Chilean System Research Articles

Occurrence of Multi-Drug-Resistant Bacteria in Rainbow Trout–Lettuce Bio-Integrated Culture Systems in Chile

In an aquaponic system, fish and plants are cultivated together in a symbiotic environment where they mutually benefit, using significantly less water than traditional farming methods. The main aim of this study was to investigate the occurrence of antimicrobial resistance in two aquaponic systems implemented in two Chilean high schools using rainbow trout and lettuce cultures. When water samples (fish tank, biofilter, and plant raft) were analyzed over a three-month period, no resistance to oxytetracycline was detected, whereas the occurrence of resistance to florfenicol was rather small, ranging from 0.01% to 3.1% of bacterial culturable counts. Eighteen isolates were recovered from various sources as representatives of the florfenicol-resistant population, and all of them belonged to the Pseudomonas genus, showing a multi-drug-resistance phenotype and exhibiting simultaneous resistance to 7–13 antimicrobials. All isolates exhibited resistance to amoxicillin, chloramphenicol, florfenicol, and furazolidone and susceptibility to meropenem, oxytetracycline, oxolinic acid, flumequine, ciprofloxacin, and enrofloxacin. Five and two isolates carried the amphenicol-resistance-encoding genes floR and cmlA, respectively, whereas no carriage of integrons or the fexA, fexB, pexA, optrA, and cfr genes encoding for florfenicol resistance was detected. Eleven isolates carried plasmids, but only two of them were able to transfer their plasmid content by conjugation. The knowledge of the microbiome associated with aquaponic systems is still scarce, and their role as potential reservoirs of antimicrobial-resistant bacteria and related genes of these systems must be elucidated.

Evolving Dairy Cattle Systems in Chile: Structural Shifts and Adaptation Strategies.

This study examines the structural and geographical changes in Chile's dairy cattle systems from 1997 to 2021, using data from agricultural censuses. It focuses on variables like animal stocks, herd sizes, pasture utilization, and stocking rates, analyzed through descriptive statistics, multivariable analysis, and geographical mapping. The findings show a significant decrease in dairy farms (-69%) and dairy cattle stocks (-25.4%), with regional disparities: southern farms increased in importance while central farms declined. There is a trend towards intensification, with higher stocking rates and larger herd sizes. Grassland utilization shifted, with a decrease in natural pastures and an increase in improved and sown pastures. The study identifies four typological groups based on stocking rates, dimensions, and pasture use, reflecting distinct evolutionary paths influenced by climate change, land use, economic dynamics, and technology. Geographical analyses highlight regional variations. This research provides insights into the dynamics of Chile's dairy farming sector and its sustainability challenges and opportunities amidst changing environmental and socioeconomic conditions.

A Technological Framework to Support Asthma Patient Adherence Using Pictograms

Background: Low comprehension and adherence to medical treatment among the elderly directly and negatively affect their health. Many elderly patients forget medical instructions immediately after their appointments, misunderstand them, or fail to recall them altogether. Some identified causes include the short time slots allocated for appointments in the public health system in Chile, the complex terminology used by healthcare professionals, and the stress experienced by patients during appointments. One approach to improving patients’ adherence to medical treatment is to combine written and oral instructions with graphical elements such as pictograms. However, several challenges arise due to the ambiguity of natural language and the need for pictograms to accurately represent various medication combinations, doses, and frequencies. Objective: This study introduces SIMAP (System for Integrating Medical Instructions with Pictograms), a technological framework aimed at enhancing adherence among asthma patients through the delivery of pictograms via a computational system. SIMAP utilizes a collaborative and user-centered methodology, involving health professionals and patients in the construction and validation of its components. Methods: The technological framework presented in this study is composed of three parts. The first two are medical indications and pictograms related to the treatment of the disease. Both components were developed through a comprehensive and iterative methodology that incorporates both qualitative and quantitative approaches. This methodology includes the utilization of focus groups, interviews, paper and online surveys, as well as expert validation, ensuring a robust and thorough development. The core of SIMAP is the technological component that leveraged artificial intelligence methods for natural language processing to analyze, tokenize, and associate words and their context to a set of one or more pictograms, addressing issues such as the ambiguity in the text, the cultural factor that involves many ways of expressing the same indication, and typographical errors in the indications. Results: Firstly, we successfully validated 18 clinical indications along with their respective pictograms. Some of the pictograms were redesigned based on the validation results. However, in the final validation, the comprehension percentages of the pictograms exceeded 70%. Furthermore, we developed a software called SIMAP, which translates medical indications into previously validated pictograms. Our proposed software, SIMAP, achieves a correct mapping rate of 96.69%. Conclusions: SIMAP demonstrates great potential as a technological component for supplementing medical instructions with pictograms when tested in a laboratory setting. The use of artificial intelligence for natural language processing can successfully map medical instructions, both structured and unstructured, into pictograms. This integration of textual instructions and pictograms holds promise for enhancing the comprehension and adherence of elderly patients to their medical indications, thereby improving their long-term health.

CLINICAL EFFECTIVENESS OF PRIMARY HEALTH CARE IN CHILE: INNOVATIONS AND CHALLENGES

Chile presents a dissociation between the high level of human development indexes and public health indicators achieved versus the existent relatively low clinical effectiveness level, especially at the primary health care (PHC) system. PHC in Chile has developed a number of pilot innovations that could be replicated and escalated at a national level, to improve clinical effectiveness and the health care level of the population. The development of new models in clinical effectiveness in Chile, has been associated with significant reductions in inappropriate referrals, hospitalizations, emergency care visits and even general mortality. The Chilean PHC system has implemented pilot and innovative interventions in cancer prevention, early detection of gallbladder disease, peptic ulcer disease and gastric cancer, as well as innovative clinical management initiatives on COVID-19 infections and cardiovascular disease. Specific instruments and strategies have been tested and validated to implement the person-centered family systems approach. New initiatives on rapid tests and clinical ultrasound for cardiovascular and respiratory disease should be inte­grated soon in PHC in Chile given the existent evidence on their effectiveness and relative low cost. It is recommended to assess locally clinical new practices at the primary care level before escalating them to the entire network given that in many cases, available clinical information comes from clinical scenarios that are not necessarily equivalent to primary care. The primary care system in Chile has the challenge to implement strategies of proven effectiveness at local level that should be escalated to a national level.

Measurement of efficiency and its drivers in the Chilean banking industry.

This paper estimates efficiency measures for the banking system in Chile for the period 2000-2019. In contrast to previous studies, we use input-distance functions, introduce the nonparametric slack-based model, and choose the intermediate inputs approach in determining inputs and outputs. Our results suggest that the Chilean system has achieved relatively high levels of efficiency, although with no significant variation over the sample period. Ownership (government, foreign and public) and size had a positive impact on efficiency. On average, mergers and acquisitions seem to have targeted highly efficient banks in order to improve the overall efficiency of the controlling institution in the short run. Other sources of efficiency gains could be an increase in bond funding or a reduction in expenses and capital holdings. The latter could be induced by deepening the local derivatives market.

Comparison of the environmental impacts of heating systems in Chile by life cycle assessment

The present study conducts a Life Cycle Assessment (LCA) to evaluate the environmental impacts of heating technologies commonly used in Chile based on six environmental indicators: Climate Change (CC), Human Toxicity (HT), Formation of Particulate Matter (PM), Formation of Photochemical Oxidants (PO), Ozone Destruction (OD), and Water Depletion (WD). Due to the extensive length of the territory studied, it is demonstrated that the environmental impacts depend on the geographical location where the heating equipment is used. Stoves that use wet firewood presented the highest environmental impact in CC, PM, HT, and PO. Using dry firewood could reduce pollution by 14%–81%, compared to wet firewood. Replacing wood heating with natural gas, LPG, and kerosene stoves reduces the CC and HT indicators. On the other hand, switching to electric heating, such as split inverter heat pumps, could transfer these impacts to areas where electricity is generated using coal. When the pellet is a byproduct of the forestry industry and transportation distances are not very high, the pellet stove stands out for its lower CC. In Magallanes, electric heating appears environmentally attractive due to using natural gas for electricity generation.

Beef production and the beef evaluation system in Chile: description, characterization, and quality.

Beef production and the beef evaluation system in Chile: description, characterization, and quality.

Identifying outbreaks in sewer networks: An adaptive sampling scheme under network’s uncertainty

Motivated by the implementation of a SARS-Cov-2 sewer surveillance system in Chile during the COVID-19 pandemic, we propose a set of mathematical and algorithmic tools that aim to identify the location of an outbreak under uncertainty in the network structure. Given an upper bound on the number of samples we can take on any given day, our framework allows us to detect an unknown infected node by adaptively sampling different network nodes on different days. Crucially, despite the uncertainty of the network, the method allows univocal detection of the infected node, albeit at an extra cost in time. This framework relies on a specific and well-chosen strategy that defines new nodes to test sequentially, with a heuristic that balances the granularity of the information obtained from the samples. We extensively tested our model in real and synthetic networks, showing that the uncertainty of the underlying graph only incurs a limited increase in the number of iterations, indicating that the methodology is applicable in practice.

Intercultural characterization of the empathetic physician: Experiences of chronic patients of the chilean public health system

Empathy is a fundamental element of the physician-patient relationship for treatment and therapeutic adherence that has had to face significant changes due to the migrations of the health system in Chile. Characterize the empathetic physicians according to the perceptions of chronic patients during the encounter with national and foreign doctors in the public health system in the Maule Region. Qualitative study of exploratory-descriptive type. Twenty chronic patients from public health services in the Maule region were interviewed remotely using the free listing technique. A thematic processual qualitative analysis of the content and a descriptive quantitative analysis were carried out where the frequency and salience of the Smith index assisted by the Anthropac 4.98 software were obtained. Seven categories of empathetic care were identified in the physicians-patient relationship: Affectivity (37%), Communication (19%), Attention (13%), Respect (12%), Research (9%), Knowledge (5%) and Efficiency (5%). The affective and psychoemotional aspects were more valued than the cognitive aspects of empathetic care. No differences were observed in assessing the empathetic care of patients seen by Chilean physicians and those treated by foreign physicians.

Pilot study of a digital literacy-based intervention to confront concomitant crises amongst key food system actors in Chile

IntroductionThe fragility of food systems in Chile has been exposed through concomitant crises, from a social crisis in 2019 to the COVID-19 pandemic, and ongoing climate change. There is an increased dependence on information and communication technologies (ICTs) to produce, sell, and consume food and the digital divide has increased. The lack of digital literacy in Chile has not been evaluated or considered within comprehensive interventions.MethodsTo examine how local food systems can be strengthened, we conducted a pilot study of a digital literacy-based intervention with smallholder farmers, vendors, and consumers (n = 96) of different age groups (25–45 y, and 46–65 y) from adjacent urban and rural regions in Chile. Telephone surveys were carried out on the use of ICTs, access to the food environment, and agricultural practices during crises. A 5-week digital literacy intervention was carried out on digital confidence, the use of ICTs to generate networks, networks, the use of apps to sell or buy food, banking operations, and communication with state agencies. We also planned a virtual conversation about the food system and nutrition in Chile.ResultsAll participants knew how to read and send WhatsApp messages but >50% of farmers and vendors reported cell signal problems. Between the 2019 social crisis and the COVID-19 pandemic, supermarkets as the main source of food decreased from 79 to 57%, and delivery increased from 2 to 17%. In total, 92% of the participants received the intervention, and 52% expressed satisfaction. Across participants, the average implementation score was 61%. Only one person connected to the virtual conversation.DiscussionCrises have impacted how the Chilean population in both urban and rural regions navigate their food environment for their household as well as small-scale agricultural production in these areas; elucidating a greater dependency on ICTs amongst small-scale farmers, vendors, and consumers in Chile to buy and/or sell food. We also conclude that it is feasible to implement a digital literacy intervention for key food system actors in urban and rural settings in Chile. Future studies will contribute to the evidence base about the feasibility and impact of similar digital literacy interventions; an area of increasing importance given the rising prevalence of the digital food environment worldwide.

Qualitative analysis of health preparedness policies in ChileUma análise qualitativa das políticas de preparação na área de saúde no Chile

Analyze health preparedness policies in Chile and identify their strengths and weaknesses. No other studies to date provide an analysis of the country's preparedness policies. A desk review and semi-structured interviews with experts in emergency preparedness and response were conducted to identify the regulatory framework, key actors, and the strengths and weaknesses of health preparedness policies. The researchers identified 103 standards and interviewed seven preparedness experts. The reviewed standards and interviews show that Chile is in a transitional phase between the old National Civil Protection System and the new National Disaster Prevention and Response System. Only three standards were directly related to health, but the preparedness regulations provide for a multidisciplinary set of actors to address any threat. The experts gave a positive assessment of the Chilean system, although they agreed that certain weaknesses must be corrected. The country's main strength is its disaster response experience, along with its coordination mechanisms. The main shortcomings include risk communication, mitigation, preparedness and assessment, and human resources. Chile has a solid regulatory framework with an all-hazards approach and a set of multisectoral institutions. The new National Disaster Prevention and Response System must build on its strengths to correct the weaknesses that limit its emergency preparedness and response capacity.

Novice teachers in Chile: ELT teaching capability development and social (in)justice awareness in educational marginalization

ABSTRACT The Chilean system is known worldwide for the detrimental effect of neoliberal policies on public education and school segregation (Bellei et al. 2022). Drawing on Sen’s Capability Approach (1999), this paper examines how novice teachers of English balance the tension between the constraints of the social and educational systems (unfreedoms) to develop agency and transform challenges into English-language teaching opportunities (capabilities), and how they develop social (in)justice awareness to become helpful, caring, and committed ELT practitioners in their school communities. Data collected through open-ended surveys and semi-structured interviews reveal that novice teachers understand and question systemic unfreedoms (social, institutional, market-driven educational constraints) and social (in)justice in Chilean education and ELT. Such reflections allow them to distance themselves from curricular mandates, to develop ELT capabilities based on the academic and emotional needs of their learners, and intertwine English teaching with affective care and commitment to their schools’ educational projects and the wellbeing of marginalized students.

An adaptive methodology for curriculum redesign based on performance indicators of the student progression

ABSTRACT We propose an adaptive methodology for the curricular redesign based on the performance indicators of the student progression observed after a follow-up period. The feasibility of adopting the same approach should be thoroughly studied to assess its compatibility with institutions and countries that employ an academic credit system based on student workload, such as the European Credit Transfer System. This approach was applied here for the Chilean system, which is highly consistent with the European case. The resulting methods can be automated and integrated into institutional databases for the management of teaching-learning processes to enhance decision-making. Special attention is devoted to the methods for estimating the credit points and the relative position of each course in the curriculum sequence chart of a university degree. As an example of application, we discuss the curriculum redesign of the B.Sc. degree in Physics offered by the Universidad Católica del Norte. The analysis is based on the statistical report of performance indicators of this undergraduate program during the follow-up period 2015–2019 (five years). We report a certain correspondence between the problem of credit allocation and the behavior in the student progression, which represents an empirical evidence of the effectiveness of the associated credit points estimation.

The continuum of violence against women: Gynecological violence within the Medical Model in Chile

ObjectiveThis study aims to investigate the presence of gynecological violence within the health system in Chile, quantify the magnitude of this problem, define its general contours, and shed light on a phenomenon that has long been silenced. Additionally, we are interested in detecting differences between public and private health services, as well as exploring the role played by variables such as sexual orientation, ethnicity, age, and educational level in contributing to the prevalence of gynecological violence. MethodsThis study employed a cross-sectional and not probabilistic sampling approach. It included a sample of 1503 women from all regions of Chile, who were of legal age and who had attended gynecological services. A questionnaire was applied between January 2021 and April 2022 using the online platform SurveyMonkey®. Data were collected through the second national survey on obstetric and gynecological violence (GinObs 2021). The study adheres to activist research methodologies and was conducted in collaboration with activists and academic researchers. Results57.9% of the women participants reported having experienced violence. Such violence appears to occur most frequently in the public health system, although not exclusively, and the victims are often people who belong to native ethnic groups, who identify as of African descent, whose sexual orientation is lesbian, who are elderly, and who have a lower level of education. ConclusionGynecological violence is an integral part of the continuum of violence against women and is consistently reported in both public and private health services. This form of violence has serious consequences for women's health and constitutes a significant public health problem.

A Useful (But Painful) Risk-Management Lesson from the Chilean Pension System

This article demonstrates the dangers of attempting to create investment funds with different risk-return profiles by relying only on investment policies based on asset class-limits, but without incorporating portfolio-level risk constraints. The analysis is based on a natural experiment: the Chilean pension system. The study considers monthly returns data from the five investment funds that constitute the bedrock of the Chilean system and covers the period October 1, 2002 to June 1, 2020. The analysis, which relies on the use of different rank-order metrics, shows that the five funds delivered returns incompatible with their intended risk-return profile. In short, rank-ordering the five funds based on their cumulative returns resulted in a sequence at odds with the original intention; that is, contrary to the regulator’s aim, riskier funds frequently delivered lower returns. These findings are relevant for policy makers and the private sector, as many institutional investors (not only pension funds) based their investment policies on such limits alone.

A Smithian Reading of Chilean Free Banking

Abstract In the second half of the nineteenth century, the Chilean free banking system worked similarly to how Adam Smith describes the eighteenth-century free banking system in Scotland. The characteristics of free banking that Smith identifies as conductive of successful outcomes—free entry, unlimited liability, and convertibility on demand—are present in both Scotland and Chile. And the Chilean system failed for similar reasons to the worries Smith had about the Scottish system: inconvertibility, legal tender, involvement with government borrowing, and lobbying. The Chilean experience of free banking appears to follow Smith's account of free banking.

Becoming a (Neuro)Migrant: Attachment, Early Stimulation, and the Government of the Future of Chile

The encounters between health institutions, practitioners, and Haitian and Dominican communities have triggered several frictions and conflicts in the public health system in Chile since 2010, especially in maternal child health. In this article, I explore the interactions between health institutions, “psy” technologies, and afro-descendant women registered in the “Chile Crece Contigo” program and how these interactions impact women’s subjectivity and everyday lives. Developmental sciences, especially neurosciences, play a crucial role in the program by promoting comprehensive childhood development. I argue that the entanglements between attachment theory, neurosciences, and epigenetics gained authority for health practitioners and shaped migrants’ representations of motherhood and child-rearing anchored in neurobiology. Although health institutions have encouraged the adoption of “cultural competencies,” practitioners’ interventions have tended to promote a neurobiological understanding of attachment and early stimulation, neglecting moral and contextual aspects involved in migrants’ parenting practices. Interventions have delineated representations of “(ab)normal” motherhood and childhood, shaping moral ideals of children’s development and a migrant citizenship project for the future of Chile. I also argue that by placing concerns on the table about migrant children’s neurobiological development and social vulnerability, the program has shaped what some researchers call the “neuroscience of poverty.”

New and old educational inequalities in socio-cultural minorities: exploring the school choice experiences of families under the new school admission system in Chile

ABSTRACT In 2016, the Chilean Ministry of Education implemented the new School Admission System (SAS) designed with the goal of equalizing access to schools for the most disadvantaged families and reduce educational segregation. Yet it is not clear if the SAS is sensitive to socio-cultural minorities and their particular conditions. Hence, in this article we explore the school choice experiences of parents from three socio-cultural minorities under the new SAS: Mapuche – indigenous families, Latin American migrant parents, and parents with children with disabilities. Using an intersectional theoretical approach and a qualitative research design, we show that while in some cases the implementation of SAS impedes previous discriminatory processes, in others this new system alone has not yet overcome long-established and inherent educational inequalities in Chilean education. Besides, SAS has also resulted in new challenges in the school choice processes of these parents. Their experiences with the SAS express the intersection of different axis of inequality, according to the conditions and historicities of each group of families. Finally, we reflect on the challenges that the policy faces in regard to develop an educational policy that is fairer to all families, in the context of the unequal and marketized Chilean educational system.

A conceptual hydrological model of semiarid Andean headwater systems in Chile

Semiarid Andean headwaters are key components of the hydrological system of north-central Chile as this is the main source of runoff which supports ecosystems and population located downstream. This study develops a conceptual hydrological model of the Chilean semiarid Andes headwaters, based on an integrative critical analysis of the current state of published research in the region. We combine a plethora of literature focused on isolated hydrological units including extensive literature on glacier and snowpack hydrological processes and less abundant literature on permafrost landforms, groundwater dynamics and other hydrological features. Among others, we identify important knowledge gaps related to the hydrogeomorphological understanding of permafrost area and its interaction with groundwater, as well as deep aquifer recharge and circulation. These two research topics are necessary next steps to better constrain model predictions of catchment response to future climatic scenarios associated with decreasing water contribution from glaciers and precipitation.

One hundred years of health in a demographic, epidemiological and public policy context: the transition of childhood morbidity and its challenges

Chile is in an advanced stage of demographic and epidemiological transition. It is in this scenario that the political, economic and health crisis occurred, with the social outbreak in 2019 and then the COVID-19 pandemic. The mortality of children and adolescents dropped significantly, however, changes in lifestyles and demotivation, associated with long confinement and worsening health of parents and caregivers triggered an epidemic of mental health, developmental and nutritional problems. Pediatricians were forced to reinvent themselves, exposing themselves to stress and burnout. The aim of the manuscript is to describe the demographic, epidemiological and public policy context of child health in Chile in the last century, as a backdrop to dimension the immediate impact of the COVID-19 pandemic. The new health challenges for this age group in the medium and long term are discussed. Some theories, conceptualizations, and relevant milestones of the public health system in Chile are presented. The emergence of "post-pandemic morbidity", such as sedentary lifestyle, food insecurity, screen addiction, identity conflicts, violence, mental health disorders and reemergence of morbidity and mortality due to infectious and contagious diseases is discussed. Professionals responsible for the care of children must redouble their efforts to provide comprehensive care, accompanying families in the new challenges, in order to rehabilitate a healthy childhood.