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Reducing global inequities in medical oxygen access: the Lancet Global Health Commission on medical oxygen security
(Elsevier BV, 2025-03)
Hamish R Graham
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Carina King
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Ahmed Ehsanur Rahman
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Freddy Eric Kitutu
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Leith Greenslade
Scopus© Citations 53 1
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Arsenic Exposure During Pregnancy and Childhood: Factors Explaining Changes over a Decade
(MDPI AG, 2025-03-16)
RUBILAR RAMIREZ, PAOLA ANDREA
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HIRMAS ADAUY, MACARENA SOLEDAD
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APABLAZA SALINAS, MAURICIO IVÁN
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Camila Awad
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Xaviera Molina
Arsenic chronic exposure, particularly in its inorganic form, represents a significant public health concern. This study was conducted in Arica, the northernmost city in the country, whose inhabitants have been exposed to inorganic arsenic both naturally through drinking water and anthropogenically due to a toxic waste disposal site. We explored changes in inorganic arsenic levels in a cohort of pregnant women and their children over a decade, identifying exposure trends and their determinants. We used data on arsenic exposure through maternal urine samples during pregnancy, collected by the Health Authority between 2013 and 2016 (measurement 1), and followed up with assessments of their children in 2023 (measurement 2). Temporal changes in inorganic arsenic concentration were analyzed using the Wilcoxon Signed-Rank test, and a mixed linear regression model was employed to determine which factors contributed to urinary inorganic arsenic levels. We did not observe significant differences in mean arsenic concentrations between the two-time points (p = 0.4026). The mixed linear regression model revealed that children consuming bottled water had 8.3% lower urinary inorganic arsenic concentrations than those drinking tap water (95% CI: −15.36 to −0.54%). Additionally, children from ethnic groups had 8.64% higher inorganic arsenic concentrations (95% CI: 0.49 to 17.5%), while those with caregivers with higher education showed a 13.67% reduction (95% CI: −25.06 to −0.56%). Despite mitigation efforts, these findings underscore the ongoing risk of inorganic arsenic exposure among vulnerable populations. They further emphasize the importance of addressing natural arsenic contamination in water and implementing targeted interventions to reduce disparities associated with socioeconomic and demographic factors.</jats:p>
Scopus© Citations 1 6
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Barriers to accessing formal cancer care from the perspective of informal caregivers: a qualitative study
(Springer Science and Business Media LLC, 2025-04-21)
CAMPAÑA, CARLA
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CABIESES VALDES, BALTICA BEATRIZ
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OBACH KING, ALEXANDRA ALICE
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Francisca Vezzani
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Angela Estay
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Therapeutic trajectories of families with rare diseases in Chile from the perspectives of patients, carers, and healthcare workers: a qualitative study
(Springer Science and Business Media LLC, 2025-02-25)
CABIESES VALDES, BALTICA BEATRIZ
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OBACH KING, ALEXANDRA ALICE
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Antonia Roberts
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REPETTO LISBOA, MARIA GABRIELA
Background Rare diseases are conditions that have a low prevalence in the population and a high disease burden and are often chronic and progressive. International evidence concerning the experience of people and families living with rare diseases is scarce, leading to late and erroneous diagnoses, as well as non-specific treatments. This study explored the therapeutic trajectories of people and families living with rare diseases within Chile’s public and private healthcare systems from the perspective of patients, caregivers, and medical teams, including the initial symptoms, first consultation, testing, diagnosis, treatment, and follow-up. Methods A qualitative exploratory study was conducted through multiple case studies. Sixty participants were interviewed in person and/or virtually: patients (n = 16), caregivers (n = 22), healthcare workers (n = 20), and two patient organisation leaders. The material was analysed using thematic analysis. The project was approved by the Scientific Ethics Committee of Facultad de Medicina Clínica Alemana, Universidad del Desarrollo. Results After similar initial symptoms and first consultation, three main types of trajectories were identified: (i) the path taken by those who reach a diagnosis for a disease that has specific treatment available; (ii) the journey of those who reach a diagnosis for their health condition, but their disease does not have a specific treatment available; and (iii) the trajectory of those who have not reached a diagnosis and receive symptomatic treatments for symptoms. Conclusions The therapeutic trajectories of patients with rare symptoms are similar in terms of initial symptoms and first consultation. However, their paths diverge at the diagnostic stage, with diverse experiences related to these journeys, largely based on having a diagnosis and whether there is a specific treatment. Rare conditions in Chile requires further attention and urgent action that considers those who live with them and their families.
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Top ten research priorities in global burns care: findings from the James Lind Alliance Global Burns Research Priority Setting Partnership
(Elsevier BV, 2025-06)
Hollie Sarah Richards
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Robert M T Staruch
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Suzannah Kinsella
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Jelena Savovic
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Riaz Qureshi
Scopus© Citations 27 2
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Your baby has down syndrome: a reflexive thematic analysis of breaking the news to parents
(Springer Science and Business Media LLC, 2025-05-06)
TENORIO DELGADO, MARCELA
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Johanna Sagner-Tapia
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Renata Garibaldi
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Vaso Totsika
Scopus© Citations 1 6
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Cancer plans should consider local needs
(Elsevier BV, 2025-02)
Bettina Müller
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Raul Murillo
1Scopus© Citations 2
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Unravelling the potential relationship between the climate crisis and the health of migrant children in LAC: perceptions from migrant parents and healthcare professionals in Chile
(BMJ, 2024-12)
CARREÑO CALDERON, ALEJANDRA ANGELICA
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Alice Bluckaz
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CABIESES VALDES, BALTICA BEATRIZ
<jats:sec><jats:title>Introduction</jats:title><jats:p>Latin America and the Caribbean (LAC) is one of the regions most affected by the climate crisis, which is connected to international migration through a complex nexus. During the last years, migratory flows on the continent have increasingly included children and adolescents who are migrating through non-authorised crossing points. The existing literature shows how inequities negatively affect migrant children and the role that healthcare systems can play to mitigate them.</jats:p></jats:sec><jats:sec><jats:title>Objective</jats:title><jats:p>Based on a qualitative study, the paper aims to analyse the role of the climate crisis on the healthcare needs of migrant children from LAC who are currently living in Chile, from the point of view of parents from five main countries of immigration in Chile and healthcare professionals.</jats:p></jats:sec><jats:sec><jats:title>Method</jats:title><jats:p>An exploratory study was conducted in Arica, Antofagasta and Santiago. In-depth interviews with 20 migrant parents and 20 healthcare professionals were carried out. The interviews were transcribed verbatim and a thematic analysis was performed.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Three findings emerged from this study: (1) food insecurity affects LAC migrant children in their country of origin and during their migratory trajectories to Chile, (2) natural disasters and environmental degradation in the countries of origin are not the only drivers of migration for LAC families but also prevent returns, even when they remain undocumented and (3) LAC migrant children are exposed to urban pollution and contaminants in informal settlements due to difficulties in accessing formal housing, among others.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>The climate crisis must be integrated into the study of migrant health in LAC, considering the current context of multiple political, health and economic crises in the region. Healthcare professionals and communities play a central role in creating interventions to build sustainable and resilient universal healthcare systems.</jats:p></jats:sec>
Scopus© Citations 1 1
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SARS-CoV-2 Infection Risk by Vaccine Doses and Prior Infections Over 24 Months: ProHEpiC-19 Longitudinal Study
(JMIR Publications Inc., 2024-11-22)
Pere Torán-Monserrat
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Noemí Lamonja-Vicente
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Anna Costa-Garrido
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Lucía A Carrasco-Ribelles
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Bibiana Quirant
<jats:title>Abstract</jats:title> <jats:sec sec-type="background"> <jats:title>Background</jats:title> <jats:p>As the vaccination campaign against COVID-19 progresses, it becomes crucial to comprehend the lasting effects of vaccination on safeguarding against new infections or reinfections.</jats:p> </jats:sec> <jats:sec sec-type="objective"> <jats:title>Objective</jats:title> <jats:p>This study aimed to assess the risk of new SARS-CoV-2 infections based on the number of vaccine doses, prior infections, and other clinical characteristics.</jats:p> </jats:sec> <jats:sec sec-type="methods"> <jats:title>Methods</jats:title> <jats:p>We defined a cohort of 800 health care workers in a 24-month study (March 2020 to December 2022) in northern Barcelona to determine new infections by SARS-CoV-2. We used extended Cox models, specifically Andersen-Gill (AG) and Prentice-Williams-Peterson, and we examined the risk of new infections. The AG model incorporated variables such as sex, age, job title, number of chronic conditions, vaccine doses, and prior infections. Additionally, 2 Prentice-Williams-Peterson models were adjusted, one for those individuals with no or 1 infection and another for those with 2 or 3 infections, both with the same covariates as the AG model.</jats:p> </jats:sec> <jats:sec sec-type="results"> <jats:title>Results</jats:title> <jats:p>The 800 participants (n=605, 75.6% women) received 1, 2, 3, and 4 doses of the vaccine. Compared to those who were unvaccinated, the number of vaccine doses significantly reduced (<jats:italic>P</jats:italic><.001) the risk of infection by 66%, 81%, 89%, and 99%, respectively. Unit increase in the number of prior infections reduced the risk of infection by 75% (<jats:italic>P</jats:italic><.001). When separating individuals by number of previous infections, risk was significantly reduced for those with no or 1 infection by 61% (<jats:italic>P</jats:italic>=.02), and by 88%, 93%, and 99% (<jats:italic>P</jats:italic><.001) with 1, 2, 3, or 4 doses, respectively. In contrast, for those with 2 or 3 previous infections, the reduction was only significant with the fourth dose, at 98% (<jats:italic>P</jats:italic><.001). The number of chronic diseases only increased the risk by 28%‐31% (<jats:italic>P</jats:italic><.001) for individuals with 0‐1 previous infections.</jats:p> </jats:sec> <jats:sec sec-type="conclusions"> <jats:title>Conclusions</jats:title> <jats:p>The study suggests that both prior infections and vaccination status significantly contribute to SARS-CoV-2 immunity, supporting vaccine effectiveness in reducing risk of reinfection for up to 24 months after follow-up from the onset of the pandemic. These insights contribute to our understanding of long-term immunity dynamics and inform strategies for mitigating the impact of COVID-19.</jats:p> </jats:sec>
Scopus© Citations 1 2
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“Hasta que me embaracé no conocí matrona”: salud sexual y reproductiva de jóvenes mujeres mapuche, Chile
(FapUNIFESP (SciELO), 2024)
CARREÑO CALDERON, ALEJANDRA ANGELICA
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OBACH KING, ALEXANDRA ALICE
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Correa-Matus, Eliana
<jats:p>Resumen Este estudio pretende explorar la prevención y promoción de salud sexual y reproductiva en jóvenes mapuche de entre 18 y 24 años, indagando en las relaciones que establecen con el sistema de salud biomédico y en los desafíos para la inclusión de la interculturalidad en las prestaciones dirigidas a esta población. Se trata de una investigación cualitativa de estudio de caso. Se aplicaron 32 entrevistas en profundidad a jóvenes mapuche de sectores rurales y urbanos de la región de la Araucanía, Chile. Se identifica la persistencia un abordaje sanitario que carece de herramientas interculturales y de enfoque de derechos sexuales y reproductivos. Las jóvenes reportan falta de acceso a educación sexual tanto por la distancia que establecen con los servicios biomédicos de atención primaria como por las dificultades de hablar de sexualidad con los adultos de sus comunidades. Se concluye que persisten inequidades en el derecho a la salud sexual y reproductiva de jóvenes indígenas, especialmente en mujeres. Es necesario incorporar el enfoque intercultural y de derechos en la formulación de políticas públicas para esta población. Tales intervenciones requieren ser diseñadas e implementadas involucrando tanto a la población joven como a los agentes de salud de sus comunidades de origen.</jats:p>
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