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    The path of Chile towards the institutionalisation of evidence-based health policy
    (BMJ, 2025-03-20)
    Paula García-Celedón
    ;
    Deborah Navarro-Rosenblatt
    ;
    Carolina Ibarra-Castillo
    ;
    Lucy Kuhn-Barrientos
    ;
    Cristián Mansilla
      3
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    A snapshot of cancer in Chile II: an update on research, strategies and analytical frameworks for equity, innovation and national development
    (Springer Science and Business Media LLC, 2024-12-18)
    Cristóbal Vacarezza
    ;
    Julieta Araneda
    ;
    Pamela Gonzalez
    ;
    Oscar Arteaga
    ;
    Katherine Marcelain
    <jats:title>Abstract</jats:title><jats:sec> <jats:title>Introduction</jats:title> <jats:p>Chile has achieved developed nation status and boasts a life expectancy of 81 + years; however, the healthcare and research systems are unprepared for the social and economic burden of cancer. One decade ago, the authors put forward a comprehensive analysis of cancer infrastructure, together with a series of suggestions on research orientated political policy.</jats:p> </jats:sec><jats:sec> <jats:title>Objectives</jats:title> <jats:p>Provide an update and comment on policy, infrastructure, gender equality, stakeholder participation and new challenges in national oncology. Assess the funding and distribution of cancer investigation. Present actions for the development of oncology research, innovation and patient care.</jats:p> </jats:sec><jats:sec> <jats:title>Methods</jats:title> <jats:p>Triangulating objective system metrics of economic, epidemiological, private and public sector resources together with policy analysis, we assessed cancer burden, infrastructure, and investigation. We analyzed governmental and private-sector cancer databases, complemented by interviews with cancer stakeholders.</jats:p> </jats:sec><jats:sec> <jats:title>Results</jats:title> <jats:p>Governmental policy and patient advocacy have led to the recognition of cancer burden, a cancer law, and a national cancer plan. Cancer has become the leading cause of death in Chile (59,876 cases and 31,440 cancer deaths in 2022), yet only 0.36% gross domestic product (GDP) is directed to research and development. Inequalities in treatment regimens persist. Prevention policy has lowered tobacco consumption, sugar intake via soft drinks and offered a high coverage of HPV vaccines. A high-quality cancer research community is expanding, and internationally sponsored clinical oncology trials are increasing.</jats:p> </jats:sec><jats:sec> <jats:title>Conclusions</jats:title> <jats:p>The cancer law has facilitated advancement in policy. Prevention policies have impacted tobacco and sugar intake, while gender equality and care inequality have entered the public forum. Cancer research is stagnated by the lack of investment. Implementation of a cancer registry and biobanking, reinforcement of prevention strategies, development of human resources, promotion of clinical trial infrastructure and investment in new technologies must be placed as a priority to permit advancements in innovation and equitable cancer care.</jats:p> </jats:sec>
      8
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    Scopus© Citations 6  5
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      1Scopus© Citations 22
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      13
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    Adaptation Strategies of Multinational Corporations, State-Owned Enterprises, and Domestic Business Groups to Economic and Political Transitions: A Network Analysis of the Chilean Telecommunications Sector, 1958–2005
    (2014)
    Marcelo Bucheli
    ;
    SALVAJ CARRERA, ERICA HELENA  
    <jats:p>This paper compares the corporate network strategies between multinational corporations of two different origins (United States and Spain), business groups, and state-owned enterprises in the public utility sector of a developing country going through economic and political transitions. The transitions we consider are from an import substitution industrialization model to an open market economy and from a democratic regime to a dictatorial one and back to democracy. We analyze the Chilean telecommunications sector between 1958 and 2005 and find that during a democratic regime all firms sought to build more networks with each other, while incentives decrease under an authoritarian regime. In the protectionist era, US investors built links with Chile’s corporate elite, while in times of an open economy, Spanish investors built these links with the government. State-owned corporations did not attempt to build links with other actors at any time, and business groups sought to build most networks among members of the group. Our findings challenge two commonly held assumptions: first, that open economies decrease incentives for domestic actors to build links with each other and, second, that close political regimes increase incentives to build networks among economic actors.</jats:p>
    Scopus© Citations 20  1
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    Status and Trends of Physical Activity Surveillance, Policy, and Research in 164 Countries: Findings From the Global Observatory for Physical Activity—GoPA! 2015 and 2020 Surveys
    (2023)
    Andrea Ramírez Varela
    ;
    Pedro C. Hallal
    ;
    Juliana Mejía Grueso
    ;
    Željko Pedišić
    ;
    Deborah Salvo
    <jats:p><jats:italic><jats:bold>Background</jats:bold>:</jats:italic> Physical activity (PA) surveillance, policy, and research efforts need to be periodically appraised to gain insight into national and global capacities for PA promotion. The aim of this paper was to assess the status and trends in PA surveillance, policy, and research in 164 countries. <jats:italic><jats:bold>Methods</jats:bold>:</jats:italic> We used data from the Global Observatory for Physical Activity (GoPA!) 2015 and 2020 surveys. Comprehensive searches were performed for each country to determine the level of development of their PA surveillance, policy, and research, and the findings were verified by the GoPA! Country Contacts. Trends were analyzed based on the data available for both survey years. <jats:italic><jats:bold>Results</jats:bold>:</jats:italic> The global 5-year progress in all 3 indicators was modest, with most countries either improving or staying at the same level. PA surveillance, policy, and research improved or remained at a high level in 48.1%, 40.6%, and 42.1% of the countries, respectively. PA surveillance, policy, and research scores decreased or remained at a low level in 8.3%, 15.8%, and 28.6% of the countries, respectively. The highest capacity for PA promotion was found in Europe, the lowest in Africa and low- and lower-middle-income countries. Although a large percentage of the world’s population benefit from at least some PA policy, surveillance, and research efforts in their countries, 49.6 million people are without PA surveillance, 629.4 million people are without PA policy, and 108.7 million live in countries without any PA research output. A total of 6.3 billion people or 88.2% of the world’s population live in countries where PA promotion capacity should be significantly improved. <jats:italic><jats:bold>Conclusion</jats:bold>:</jats:italic> Despite PA is essential for health, there are large inequalities between countries and world regions in their capacity to promote PA. Coordinated efforts are needed to reduce the inequalities and improve the global capacity for PA promotion.</jats:p>
      1  2Scopus© Citations 46
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    The Work, Economic, and Remittance Stress and Distress of the COVID-19 Pandemic Containment Policies: The Case of Venezuelan Migrants in Argentina and Chile
    (2023)
    Deisy Del Real
    ;
    Felipe Crowhurst-Pons
    ;
    Lizeth Olave
    <jats:p>According to the social stress process model, global crises are macro-level stressors that generate physiological stress and psychological distress. However, existing research has not identified immigrants’ COVID-19 containment policy stressors or examined the social stress of sending remittances amid crises. Drawing on in-depth longitudinal interviews with 46 Venezuelan immigrants—half before and half during the pandemic—in Chile and Argentina, we identified the COVID-19 containment policies’ stressors. We focused on Venezuelan immigrants because they constitute one of the largest internationally displaced populations, with most migrating within South America. We found that the governmental COVID-19 containment measures in both countries generated four stressors: employment loss, income loss, devaluation of employment status, and inability to send needed remittances. Moreover, sending remittances helped some migrants cope with concerns about loved ones in Venezuela. However, sending remittances became a social stressor when immigrants struggled to simultaneously sustain their livelihoods and send financial support to relatives experiencing hardships in Venezuela. For some immigrants, these adversities generated other stressors (e.g., housing instability) and symptoms of anxiety and depression. Broadly, for immigrants, the stressors of global crises transcend international borders and generate high stress, which strains their psychological well-being.</jats:p>
      2Scopus© Citations 9
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    Breaking Down Barriers: Findings from a Literature Review on Housing for People with Disabilities in Latin America
    (2023)
    VALDERRAMA ULLOA, CLAUDIA ALEJANDRA  
    ;
    FERRADA CALVO, XIMENA VERÓNICA  
    ;
    Felipe Herrera
    Accessibility to housing is crucial for people with disabilities as it provides them with equal opportunities and allows them to live independently. A systematic literature review has been conducted to understand the current research on accessibility in housing for people with disabilities in Latin America. The study analysed 56 papers and used co-word analysis to identify common themes and topics within the documents. The results of the analysis showed that Brazil (61%) is the country with the most research on the subject, physical disability, at 36%, is the impairment most analysed, and interventions or analysis for the older people (45%) in their homes is the most researched type of population. The co-word analysis revealed that topics such as policy, regulations, the use of technologies, ergonomics interventions, and architectural criteria or barriers to the daily life of disabled people were frequently discussed in the papers. Although this work shows a substantial and growing increase in research on housing for people with disabilities in Latin America, it also demonstrates the importance of increasing research on other types of impairment, such as visual and cognitive-intellectual disabilities, and including children, caregivers, or even young adults.
    Scopus© Citations 3  9
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    A multinational Delphi consensus to end the COVID-19 public health threat
    (2022)
    Jeffrey V. Lazarus
    ;
    Diana Romero
    ;
    Christopher J. Kopka
    ;
    Salim Abdool Karim
    ;
    Laith J. Abu-Raddad
    <jats:title>Abstract</jats:title><jats:p>Despite notable scientific and medical advances, broader political, socioeconomic and behavioural factors continue to undercut the response to the COVID-19 pandemic<jats:sup>1,2</jats:sup>. Here we convened, as part of this Delphi study, a diverse, multidisciplinary panel of 386 academic, health, non-governmental organization, government and other experts in COVID-19 response from 112 countries and territories to recommend specific actions to end this persistent global threat to public health. The panel developed a set of 41 consensus statements and 57 recommendations to governments, health systems, industry and other key stakeholders across six domains: communication; health systems; vaccination; prevention; treatment and care; and inequities. In the wake of nearly three years of fragmented global and national responses, it is instructive to note that three of the highest-ranked recommendations call for the adoption of whole-of-society and whole-of-government approaches<jats:sup>1</jats:sup>, while maintaining proven prevention measures using a vaccines-plus approach<jats:sup>2</jats:sup> that employs a range of public health and financial support measures to complement vaccination. Other recommendations with at least 99% combined agreement advise governments and other stakeholders to improve communication, rebuild public trust and engage communities<jats:sup>3</jats:sup> in the management of pandemic responses. The findings of the study, which have been further endorsed by 184 organizations globally, include points of unanimous agreement, as well as six recommendations with &gt;5% disagreement, that provide health and social policy actions to address inadequacies in the pandemic response and help to bring this public health threat to an end.</jats:p>
      10Scopus© Citations 179