CRIS

Permanent URI for this communityhttps://investigadores.udd.cl/handle/123456789/1

Browse

Search Results

Now showing 1 - 10 of 17

Some of the metrics are blocked by your
consent settings
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
;
OBACH KING, ALEXANDRA ALICE
;
Antonia Roberts
;
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.
1
Some of the metrics are blocked by your
consent settings
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><.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
Some of the metrics are blocked by your
consent settings
Immigrant health workers in Chile: is there a Latin American "brain drain"?
(2012)
CABIESES VALDES, BALTICA BEATRIZ
;
Helena Tunstall
Scopus© Citations 6 1
Some of the metrics are blocked by your
consent settings
Where culture meets genetics: Exploring Latina immigrants’ lay beliefs of disease inheritance
(2021)
Katie Fiallos
;
Jill Owczarzak
;
Joann Bodurtha
;
Sonia Beatriz Margarit
;
Lori Erby
4Scopus© Citations 9
Some of the metrics are blocked by your
consent settings
Longitudinal assessment of SARS-CoV-2 IgG seroconversionamong front-line healthcare workers during the first wave of the Covid-19 pandemic at a tertiary-care hospital in Chile
(2021)
IRURETAGOYENA BRUCE, MIRENTXU INES
;
Macarena R. Vial
;
Maria Spencer-Sandino
;
Pablo Gaete
;
Anne Peters
<jats:title>Abstract</jats:title><jats:sec> <jats:title>Background</jats:title> <jats:p>Healthcare workers (HCWs) are at high risk of exposure to SARS-CoV-2. Cross-sectional studies have provided variable rates of seroprevalence in HCWs. Longitudinal assessments of the serological response to Covid-19 among HCWs are crucial to understanding the risk of infection and changes in antibody titers over time. We aimed to investigate seroprevalence and risk factors associated with seroconversion in a prospective cohort of HCWs during the peak of the first wave of the Covid-19 pandemic.</jats:p> </jats:sec><jats:sec> <jats:title>Methods</jats:title> <jats:p>We conducted a longitudinal study among 446 front-line HCWsin a tertiary-care hospital in Chile from April to July 2020. IgG was determined monthly using two different ELISAs in serum samples of HCWs, during the three-month period. In each visit, demographic data, symptoms, risk factors, and exposure risks were also assessed.</jats:p> </jats:sec><jats:sec> <jats:title>Results</jats:title> <jats:p>The overall seroprevalence at the end of the study period was 24% (95% CI20.2–28.3), with 43% of seropositive HCWs reporting no prior symptoms. Seroconversion rates significantly differed over the study period, from 2.1% to as high as 8.8% at the peak of the epidemic. There were no statistically significant differences observed between HCWs in direct clinical care of patients with Covid-19 and those working in low risk areas. Antibody titers appeared to wane over time.</jats:p> </jats:sec><jats:sec> <jats:title>Conclusions</jats:title> <jats:p>HCWs were severely affected with a high rate of seroconversion that appeared to mirror the local epidemiological situation. A significant amount of participants underwent an asymptomatic infection, highlighting the need for improved surveillance policies. Antibody titers appear to wane over time; further studies to understand this finding’s impact on the risk of reinfection are warranted.</jats:p> </jats:sec>
1Scopus© Citations 21 2
Some of the metrics are blocked by your
consent settings
Experiences and well-being of healthcare professionals working in the field of ultrasound in obstetrics and gynaecology as the SARS-CoV-2 pandemic were evolving: a cross-sectional survey study
(2022)
Tom Bourne
;
Christopher Kyriacou
;
Harsha Shah
;
Jolien Ceusters
;
Jessica Preisler
<jats:sec><jats:title>Objective</jats:title><jats:p>Assess experience of healthcare professionals (HCPs) working with ultrasound in obstetrics and gynaecology during the evolving SARS-CoV-2 pandemic, given the new and unprecedented challenges involving viral exposure, personal protective equipment (PPE) and well-being.</jats:p></jats:sec><jats:sec><jats:title>Design</jats:title><jats:p>Prospective cross-sectional survey study.</jats:p></jats:sec><jats:sec><jats:title>Setting</jats:title><jats:p>Online international survey. Single-best, open box and Hospital Anxiety and Depression Scale (HADS) questions.</jats:p></jats:sec><jats:sec><jats:title>Participants</jats:title><jats:p>The survey was sent to 35 509 HCPs in 124 countries and was open from 7 to 21 May 2020. 2237/3237 (69.1%) HCPs from 115 countries who consented to participate completed the survey. 1058 (47.3%) completed the HADS.</jats:p></jats:sec><jats:sec><jats:title>Primary outcome measures</jats:title><jats:p>Overall prevalence of SARS-CoV-2, depression and anxiety among HCPs in relation to country and PPE availability.</jats:p></jats:sec><jats:sec><jats:title>Analyses</jats:title><jats:p>Univariate analyses were used to investigate associations without generating erroneous causal conclusions.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Confirmed/suspected SARS-CoV-2 prevalence was 13.0%. PPE provision concerns were raised by 74.1% of participants; highest among trainees/resident physicians (83.9%) and among HCPs in Spain (89.7%). Most participants worked in self-perceived high-risk areas with SARS-CoV-2 (67.5%–87.0%), with proportionately more trainees interacting with suspected/confirmed infected patients (57.1% vs 24.2%–40.6%) and sonographers seeing more patients who did not wear a mask (33.3% vs 13.9%–7.9%). The most frequent PPE combination used was gloves and a surgical mask (22.3%). UK and US respondents reported spending less time self-isolating (8.8 days) and lower satisfaction with their national pandemic response (37.0%–43.0%). 19.8% and 8.8% of respondents met the criteria for moderate to severe anxiety and depression, respectively.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Reported prevalence of SARS-CoV-2 in HCPs is consistent with literature findings. Most respondents used gloves and a surgical mask, with a greater SARS-CoV-2 prevalence compared with those using ‘full’ PPE. HCPs with the least agency (trainees and sonographers) were not only more likely to see high-risk patients but also less likely to be protected. A fifth of respondents reported moderate to severe anxiety.</jats:p></jats:sec>
11Scopus© Citations 2
Some of the metrics are blocked by your
consent settings
International perspective on healthcare provider gender bias in musculoskeletal pain management: a scoping review protocol
(2022)
Katherine Fisher Wilford
;
Maria Jesus Mena-Iturriaga
;
Margaret Vugrin
;
Macarena Wainer
;
Phillip S Sizer
<jats:sec><jats:title>Introduction</jats:title><jats:p>Chronic pain affects millions of individuals worldwide. Healthcare provider gender bias in the management of these individuals has societal and individual ramifications. Yet, a thorough and comprehensive literature summary on this topic is lacking. Therefore, this study aims to systematically: (1) identify and map the available scientific and grey literature as it relates to healthcare provider gender bias in the assessment, diagnosis and management of (chronic) musculoskeletal pain and (2) identify current gaps that necessitate further research.</jats:p></jats:sec><jats:sec><jats:title>Methods and analysis</jats:title><jats:p>This scoping review will be conducted in accordance with recent guidelines, and the results will be reported via the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. The following databases will be searched: PubMed (National Library of Medicine), Embase (Elsevier), Scopus (Elsevier), CINAHL Complete (Ovid), Academic Search Complete (Ebscohost), Pre-Prints Database (National Library of Medicine) and Rehabilitation Reference Center from inception to August 2022. Additionally, relevant grey literature will be identified. All screening will be done by two independent reviewers during two stages: first title/abstract screening followed by full-text screening. Data will be extracted from the bibliometric, study characteristics, and pain science families of variables. Results will be descriptively mapped, and the frequency of concepts, population, characteristics and other details will be narratively reported. Additionally, results will be presented in tabular and graphical form.</jats:p></jats:sec><jats:sec><jats:title>Ethics and dissemination</jats:title><jats:p>As this study will neither involve human subject participation nor utilisation of protected data, ethical approval is not required. This study’s methodological approach follows current recommendations. Study findings will be disseminated through conference presentations and international peer-review journal publication. In addition, infographics available in English, Spanish and German will be disseminated.</jats:p></jats:sec><jats:sec><jats:title>Registration details</jats:title><jats:p>This project will be registered in Open Science Framework prior to data collection.</jats:p></jats:sec>
17Scopus© Citations 1
Some of the metrics are blocked by your
consent settings
How Do Health Teams Perceive International Migrant Users of Primary Care?
(2022)
Consuelo Cruz-Riveros
;
Alfonso Urzúa
;
Gustavo Macaya-Aguirre
;
CABIESES VALDES, BALTICA BEATRIZ
<jats:p>The following study aims to describe the perception of international migrants who use the primary level of care by health personnel and to explore how this perception can affect the care process in the commune of Antofagasta, north of Chile. Methodology: The methodology was qualitative using a phenomenological descriptive design, through which the discourses of the health personnel of three primary health care centers (n = 14) were explored. Results: The participants presented two thematic categories. The first one related to experiences during delivery of care to migrants and included perceptions and beliefs, factors associated with using services, and reasons for consultation. The second category related to stereotypes towards migrants, including prejudices, beliefs about their lives and reasons for migration. Conclusions: The therapeutic relationship with migrants in primary care depends on the health care personnel’s acceptability of this population, hence, allowing the delivery of care based on respect for their culture and rights.</jats:p>
5Scopus© Citations 5
Some of the metrics are blocked by your
consent settings
Perceptions of Health Needs among Venezuelan Women Crossing the Border in Northern Chile during the COVID-19 Pandemic
(2022)
Alice Blukacz
;
CARREÑO CALDERON, ALEJANDRA ANGELICA
;
OBACH KING, ALEXANDRA ALICE
;
CABIESES VALDES, BALTICA BEATRIZ
;
Jeniffer Peroncini
<jats:p>In parallel to the COVID-19 pandemic, Chile has experienced a significant influx of international migrants, many of whom are Venezuelan women who have entered the country through unauthorized crossing points. In this context, gender and migration intersect as the social determinants of health, leading to their experiencing a range of adverse events. This poses important challenges in terms of short- and long-term health outcomes, the social determinants of health, and access to healthcare. This study aims at describing Venezuelan women’s perceptions of their health needs as they migrate to Chile via an unauthorized crossing point, with a focus on adverse events throughout the migration cycle, self-reported health needs, and responses. A qualitative case study was carried out with 22 participants in the Antofagasta region of Chile, including Venezuelan migrant women, healthcare professionals, and social workers from the public healthcare system, stakeholders from non-governmental and international organizations, and local government officials. The semi-structured, individual interviews were analyzed thematically. The results show that Venezuelan women face a range of adverse events throughout the migration cycle. The perceived health needs that are reported are sometimes linked to these adverse events or existed prior to migration and were exacerbated throughout the migratory cycle. Addressing these physical and mental health needs is essential for short- and long-term individual and public health; however, despite substantial efforts to ameliorate the situation, persisting gaps in access to care are reported.</jats:p>
16Scopus© Citations 11
Some of the metrics are blocked by your
consent settings
Discrepancies in infant feeding recommendations between grandmothers and healthcare providers in rural Mexico
(2022)
Paulina Luna
;
Nerli Paredes-Ruvalcaba
;
Tania Valdes
;
Barbara Guerrero
;
Angélica García-Martínez
<jats:title>Abstract</jats:title><jats:sec> <jats:title>Background</jats:title> <jats:p>Infant feeding practices are rapidly changing within rural areas in Mexico, including indigenous communities. The aim of this study was to compare infant feeding recommendations between grandmothers and healthcare providers, to better understand the factors that may influence these practices within these communities. This study builds on research that recognizes the legacy of colonization as an ongoing process that impacts the lives of people through many pathways, including the substandard healthcare systems available to them.</jats:p> </jats:sec><jats:sec> <jats:title>Methods</jats:title> <jats:p>Qualitative study based on secondary data analysis from interviews and focus groups guided by a socioecological framework conducted in 2018 in two rural, Indigenous communities in Central Mexico. Participants were purposively selected mothers (<jats:italic>n</jats:italic> = 25), grandmothers (<jats:italic>n</jats:italic> = 11), and healthcare providers (<jats:italic>n</jats:italic> = 24) who offered care to children up to two years of age and/or their mothers. Data were coded and thematically analyzed to contrast the different perspectives of infant feeding recommendations and practices between mother, grandmothers, and healthcare providers.</jats:p> </jats:sec><jats:sec> <jats:title>Results</jats:title> <jats:p>Grandmothers and healthcare providers differed in their beliefs regarding appropriate timing to introduce non-milk foods and duration of breastfeeding. Compared to grandmothers, healthcare providers tended to believe that their recommendations were superior to those from people in the communities and expressed stereotypes reflected in negative attitudes towards mothers who did not follow their recommendations. Grandmothers often passed down advice from previous generations and their own experiences with infant feeding but were also open to learning from healthcare providers through government programs and sharing their knowledge with their daughters and other women. Given the contradictory recommendations from grandmothers and healthcare providers, mothers often were unsure which advice to follow.</jats:p> </jats:sec><jats:sec> <jats:title>Conclusions</jats:title> <jats:p>There are important differences between grandmothers and healthcare providers regarding infant feeding recommendations. Healthcare providers may perceive their recommendations as superior given the neocolonial structures of the medical system. Public health policies are needed to address the different recommendations mothers receive from different sources, by harmonizing them and following an evidence-informed approach. Breastfeeding programs need to value and to seek the participation of grandmothers.</jats:p> </jats:sec>
Scopus© Citations 2 2

CRIS

Browse

Filters

Settings

Sort By

Results per page

Search Results