitudinal de la Primera Infancia cohort. Maternal reports using the Child Behaviour Checklist (CBCL) were completed when children were three, five and eleven years old. Information on risk/protective factors was collected using maternal reports and standardised assessments when children were aged three. Group-based multi-trajectory analysis was implemented. Results indicated that a five-group model best fit the data, with co-occurring symptoms across domains for all groups. Risk factors for membership of groups with the most elevated risk profiles included child sex, maternal age, single parent status, and maternal education, whilst children’s receptive language, maternal vocabulary skills, and not having early attendance in the educational system emerged as protective factors. These identified risk factors may be important targets for future intervention programmes in the Chilean context.

Loneliness as a Potential Mechanism of the Association Between Ageism and Mental Health Outcomes in the Chilean Context.

The negative impact of ageism on the mental health of older persons has been well studied, but the mechanisms underlying this relationship have not been explored in detail. The present study examines the relationship of ageism with depressive and anxious symptoms in older people, evaluating the indirect effect via loneliness. The analysis was carried out with a sample of 577 older adults living in Chile, using structural equation modeling to assess the direct and indirect effects of the proposed model.The results showed the direct and indirect association of ageism with mental health outcomes. Ageism is positively related to loneliness and, in turn, to increased depressive and anxious symptoms. We discuss how loneliness linked with an ageist context contributes to anxiety and depressive symptomatology in the older population and the need to reduce ageism to favor the mental health of this age group.

Food Studies in Latin American Literature: Perspectives on the Gastro-Narrative by Rocío Del Águila and Vanesa Miseres

Reviewed by: Food Studies in Latin American Literature: Perspectives on the Gastro-Narrative by Rocío Del Águila and Vanesa Miseres Lara Anderson Del Águila, Rocío and Vanesa Miseres. Food Studies in Latin American Literature:Perspectives on the Gastro-Narrative. U of Arkansas P, 2021. 280 pp. ISBN: 978-1-68226-181-1. Food Studies in Latin American Literature is a welcome addition to the growing fields of Iberian, Latin American and Hispanic Cultural Food Studies/Food Studies. This volume offers many strong chapters, which look at topics such as culinary fusion at the time of colonialism, nineteenth-century modernity and transnational foodways, gender and food consumption, as well as issues pertaining to food writing. The aim of the introduction is mainly clear and well argued, that is to show how the different chapters are linked to key moments of Latin American history and Latin America literature. Although the authors state that gastro-narrative is both object of study and methodology, I would suggest that the term gastro-criticism, a recognised [End Page 157] subcategory of socio/cultural-criticism, be also used to describe the study's methodology. It is not clear how all the chapters and/or food texts fall under the rubric of literature since some are recipe books, commentary, advertising, and chronicles. If the aim of the current volume is indeed to understand the essence of Latin American literary food studies, then the focus of this study should be just on literature rather than other cultural texts as well. The texts could be described as food texts, literary or otherwise which make up Latin American Food Cultural Studies and are part of a body of texts that take part in the creation and or subversion of identities and mapping of food and foodways onto the continent. Part 1 focuses on indigenous traditions, food legacies and exchanges starting from the time of colonialism, Part 2 on 19th century food cultures, Part 3 on gender and food, and Part 4 on food writing. Chapter 1 offers a fascinating account of how the Crown used food to control the Andeans, yet there were often ways of subverting hegemonic food discourse with indigenous writings that reflected a deep pride in native cuisine. Chapter 2 which focuses on the potato has lots of fascinating material but is too broad in its focus which includes chronicles, songs, and drawings from the early modern period to film prose and poetry from the contemporary Peruvian and Chilean contexts. Chapter 3's discussion of the culinary word of Sor Juana is most fascinating and provides insight into the material culture of New Spain. Her recipes which evince a mix of European, Arab-Andalusian, and Mesoamerican culinary traditions are cultural reflections of the time and demonstrate how food texts most often transcend the kitchen. She also upturns gender dictates in her fusion of cuisine and philosophy. Chapter 4 which starts Part 2 provides a most interesting discussion of how food changed in Mexico and Peru in the 19th century because of waves of migration. Food in this context was used to show class status and domestic imported foods was one of the ways to enhance status. Chapter 5 shows how male travel writing was replete with reactions of disgust in the face of food that was considered inedible thereby reinforcing the racist logic of colonialism which was based on white male supremacy. And in a similar fashion Chapter 6 describes Eduarda Mansilla's trip to New York during which she wrote travel literature with a multitude of references to how bad American food was, she judges American eating habits poorly indeed. I have written a great deal about the potential for food to act divisively during times of conflict or intercultural conflict and these negative descriptions of other people's food culture reminds us that we must find ways of using food as a force of good. Chapter 7 provides a fascinating account of homemaking in 1950's Mexico showing how through the food discourse they read or consumed, housewives were instructed in the uptake of modernization and mestizaje, deemed as superior to traditional indigenous culinary traditions. Chapter 8 focuses on Rosario Castellano's...

Co-naturing informality in Chile


 
 
 
 Inspired by Donna Haraway’s concept of Making Kind, the investigation of the relationships between different objects of nature and non-nature subjected to today’s climate change is born. Looking today at the transformations of the planet, Chile represents an exemplary case study. Within its particular geomorphological condition, it is impossible to exclude the continuous evolution separating humans from other living species. This integration is the rise of campamentos, Chilean informal settlements. This contribution investigates the natural processes and informality in Chile through the lens of Landscape ecology. Specifically, it analyses the symbiotic relationship between the informal development and the morphological conformation of the natural Chilean context, with the consequent intersection of the inhabited space and the natural one.
 
 
 

Declining Quantity and Quality of Births in Chile amidst the COVID‐19 Pandemic

AbstractExtensive demographic scholarship shows that the population‐level implications of mortality crises such as the COVID‐19 pandemic extend beyond mortality dynamics to affect fertility and family‐formation strategies. Using novel municipality‐level data from Chile covering all births that occurred between January 2017 and December 2021, this study explores trends in fertility and implications of the COVID‐19 pandemic for “quantum” and “quality” of births in the Chilean context. Building both a monthly and a yearly panel of 346 municipalities and leveraging fixed‐effects regression analyses, we focus on births and crude birth rates to measure quantum, while quality is assessed through the share of births that are low‐weight (LBW) and preterm (PTB). Our findings provide evidence of a significant drop in fertility in the wake of COVID—of the magnitude of a reduction of 1.3 live births per 1,000 individuals—which reaches a minimum around February 2021, followed by an incipient rebound in late 2021. Moreover, estimates on child health at birth suggest that the COVID period was associated with an increase in LBW and, foremost, PTB, by 1 and 2.2 percentage points, respectively. Findings from this study shed light on the role of policy interventions in the health arena and the linkages between short‐ and long‐run effects in relation to the various COVID‐19 waves in Chile.

Building bridges through cultural adaptation: Examining the initial impact of a culturally adapted parent training intervention for the Chilean context.

Child exposure to maltreatment and neglect constitutes a significant public health problem throughout Latin American and Caribbean (LAC) countries. Although evidence-based parent training (PT) interventions constitute an empirically demonstrated alternative to prevent child maltreatment and neglect, multiple implementation barriers have prevented the large-scale dissemination of evidence-based PT interventions across LAC countries. This selective prevention study consisted of an exploratory quasi-experimental design implemented in Chile, aimed at examining the initial impact of a culturally adapted version of the evidence-based PT intervention known as GenerationPMTO©. The parenting intervention was adapted in a previous pilot study, according to a rigorous model of cultural adaptation. Based on self-reports completed by 281 caregivers, when compared to baseline measurements, significant improvements at intervention completion were observed in the majority of caregivers' parenting practices, as well as child internalizing and externalizing problematic behaviors. This study provides promising initial empirical evidence that efficacious PT interventions developed in the US can be transported to Latin American contexts, as long as they are thoroughly adapted to achieve high contextual and cultural relevance. The rates of child maltreatment across LAC countries constitute an urgent and permanent call for strongly promoting this line of prevention research.

Mapping the astronomy content knowledge of Chilean in-service teachers

ABSTRACT This paper reports a mapping of the astronomy content knowledge held by a sample of 171 Chilean in-service teachers, both from primary and secondary education, using a multiple-choice test. The responses were analysed by total achievement, and the proportion of alternative conceptions for each item was identified. Moreover, the test items were divided by Big Ideas in Astronomy and curricular topics to analyse teachers’ performance by subject, and the effect of some demographic factors was calculated. The results show a relatively low level of astronomy content knowledge and a considerable presence of alternative conceptions amongst Chilean in-service teachers, especially in day-to-day topics like diurnal motion, seasons, and Moon phases. Furthermore, we detected a significant effect on secondary teachers’ performance depending on their teaching degree and on primary teachers’ performance concerning their gender and previous participation in astronomy professional development programmes. Our outcomes offer evidence to improve astronomy teacher training, especially in the Chilean context, and contribute to the still scarce astronomy education research from the country.

Emotional Exhaustion Variables in Trainee Teachers during the COVID-19 Pandemic.

emotional exhaustion among trainee teachers is a relevant topic since it could have repercussions regarding the lives of their future pupils. Our objective was to determine the degree of trainee teachers' emotional exhaustion and associated variables during the COVID-19 pandemic. the design was cross-sectional and descriptive. Questionnaires with sociodemographic variables, perceptions of mental health, and the Emotional Exhaustion Scale (ECE) (α = 0.890; ω = 0.893) validated for the Chilean context were answered by 204 trainee teachers. The results were analyzed using SPSS software version 25 and the Emotional Exhaustion Interpretation Table (EES-Int). the results show that 92.2% of the trainee teachers presented a worsening in their mental health, stress (66.2%), irritability (38.2%), anxiety (37.7%), and depressive symptoms (32.8%). Online classes (73.04%) and the pandemic (67.6%) were the main influencing factors. Education students who perceived their mental health had worsened became 6.63 times more likely to develop emotional exhaustion [AOR = 6.63; 95% CI: 1.78, 24.69]. In addition, education students with a high perception of academic stress were 7.45 more likely to develop emotional exhaustion [AOR = 7.45; 95% CI: 1.98, 28.09]. we can conclude that trainee teachers have high levels of emotional exhaustion and their perception of their mental health and the academic stress they are being subjected to during the COVID-19 pandemic may lead them to present symptoms of frequent or permanent problems with concentration, attention, recall of information, dissatisfaction with their performance, and frequent learning difficulties. From the affective dimension, they present frequent or permanent anxiety, restlessness, irritability, indifference, low mood, and psychomatization. From the socio-interactional dimension, they present frequent or permanent social withdrawal, interpersonal problems, problems at work or school, and family and relationship problems. Increasing the sample to delve into emotional exhaustion by subject area is necessary. For future studies, research should be conducted on the causes of emotional exhaustion by subject area and the coping strategies of trainee teachers to understand differences and provide input on emotional support in practice.

A multicomponent intervention to reduce internalized stigma in persons with a diagnosis of severe mental disorder: protocol of a pilot randomized mixed trial

Background: People with mental disorders face stigma as a social obstacle in multiple areas of their lives. Therefore, stigma toward this population is a priority for global public health due to its numerous consequences for those affected. One of its manifestations is internalized stigma, which also has severe implications for people with mental disorders. This study presents the protocol of a multicomponent intervention aimed at reducing internalized stigma in people with severe mental disorders. Methods: The intervention is based on a mixed-method experimental design. The main design is an external randomized pilot trial with two arms, parallel, double-blind, equally randomized, and single-center. Qualitative data before and after the completion of the intervention are included as a secondary component of the main design. The study will be carried out in health service of the secondary level of care in Gran Concepción, Biobío Region, Chile. Twelve people will participate in the qualitative pre-intervention stage and 34 in the intervention stage, 17 in the experimental group, and 17 in the control group. The experimental group will receive the intervention plus the usual treatment, and the control group will only receive the usual treatment. The intervention is carried out in 10 sessions lasting 90 minutes each and is administered by a health service professional. Conclusions: The study will provide evidence on the acceptability and feasibility of the intervention in the Chilean context, advancing knowledge and understanding in the field. Trial Registration: The study has been registered with trial registration no. ACTRN12622000919718.