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Author: search.filters.author.Xaviera MolinaSubject: search.filters.subject.human

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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  
    ;
    HIRMAS ADAUY, MACARENA SOLEDAD  
    ;
    APABLAZA SALINAS, MAURICIO IVÁN  
    ;
    Camila Awad
    ;
    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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      10
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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
    ;
    Noemí Lamonja-Vicente
    ;
    Anna Costa-Garrido
    ;
    Lucía A Carrasco-Ribelles
    ;
    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>&lt;.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>&lt;.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>&lt;.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>&lt;.001). The number of chronic diseases only increased the risk by 28%‐31% (<jats:italic>P</jats:italic>&lt;.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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    Preventive behaviors for COVID-19 in Chile: Lessons from a population follow-up for 2021 and 2022
    (2024)
    RUBILAR RAMIREZ, PAOLA ANDREA  
    ;
    Loreto Núñez-Franz
    ;
    APABLAZA SALINAS, MAURICIO IVÁN  
    ;
    Muriel Ramírez-Santana
    ;
    Xaviera Molina
    <jats:p>Introduction The rapid emergence of COVID-19 urged policy responses worldwide, focusing on vaccination and mobility restrictions. Chile represents a unique scenario for analyzing personal preventive measures amid intensive communication and vaccination campaigns. This study aims to explore changes in population adherence to non-pharmacological preventive measures during the pandemic and the factors that explain this adherence each year. Methods 386 individuals who participated in two population-based studies (2021 and 2022) were considered. An interview was conducted to measure adherence to self-care practices, and case and contact tracing by the health authorities. The Wilcoxon signed-rank test was performed to measure change between 2021 and 2022, bivariate analysis, and a linear regression model for each year were performed. Results Mask-wearing in public places was the most commonly used measure (95.9% in 2021, 89.9% in 2022). Follow-up of cases and cases contacts by the health authority had high coverage in 2021 (94.3% and 83% respectively). A greater decrease was observed in contact tracing in 2022 totaling 33.3%. An increase in the score of adherence to preventive practices was observed in 2022 (p &lt; 0.00). The regression model showed in 2021 that women were more likely to adopt preventive behaviors (95% confidence interval: 0.27 to 1.13) and the overweight/obese had higher adherence compared to normal body mass index (95% confidence interval: 0.06 to 0.98). In 2022 being a young adult (30 to 49 years) predicted the adoption of behavioral precautions (95% confidence interval: 0.00 to 1.32). Conclusions Adherence to preventive measures increased even with high vaccination coverage, likely due to the epidemiological situation with the Omicron variant circulating in 2022.</jats:p>
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    Consumo de tabaco en pacientes hospitalizados en Clínica Alemana de Santiago de Chile
    (2023)
    Xaviera Molina
    ;
    Mauricio Fernández
    ;
    Óscar Urrejola
    ;
    Karen Czichke
    ;
    Marcela Gómez
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      5Scopus© Citations 2
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    Compliance with the smoking ban in enclosed, semiopen and open areas of workplaces and public places in Chile
    (2020)
    PERUGA URREA, ARMANDO  
    ;
    Xaviera Molina
    ;
    DELGADO BECERRA, OROZIMBA IRIS  
    ;
    MATUTE WILLEMSEM, MARIA ISABEL  
    ;
    OLEA NORMANDIN, ANDREA MARIA  
    <jats:sec><jats:title>Objective</jats:title><jats:p>To assess the national level of compliance with the Chilean comprehensive smoke-free legislation by observing healthcare facilities, education centres, government offices, hospitality venues and private workplaces, by type of area within workplaces and public places: enclosed, semiopen and open.</jats:p></jats:sec><jats:sec><jats:title>Methodology</jats:title><jats:p>In this cross-sectional observational study, we studied a national representative sample of 3253 venues obtained through a two-stage cluster sampling design. First, 57 municipalities were randomly selected, proportionally to the total number of venues of interest. Second, within each selected municipality, a maximum of 12 venues of each sector was selected systematically from a list of existing sites. We determined the non-compliance level by estimating the percentage of the visited venues where smoking was observed or suspected in banned areas of the premises.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Smoking or suspicion thereof was not observed in any enclosed area of any establishment. However, smoking violations were observed in semiopen areas ranging from less than 0.5% of schools and healthcare centres to around 10% of hospitality venues or 23.0% of higher education centres. Smoking violations were also observed in outdoor areas of 6.7% and 1.6% of the health centres and schools, respectively.</jats:p></jats:sec><jats:sec><jats:title>Discussion</jats:title><jats:p>The stark contrast in compliance with the smoking ban between the enclosed areas and the semiopen areas may be a consequence of the complex definition of semiopen areas in the regulations. The study also reflects the need to improve the overall enforcement of the smoke-free law, particularly in universities and hospitality venues.</jats:p></jats:sec>
    Scopus© Citations 6  1
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    Barriers and Facilitators in Access to Diabetes, Hypertension, and Dyslipidemia Medicines: A Scoping Review
    (2022)
    CASTILLO LABORDE, CARLA CECILIA  
    ;
    Macarena Hirmas-Adauy  
    ;
    MATUTE WILLEMSEM, MARIA ISABEL  
    ;
    Anita Jasmen
    ;
    Oscar Urrejola
    <jats:p><jats:bold>Objective:</jats:bold> Identify barriers and facilitators in access to medicines for diabetes, hypertension, and dyslipidemia, considering patient, health provider, and health system perspectives.</jats:p><jats:p><jats:bold>Methods:</jats:bold> Scoping review based on Joanna Briggs methodology. The search considered PubMed, Cochrane Library, CINAHL, Academic Search Ultimate, Web of Science, SciELO Citation Index, and grey literature. Two researchers conducted screening and eligibility phases. Data were thematically analyzed.</jats:p><jats:p><jats:bold>Results:</jats:bold> The review included 219 documents. Diabetes was the most studied condition; most of the evidence comes from patients and the United States. Affordability and availability of medicines were the most reported dimension and specific barrier respectively, both cross-cutting concerns. Among high- and middle-income countries, identified barriers were cost of medicines, accompaniment by professionals, long distances to facilities, and cultural aspects; cost of transportation emerges in low-income settings. Facilitators reported were financial accessibility, trained health workers, medicines closer to communities, and patients’ education.</jats:p><jats:p><jats:bold>Conclusion:</jats:bold> Barriers and facilitators are determined by socioeconomic and cultural conditions, highlighting the role of health systems in regulatory and policy context (assuring financial coverage and free medicines); providers’ role bringing medicines closer; and patients’ health education and disease management.</jats:p>
    Scopus© Citations 12  1
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    La oportunidad de incorporar el bienestar subjetivo en la protección de la infancia y adolescencia en Chile
    (2020)
    CABIESES VALDES, BALTICA BEATRIZ  
    ;
    Xaviera Molina
    ;
    OBACH KING, ALEXANDRA ALICE  
    <jats:p>Los niños, niñas y adolescentes (NNA) representan a un cuarto de la población chilena, sobre la cual en términos de protección el país se ha enfocado en la promoción de igualdad de oportunidad de derechos en base a convenciones internacionales. Sin embargo, aún los NNA siguen muriendo por causas prevenibles y modificables, además de experimentar importantes grados de vulnerabilidad, situación que repercute en complejos efectos emocionales y cognitivos a lo largo de su ciclo vital. Según la evidencia internacional el bienestar de los NNA va directamente relacionado con los índices de desigualdad social, valorando el bienestar como un componente esencial y transversal a los derechos de los NNA del país. En Chile, el bienestar subjetivo se define como las percepciones de los NNA respecto de sus condiciones vitales -tanto en el aspecto económico, como social, cultural, de salud y logros personales. Este concepto se ha estudiado a través de diferentes instrumentos los cuales podrían ser de gran utilidad para promover el componente psicosocial y calidad de vida de los NNA en las estrategias y políticas nacionales en esta población. En esta revision se propone integrar de manera explícita en las políticas públicas de la infancia y adolescencia el concepto de bienestar subjetivo, con el fin de entregar oportunidades justas, positivas y sistemáticas para el máximo desarrollo de los NNA en su ciclo vital, validando empíricamente las condiciones necesarias del buen vivir basado en un enfoque moderno de derechos humanos al cual el país se ha comprometido.</jats:p>
    Scopus© Citations 7  1