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Objectives: The Chilean health system mandates providers to ensure assistance under a guaranteed system, the Explicit Guarantees in Healthcare (EGH) program. The Health Ministry has developed clinical practice guidelines (CPGs), but independent assessment of their quality is lacking., Study Design and Setting: We assessed all CPGs of the EGH program using Appraisal of Guidelines for Research & Evaluation II (AGREE II) tool for appraising quality, validity period, and last update., Results: Eighty-six CPGs were published between 2005 and 2016. Only 15 (17.4%) were updated. The overall mean raw score was 4.18 (±0.98). The scaled scores for each domain were: Scope and objectives 79.7%, Stakeholder involvement 46.2%, Rigor of development 36.3%, Clarity of presentation 82.8%, Applicability 23.5%, and Editorial independence 39.2%. The highest items were: overall objectives described, population described, options for management clearly presented, and key recommendations easily identifiable. The worst evaluated items were: views and preferences of the target population, strengths and limitations of the body of evidence, methods for formulating the recommendations, external review by experts, and description of facilitators and barriers to application., Conclusion: Most Chilean CPGs included in the EGH program are outdated and show items that should be improved, mainly through a more rigorous methodology, the inclusion of patients in its development, and appropriate consideration of its applicability., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Caging experiments were conducted using hatchery-reared, immature, female rainbow trout (Oncorhynchus mykiss) in three previously defined areas of the Biobio River (south central Chile) representing a pollution gradient from the pulp and paper mill discharges area: a pre-impact area (upstream area, reference location), an impact area (area directly influenced), and a postimpact area (downstream area, less influenced). No significant changes were observed in the physiological index as represented by condition factor (K) and liver somatic index during different sampling times (after 11, 21, and 30 d of exposure). Ethoxyresorufin-O-deethylase activities were significantly higher in trout caged at the impact and postimpact discharges areas (two- to fourfold) compared with the reference (pre-impact) area, and a strong inhibition of acetylcholinesterase activity, reaching 50%, was observed mainly in fish caged at the impact area. A significant endocrine-disrupting effect (reproductive level) was evidenced by significant increments in gonad somatic index and plasma vitellogenin levels combined with an induction of gonad maturation (presence of vitellogenic oocytes) in trout caged at the impact and postimpact areas. These results, generated by an in situ approach, confirmed our group's findings for trout exposed to sediment in the laboratory: discharges of pulp mill effluent in the Biobio River are associated with the effects evaluated at different biological levels.

Bioactive substances in the Biobio River Basin in Chile were examined by deploying Semi Permeable Membrane Devices (SPMDs) upstream and downstream of 4 pulp mill effluent discharges. Androgenic and estrogenic activity of SPMD extracts were then evaluated using in vitro fish sex steroid receptor binding assays. The results indicated the occurrence of estrogenic type compounds associated with one of the mill discharges. A significant correlation among the presence of these compounds, an increase in gonadosomatic index GSI and induction of hepatic EROD activity of two native fish species was observed. However, no significant presence of mature oocytes in female gonads was detected. Although EROD induction was observed in sites impacted by mill effluents, an increase of its activity occurred towards the downstream areas, suggesting other non-mill sources. More research is needed to understand the environmental changes in context of the new technological improvements in treatment systems to MBBR (Moving Bed Biofilm Reactor) recently implemented by the pulp mill industries., (Copyright © 2018 Elsevier Inc. All rights reserved.)

The anchoveta (Engraulis ringens) and sardine (Strangomera bentincki) are coastal pelagic species with important spawning areas off the coast of Chile. The discharge of secondary-treated effluents from a kraft pulp plant near one of these spawning areas has raised environmental concerns. Therefore, effluent effects on the development of anchoveta and sardine eggs were assessed by in vitro exposure. Eggs were sampled between 2007 and 2010 off Talcahuano, Chile. Subsequent toxicity tests (96 h duration, 12 °C) were performed using increasing effluent concentrations, a filtered seawater control, and two potassium dichromate concentrations (to verify consistent embryonic sensitivity). Egg mortality and hatching success were evaluated. For anchoveta, mortality (9.9 ± 7.1%) did not significantly differ among groups in five toxicity tests except the final toxicity test that showed significant differences in mortality (5.6% control vs 27.8% in 100% effluent). For sardines, no differences in mortality existed between the effluent dilutions (2.6 ± 3.6%) and control (6.3 ± 3.9%). Notably, anchoveta egg survival and hatching success rates were inconsistent, i.e., the highest rates of hatching failure occurred on the same sampling date with the highest rates of survival for the 100% effluent group (72%). In conclusion, the obtained results indicate that (i) anchoveta egg mortality and hatching failure increase only under 100% effluent exposure, coinciding with decreased egg quality near the end of spawning season and (ii) high effluent dilutions not significantly increase sardine and anchoveta egg mortalities. Nevertheless, the recorded adverse effects to the hatching process should be studied in greater detail, particularly considering interspecific variability and the complexity of reproductive processes, especially during early development.

Objective: Friction foot blisters are a common injury occurring in up to 39% of marathoners, the most common injury in adventure racing, and represent more than 70% of medical visits in multi-stage ultramarathons. The goal of the study was to determine whether paper tape could prevent foot blisters in ultramarathon runners., Methods: This prospective randomized trial was undertaken during RacingThePlanet 155-mile (250-km), 7-day self-supported ultramarathons in China, Australia, Egypt, Chile, and Nepal in 2010 and 2011. Paper tape was applied prerace to one randomly selected foot, with the untreated foot acting as the own control. The study end point was development of a hot spot or blister on any location of either foot., Results: One hundred thirty-six participants were enrolled with 90 (66%) having completed data for analysis. There were 36% women, with a mean age of 40 ± 9.4 years (range, 25-40 years) and pack weight of 11 ± 1.8 kg (range, 8-16 kg). All participants developed blisters, with 89% occurring by day 2 and 59% located on the toes. No protective effect was observed by the intervention (47 versus 35; 52% versus 39%; P = .22), with fewer blisters occurring around the tape on the experimental foot than under the tape (23 vs 31; 25.6% versus 34.4%), yet 84% of study participants when queried would choose paper tape for blister prevention in the future., Conclusions: Although paper tape was not found to be significantly protective against blisters, the intervention was well tolerated with high user satisfaction., (Copyright © 2014 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.)

We evaluated plasma testosterone (T) and 17beta-estradiol (E2) levels and ovarian aromatase CYP19a gene expression following a single intraperitoneal injection of Chilean pulp and paper mill effluent extracts into juvenile triploid rainbow trout. Fish injected with untreated effluent extracts had increased plasma T after 4 days, while plasma E2 concentration was increased in fish injected with both primary and secondary treated effluent extracts at the same sampling period. Ovarian CYP19a gene expression as measured by qRT-PCR was significantly induced in fish injected with the untreated, primary and secondary treated pulp and paper mill effluent extracts. Similar induction of CYP19a expression was found in fish injected with the androgens androstenedione (ADD) and T. A Principal Component Analysis (PCA) was conducted in order to identify structure in relationships between all measured variables and identifying which factors were most responsible for the variance observed within the plasma steroid levels, upregulation of ovarian CYP19a gene expression and the final estrogenic effect of increased plasma VTG levels. This analysis indicated a cluster correlation between plasma T levels and CYP19a gene expression (Factor 1, explaining 27.2% of total variance), a cluster including condition factor and liver somatic index (Factor 2, explaining 17.3%) and an additional cluster including plasma E2 and vitellogenin levels (Factor 3, explaining an additional 15.8%). The present results indicate that Chilean pulp and paper mill effluent extracts cause estrogenic effects in triploid rainbow trout. These effects could be related to the compounds present in the effluent that act as estrogen receptor agonists, or that induce changes leading to increased amounts of endogenous estrogens, reflected by increased E2 levels and induced aromatase expression/activity., (2010 Elsevier B.V. All rights reserved.)

We aim to estimate school value-added dynamically in time. Our principal motivation for doing so is to establish school effectiveness persistence while taking into account the temporal dependence that typically exists in school performance from one year to the next. We propose two methods of incorporating temporal dependence in value-added models. In the first we model the random school effects that are commonly present in value-added models with an auto-regressive process. In the second approach, we incorporate dependence in value-added estimators by modeling the performance of one cohort based on the previous cohort's performance. An identification analysis allows us to make explicit the meaning of the corresponding value-added indicators: based on these meanings, we show that each model is useful for monitoring specific aspects of school persistence. Furthermore, we carefully detail how value-added can be estimated over time. We show through simulations that ignoring temporal dependence when it exists results in diminished efficiency in value-added estimation while incorporating it results in improved estimation (even when temporal dependence is weak). Finally, we illustrate the methodology by considering two cohorts from Chile's national standardized test in mathematics., (© 2024. The Author(s), under exclusive licence to The Psychometric Society.)

Use of unauthorized synthetic drugs is a serious, forensic, regulatory and public health issue. In this scenario, consumption of drug-impregnated blotters is very frequent. For decades, blotters have been generally impregnated with the potent hallucinogen known as lysergic acid diethylamide (LSD); however, since 2013 blotter stamps with N-2 methoxybenzyl-substituted phenylethylamine hallucinogen designated as "NBOMes" have been seized in Chile. To address this issue with readily accessible laboratory equipment, we have developed and validated a new HPTLC method for the identification and quantitation of 25-C-NBOMe in seized blotters and its confirmation by GC-MS. The proposed method was validated according to SWGTOX recommendations and is suitable for routine analysis of seized blotters containing 25-C-NBOMe. With the validated method, we analyzed 15 real samples, in all cases finding 25-C-NBOMe in a wide dosage range (701.0-1943.5 µg per blotter). In this situation, we can assume that NBOMes are replacing LSD as the main hallucinogenic drug consumed in blotters in Chile., (© The Author 2016. Published by Oxford University Press.)

In this paper, we study the short-term effect of fine particulate matter (PM 2.5) exposure on respiratory emergency room (ER) visits in Chile, a middle-income country with high levels of air pollution. To instrument for PM 2.5, we use wind speed at different altitudes (pressure levels). Unlike previous papers, our data allow us to study the impact of high pollution levels across all age groups. We find that a 1 μg per cubic meter (μg/m 3 ) increase in PM 2.5 exposure for 1 day increases ER visits for respiratory illness by 0.36%. The effect is positive and significant for all age groups. Furthermore, the coefficients on government environmental alerts suggest that avoidance behavior becomes increasingly significant across all age groups as restrictions become more severe., (© 2023 John Wiley & Sons Ltd.)

The quantities of e-waste are expected to increase sharply in Chile. The purpose of this paper is to provide a quantitative data basis on generated e-waste quantities. A material flow analysis was carried out assessing the generation of e-waste from computer equipment (desktop and laptop PCs as well as CRT and LCD-monitors). Import and sales data were collected from the Chilean Customs database as well as from publications by the International Data Corporation. A survey was conducted to determine consumers' choices with respect to storage, re-use and disposal of computer equipment. The generation of e-waste was assessed in a baseline as well as upper and lower scenarios until 2020. The results for the baseline scenario show that about 10,000 and 20,000 tons of computer waste may be generated in the years 2010 and 2020, respectively. The cumulative e-waste generation will be four to five times higher in the upcoming decade (2010-2019) than during the current decade (2000-2009). By 2020, the shares of LCD-monitors and laptops will increase more rapidly replacing other e-waste including the CRT-monitors. The model also shows the principal flows of computer equipment from production and sale to recycling and disposal. The re-use of computer equipment plays an important role in Chile. An appropriate recycling scheme will have to be introduced to provide adequate solutions for the growing rate of e-waste generation., (Copyright 2009 Elsevier Ltd. All rights reserved.)

Background, Aim, and Scope: The Cruces River, which is located in southwest Chile, suffered from dramatic changes after the opening of a large pulp mill in 2004. A large mass mortality of the vegetation occurred. In particular, the Brazilian elodea (Egeria densa), which is the main food source of many water birds in this ecosystem, disappeared. Because of this damage, different investigations took place and the goal of this research was a description of the water quality, including filtrate, suspended matter, and sediment. In this research, inorganic parameters were the main point of interest. Furthermore, finding relations between the sampling sites and the measured parameters by applying chemometric methods was another aim of this investigation., Materials and Methods: Water and sediment samples were collected from 19 sampling sites at the Cruces River in summer (February) 2007. Fifteen elements were analyzed by atomic spectroscopic methods in filtrate, suspended matter, and sediment. Furthermore, the dissolved organic carbon, humic acids, and microbiological parameters were examined., Results: The quantitative description of the three different compartments indicates little influence of the pulp mill on the Cruces River. The comparison of the results with the Databank for Ecotoxicological Effect Data and Quality Targets illustrates the good quality of the water in the sanctuary. All quality targets, except for copper, are achieved. The amount of suspended matter increases with the beginning of the wetland. The multivariate statistical data analysis classifies the relations between the objects and variables., Discussion: The influence of the sewage, which is blamed to be the reason for increased amount of suspended matter, cannot be evaluated by this investigation. The slight increase of the concentrations of the earth alkaline and alkaline metals might cause changes in the chemical equilibrium and, therefore, the amount of suspended matter increases. Applying cluster analysis separates sampling sites by the determination of similarities between these sampling sites by means of the variables. Space-time factor analysis revealed relations between the examined parameters., Conclusions: The sewage of the pulp mill is not significantly polluted by the analyzed parameters and a negative influence to the ecosystem cannot be proved., Recommendations and Perspectives: The impact of copper should be examined in further investigations. The Pichoy River, with high concentrations of iron in the filtrate, should be examined as well. Studies about the chemical equilibrium of iron and manganese oxides in relation to the alkaline and earth alkaline elements should take place.

The new "Hazardous Waste Management Regulation" was published in the Official Newspaper of the Chilean Republic on 12 June 2003, being in force 365 days after its publication (i.e., 12 June 2004). During the next 180 days after its publication (i.e., until 12 December 2004), each industrial facility was obligated to present a "Hazardous Waste Management Plan" if the facility generates more than 12 ton/year hazardous wastes or more than 12 kg/year acute toxic wastes. Based on the Chilean industrial figures and this new regulation, hazardous waste management plans were carried out in three facilities of the most important sectors of Chilean industrial activity: a paper production plant, a Zn and Pb mine and a sawmill and wood remanufacturing facility. Hazardous wastes were identified, classified and quantified in all facilities. Used oil and oil-contaminated materials were determined to be the most important hazardous wastes generated. Minimization measures were implemented and re-use and recycling options were analyzed. The use of used oil as alternative fuel in high energy demanding facilities (i.e., cement facilities) and the re-refining of the used oil were found to be the most suitable options. In the Zn and Pb mine facility, the most important measure was the beginning of the study for using spent oils as raw material for the production of the explosives used for metals recovery from the rock. In Chile, there are three facilities producing alternative fuels from used oil, while two plants are nowadays re-refining oil to recycle it as hydraulic fluid in industry. In this sense, a proper and sustainable management of the used oil appears to be promissory.

The study aimed to estimate economic losses associated with heat stress in the eight dairy production regions (DPR), defined by the Dairy Chilean Consortium, using two comfort thermal indices, namely, the temperature-humidity index (THI) and the THI adjusted for solar radiation and wind speed (THIa). Hourly records from 19 weather stations (Nov - Mar 2017-2022) were collected to estimate the comfort thermal indices. The economic impact was estimated considering a critical threshold of 65 for both indices and the effect of higher values on loss in milk yield, days open, culling rate, and deaths. There were differences in the number of hours above the threshold among DPRs, independent of the thermal index used (P < 0.01). The greatest values were observed in DPRs I, II, and VIII, which concentrate most dairy cows. Average losses in milk yield were between 2.0 and 6.4 times higher when THIa was used instead of THI, which also depends on the DPR (P < 0.01). These estimations coincide with those observed empirically by producers. The lowest average economic losses per cow during the summer season (5 seasons average) occurred in DPR VI (US $ 91.5), and the highest losses were observed in DPR I (US $ 184.2) both using THIa. At the country level, economic losses fluctuate between US $ 29.0 and 108.4 million per summer season, depending on the comfort thermal index used. Finally, heat stress impacts negatively and significantly the Chilean dairy sector, which is highly dependent on the DPR., (© 2024. The Author(s) under exclusive licence to International Society of Biometeorology.)

For many years, the economic literature has recognized the role of attitudes, beliefs, and perceptions in estimating the value of a statistical life (VSL). However, few applications have attempted to include them. This article incorporates the perceived controllability and concern about traffic and cardiorespiratory risks to estimate VSL using a hybrid choice model (HCM). The HCM allows us to include unobserved heterogeneity and improve behavioral realism explicitly. Using data from a choice experiment conducted in Santiago, Chile, we estimate a VSL of US$3.78 million for traffic risks and US$2.06 million for cardiorespiratory risks. We found that higher controllability decreases the likelihood that the respondents would be willing to pay for risk reductions in both risks. On the other hand, concern about these risks decreases the willingness to pay for traffic risk reductions but increases it for cardiorespiratory risk reductions., (© 2024 Society for Risk Analysis.)

The high-Andean mountain of northern Chile host numerous water systems that is in risk due to increased mining activities. Total and dissolved Cd, Cr, Cu, Hg, Ni, Pb, Se, and Zn in water, and Cd, Cu, Fe, Ni, Pb, Zn, As, Mo, Al, and V in sediments of 21 aquatic systems (rivers, saline lakes, salt flats), were studied. The presence of Pb, Cd, and As in waters and sediments could be explained, in part, by mining activities. Waters are not suitable for human consumption or irrigation due to high content of Cu and As and high pH that exceed Chilean water quality guideline values. The use of different background reference values influences noticeably the conclusion related to environmental quality of sediments, measured with different environmental indexes. The local geological background suggest that Cd, Mo, Pb, and As generate some degree of contamination, while the use of unpolluted systems as background suggest that all metals measured in sediments represent a low contamination risk. The use of background values of local unpolluted systems seems to be more realistic than geological formation or Upper Continental Crust reference values to assess the environmental condition. The ecological risk assessment suggests that Cd and As are threat for communities living in these aquatic environments. However, these systems support abundant wildlife, developing unique extreme ecosystems with great potential for non-consumptive use such as special interest tourism and conservation., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

The hadopelagic environment remains highly understudied due to the inherent difficulties in sampling at these depths. The use of sediment environmental DNA (eDNA) can overcome some of these restrictions as settled and preserved DNA represent an archive of the biological communities. We use sediment eDNA to assess changes in the community within one of the world's most productive open-ocean ecosystems: the Atacama Trench. The ecosystems around the Atacama Trench have been intensively fished and are affected by climate oscillations, but the understanding of potential impacts on the marine community is limited. We sampled five sites using sediment cores at water depths from 2400 to ~8000 m. The chronologies of the sedimentary record were determined using 210 Pb ex . Environmental DNA was extracted from core slices and metabarcoding was used to identify the eukaryote community using two separate primer pairs for different sections of the 18S rRNA gene (V9 and V7) effectively targeting pelagic taxa. The reconstructed communities were similar among markers and mainly composed of chordates and members of the Chromista kingdom. Alpha diversity was estimated for all sites in intervals of 15 years (from 1842 to 2018), showing a severe drop in biodiversity from 1970 to 1985 that aligns with one of the strongest known El Niño events and extensive fishing efforts during the time. We find a direct impact of sea surface temperature on the community composition over time. Fish and cnidarian read abundance was examined separately to determine whether fishing had a direct impact, but no direct relation was found. These results demonstrate that sediment eDNA can be a valuable emerging tool providing insight in historical perspectives on ecosystem developments. This study constitutes an important step toward an improved understanding of the importance of environmental and anthropogenic drivers in affecting open and deep ocean communities., (Global Change Biology© 2024 The Author(s). Global Change Biology published by John Wiley & Sons Ltd.)

Two extracellular xylanases, denominated X2 and X3, were purified and characterized from the halotolerant bacterium Bacillus sp. Asc6BA isolated from "Salar de Ascotán" in the Atacama Desert. Xylanases were purified by anion exchange, cation exchange and size exclusion liquid chromatography. Xylanase X2 and X3 were purified ~ 690-fold and ~ 629-fold, respectively, compared to the concentrated extracellular fraction with a final specific activity of 169 and 154 u mg -1 , respectively. Optimal conditions of pH and temperature of xylanolytic activity were 6.0 and 60 °C for X2 and 7.0 and 60 °C for X3. Half-life of X2 xylanase was 30 min at 50 °C, while X3 xylanase was remarkably more thermostable, retaining more than 70% of its activity after 32 h of incubation at 50 °C. X2 exhibited K m , V max and k cat values of 7.17 mg mL -1 , 1.28 mM min -1  mg -1 and 425.33 s -1 , respectively. X3 exhibited K m , V max and k cat values of 6.00 mg mL -1 , 19.25 mM min -1  mg -1 and 82,515 s -1 , respectively. In addition to their thermal stabilities, these enzymes were shown to be resistant to freeze-drying. These stability properties, in addition to the ability of these enzymes to be active in a wide range of temperatures and pHs, make these xylanases good candidates for industrial applications.

Globally, mortality and fertility rates generally fall as resource abundance increases. This pattern represents an evolutionary paradox insofar as resource-rich ecological contexts can support higher numbers of offspring, a component of biological fitness. This paradox has not been resolved, in part because the relationships between fertility, life history strategies, reproductive behavior, and socioeconomic conditions are complex and cultural-historically contingent. We aim to understand how we might make sense of this paradox in the specific context of late-twentieth-century, mid-demographic transition Chile. We use distribution-specific generalized linear models to analyze associations between fertility-related life-history traits-number of offspring, ages at first and last reproduction, average interbirth interval, and average number of live births per reproductive span year-and socioeconomic position (SEP) using data from a cohort of 6,802 Chilean women born between 1961 and 1970. We show that Chilean women of higher SEP have shorter average interbirth intervals, more births per reproductive span year, later age at first reproduction, earlier ages at last reproduction, and, ultimately, fewer children than women of lower SEP. Chilean women of higher SEP consolidate childbearing over a relatively short time span in the middle of their reproductive careers, whereas women of lower SEP tend to reproduce over the entirety of their reproductive lifespans. These patterns may indicate that different SEP groups follow different pathways toward declining fertility during the demographic transition, reflecting different life-history trade-offs in the process., (© 2022. The Author(s).)

Background: Lesbian, gay, bisexual, transgender, intersex, queer, and other sexual and gender identities (LGBTIQ+) individuals face health inequities. Additionally, medical students report a lack of confidence in providing specific health care to LGBTIQ + individuals, and medical schools do not offer the breadth and depth of coverage needed to fully prepare and make them comfortable in caring for these individuals. This study aims to characterize the teaching of curricular content related to LGBTIQ + health issues in medical schools in Chile., Methods: This was a cross-sectional descriptive mixed-methods study based on a 15-question survey sent to school directors of the 24 medical schools in Chile, conducted between October 2020 and July 2021. The questions included in the study were mostly based on two pre-existing questionnaires covering content, assessment methods, and identification of barriers to teaching this content., Results: The validated questionnaire was answered by 14 of 24 Chilean medical schools, with 11 schools (78.9%) declaring that they included some training in their curriculum. The predominant range of time allocated to LGBTIQ + training in medical programs was between 1 and 5 h. The most addressed topics were HIV (92.85%), sexual orientation (78.57%), and chronic disease risk in LGBTIQ + populations (78.57%). Most schools, accounting for 71.5%, considered the content they delivered to be "moderately insufficient" or "insufficient". Regarding the teaching methodologies, the most used were lectures (92.8%), clinical cases (42.9%), and clinical simulation (28.6%)., Conclusion: Most surveyed medical schools reported curricular spaces dedicated to teaching health issues of LGBTIQ + individuals, primarily during the pre-internship training period. However, the time allocated is insufficient, and there is little approach to topics beyond the patient's sexual history or sexual orientation. Given the crucial role of medical schools, they must adopt both local and national strategies to enrich training focused on the care of LGBTIQ + patients., (© 2024. The Author(s).)

A primary community prevention approach in Iceland was associated with strong reductions of substance use in adolescents. Two years into the implementation of this prevention model in Chile, the aim of this study was to assess changes in the prevalence of adolescent alcohol and cannabis use and to discuss the impact of the COVID-19 pandemic on the substance use outcomes. In 2018, six municipalities in Greater Santiago, Chile, implemented the Icelandic prevention model, including structured assessments of prevalence and risk factors of substance use in tenth grade high school students every 2 years. The survey allows municipalities and schools to work on prevention with prevalence data from their own community. The survey was modified from an on-site paper format in 2018 to an on-line digital format in a shortened version in 2020. Comparisons between the cross-sectional surveys in the years 2018 and 2020 were performed with multilevel logistic regressions. Totally, 7538 participants were surveyed in 2018 and 5528 in 2020, nested in 125 schools from the six municipalities. Lifetime alcohol use decreased from 79.8% in 2018 to 70.0% in 2020 (X 2  = 139.3, p < 0.01), past-month alcohol use decreased from 45.5 to 33.4% (X 2  = 171.2, p < 0.01), and lifetime cannabis use decrease from 27.9 to 18.8% (X 2  = 127.4, p < 0.01). Several risk factors improved between 2018 and 2020: staying out of home after 10 p.m. (X 2  = 105.6, p < 0.01), alcohol use in friends (X 2  = 31.8, p < 0.01), drunkenness in friends (X 2  = 251.4, p < 0.01), and cannabis use in friends (X 2  = 217.7, p < 0.01). However, other factors deteriorated in 2020: perceived parenting (X 2  = 63.8, p < 0.01), depression and anxiety symptoms (X 2  = 23.5, p < 0.01), and low parental rejection of alcohol use (X 2  = 24.9, p < 0.01). The interaction between alcohol use in friends and year was significant for lifetime alcohol use (β = 0.29, p < 0.01) and past-month alcohol use (β = 0.24, p < 0.01), and the interaction between depression and anxiety symptoms and year was significant for lifetime alcohol use (β = 0.34, p < 0.01), past-month alcohol use (β = 0.33, p < 0.01), and lifetime cannabis use (β = 0.26, p = 0.016). The decrease of substance use prevalence in adolescents was attributable at least in part to a reduction of alcohol use in friends. This could be related to social distancing policies, curfews, and homeschooling during the pandemic in Chile that implied less physical interactions between adolescents. The increase of depression and anxiety symptoms may also be related to the COVID-19 pandemic. The factors rather attributable to the prevention intervention did not show substantial changes (i.e., sports activities, parenting, and extracurricular activities)., (© 2023. Society for Prevention Research.)

Evidence-based and person-centred care requires the measurement of treatment outcomes that matter to youth and mental health practitioners. Priorities, however, may vary not just between but also within stakeholder groups. This study used Q-methodology to explore differences in outcome priorities among mental health practitioners from two countries in relation to youth depression. Practitioners from the United Kingdom (UK) (n = 27) and Chile (n = 15) sorted 35 outcome descriptions by importance and completed brief semi-structured interviews about their sorting rationale. By-person principal component analysis (PCA) served to identify distinct priority profiles within each country sample; second-order PCA examined whether these profiles could be further reduced into cross-cultural "super profiles". We identified three UK outcome priority profiles (Reduced symptoms and enhanced well-being; improved individual coping and self-management; improved family coping and support), and two Chilean profiles (Strengthened identity and enhanced insight; symptom reduction and self-management). These could be further reduced into two cross-cultural super profiles: one prioritized outcomes related to reduced depressive symptoms and enhanced well-being; the other prioritized outcomes related to improved resilience resources within youth and families. A practitioner focus on symptom reduction aligns with a long-standing focus on symptomatic change in youth depression treatment studies, and with recent measurement recommendations. Less data and guidance are available to those practitioners who prioritize resilience outcomes. To raise the chances that such practitioners will engage in evidence-based practice and measurement-based care, measurement guidance for a broader set of outcomes may be needed., (© 2023. The Author(s).)

To evaluate the physiological state of the wild fish inhabiting the Biobío River in South-Central Chile, susceptible to the chemical contamination from different sources, biochemical and physiological biomarkers were applied to wild fish Percilia irwini and Trichomycterus areolatus in situ. Fish caught in the Biobío river in low, medium, and high anthropic impacts areas, with different pollution degrees along the river. Ethoxyresorufin O-O deethylase (EROD) activity was evaluated in fish liver. Length, weight, Gonad weight and Liver weight, Physiological Index, and gill and liver histopathology were conducted. Physicochemical parameters (pH, Temperature, Conductivity, and TDS) were measured at each sampling site. The results indicated a deteriorating condition in the biological parameters of both species in a high anthropic zone. Fishes show an increase in physiological indices and EROD liver activity, agreeing with previous studies supporting evidence of reproductive change development as we move downstream the river. Also, an increase in histopathological lesions towards the lower third stretch of the Biobío River. The Integrated Index of Physiological Biomarkers (IPBR) indicated that sites located in the high impact area (P. irwini: BC: 4.09; RC: 3.38; PC: 3.50; SJ: 2.34 and T. areolatus BC: 6.06, PC: 5.37; SJ: 5.42) have the most detrimental environmental quality, compared to reference area. The integrated biomarker analysis demonstrates that the alterations observed are related to the high anthropic activity levels downstream from the sites with the least intervention, demonstrating that the IPBR used is a complementary tool for studies of the Environmental Effects Monitoring approach.

Dermal ossifications (osteoderms, dermal ossicles, osteoscutes) appear independently in various tetrapod lineages. In mammals, however, dermal ossifications are only present in some members of Xenarthra. This clade includes Cingulata (armadillos and their relatives), and Pilosa, including Vermilingua (anteaters) and Folivora (sloths). In extant xenarthrans, osteoderms are invariably present in cingulates whereas they are absent in pilosans. Among extinct sloths, however, a limited number of taxa possessed dermal ossifications. Records of mummified skins of ground sloths bearing osteoderms found in Cueva del Milodón (Southern Chile), with a late Pleistocene age, allowed us to analyze their micro- and macroscopic morphology. The main goal of this study is to closely examine a portion of a mylodontid skin portion using radiography. The arrangement, morphology and internal structure of the ossicles are analyzed and the results are discussed in the context of previous research. The results we obtained indicate that ossicles vary in shape and size, and the integument has four different patterns of arrangement of the ossicles: that is, areas without ossicles, disorganized ossicles, rows, and mosaic areas. The latter has two variants, with clusters of ossicles forming rosettes or stars. Thin sections of the ossicles allowed us to recognize and describe anatomical features of the bone and its mode of growth. Finally, paleobiological and functional considerations of the dermal armor are discussed along with its phylogenetic and chronological implications., (© 2021 Wiley Periodicals LLC.)

We performed a bibliometric analysis of Latin American documents published between 1984 to 2019 in Scopus-indexed journals. A total of 1856 documents were analyzed. The annual scientific production was 64 documents per year, with an annual increase rate of 15.9%. The countries with the highest scientific production on BS were Brazil (64.7%) and Chile (14.5%). Most of the publications were original (76.6%) and review articles (11.9%). The journal with the highest publication record was "Obesity Surgery" (25.8%). The extra-regional collaboration was mainly with the USA. In conclusion, Latin American scientific production on BS has shown a significant increase in recent years. However, more participation is needed, fostering intra-regional collaboration and involving universities and health institutions in BS research.

Background and Objectives: There is much interest in adding social variables to hospital performance assessments. Many of the existing analyses, however, already include patients' diagnosis data, and it is not clear that adding a social adjustment variable would improve the quality of the results: the growing literature on this issue provides mixed results. The purpose in this study was to add evidence from a developing country into this discussion., Methods: We estimate the efficiency of hospitals controlling for casemix, with and without adjusting the hospital's casemix for the patients' sociodemographic variables. The magnitude of the adjustment is based on the observed impact of age, sex, and income on length of stay, conditional on the diagnosis related group (DRG). We use a data envelopment analysis (DEA) to assess the efficiency of 50 Chilean hospitals' discharges, including 780 DRGs and covering about 60% of total discharges in Chile from 2013 to 2015., Results: We found that the sociodemographic adjustment introduces very small changes in the DEA estimation of efficiency. The underlying reason is the relatively low influence of sociodemographics on hospital costs, conditional on DRG, and the changing pattern of sociodemographics across DRGs for any given hospital., Conclusion: We conclude that the casemix-adjusted estimation of hospital efficiency is robust to the heterogeneity of patients' sociodemographic heterogeneity across hospitals. These results confirm, in a developing country, what has been observed in developed countries. For management purposes, then, the processing costs of adding social variables into hospitals' performance assessments might not be justified., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

The research presented in this paper consists of a case study that analyses the elements necessary for a culturally grounded methodological strategy for the prevention of problematic alcohol consumption in rural Mapuche communities in the Araucanía region. To do this, we proposed to answer the questions: what are the particularities that alcohol consumption adopts in the local space? And what are the elements that should be considered for an intercultural preventive strategy for alcohol consumption? Oriented to the perspective of community-based participatory research, data were collected through group interviews with the local community, participant observation and in-depth interviews with people who consumed alcohol, were recovering from consumption and nondrinkers. A total of 84 people participated and the information gathered was analysed using ATLAS.ti software. The results show key aspects that must be considered for the design, including: strengthening the cultural identity, providing spaces for shared reflection in places where the community converges (schools and rural health centres), and problematising alcohol consumption from their own conceptions of normal and problematic consumption. Therefore, there is a need to focus on strengthening intracultural processes in community spaces, with a preventive strategy within the logic of action research, with increasing degrees of community participation., (© 2020 Wiley Periodicals LLC.)

The early detection of congenital anomaly epidemics occurs when comparing current with previous frequencies in the same population. The success of epidemiologic surveillance depends on numerous factors, including the accuracy of the rates available in the base period, wide population coverage, and short periodicity of analysis. This study aims to describe the Latin American network of congenital malformation surveillance: ReLAMC, created to increase epidemiologic surveillance in Latin America. We describe the main steps, tasks, strategies used, and preliminary results. From 2017 to 2019, five national registries (Argentina [RENAC], Brazil [SINASC/SIM-BRS], Chile [RENACH], Costa Rica [CREC], Paraguay [RENADECOPY-PNPDC]), six regional registries (Bogotá [PVSDC-Bogota], Cali [PVSDC-Cali], Maule [RRMC SSM], Nicaragua [SVDC], Nuevo-León [ReDeCon HU], São Paulo [SINASC/SIM-MSP]) and the ECLAMC hospital network sent data to ReLAMC on a total population of 9,152,674 births, with a total of 101,749 malformed newborns (1.1%; 95% CI 1.10-1.12). Of the 9,000,651 births in countries covering both live and stillbirths, 88,881 were stillborn (0.99%; 95% CI 0.98-0.99), and among stillborns, 6,755 were malformed (7.61%; 95% CI 7.44-7.79). The microcephaly rate was 2.45 per 10,000 births (95% CI 2.35-2.55), hydrocephaly 3.03 (2.92-3.14), spina bifida 2.89 (2.78-3.00), congenital heart defects 15.53 (15.27-15.79), cleft lip 2.02 (1.93-2.11), cleft palate and lip 2.77 (2.66-2.88), talipes 2.56 (2.46-2.67), conjoined twins 0.16 (0.14-0.19), and Down syndrome 5.33 (5.18-5.48). Each congenital anomaly showed heterogeneity in prevalence rates among registries. The harmonization of data in relation to operational differences between registries is the next step in developing the common ReLAMC database., (© 2020 Wiley Periodicals LLC.)

Background: In 2010, a political and social crisis pushed thousands of Venezuelans out of their country; today, seven million Venezuelans live abroad. In addition, during the COVID-19 pandemic, border closure increased and affected specific vulnerable migration flows, such as Venezuelans trying to migrate to Chile through the Northern borders. In this context, there is little evidence of migrants' health status and needs, their access to health services, and other basic needs (e.g., housing) from a human rights perspective. Therefore, we qualitatively explored the effects of border closure due to the COVID-19 pandemic on Venezuelan migrants' health and human rights, focusing on access to healthcare in the Northern Chilean border that adjoins Peru and Bolivia., Methods: Following a case-study qualitative design, we conducted an ethnography that included participatory observation of relevant sites (e.g., hospitals, main squares, migrant shelters) in Antofagasta, Iquique, and Arica and 30 in-depth interviews with actors in the health sector (n = 7), experts from the non-governmental sector (n = 16), and governmental actors (n = 7) in three large cities close to the Northern border., Results: We found four main dimensions: (i) border and migration processes, (ii) specific groups and intersectionality, (iii) barriers to healthcare services, and (iv) regional and local responses to the crisis during the COVID-19 pandemic. Programs characterized by the presence of healthcare providers in the field were essential to attend to migrants' health needs at borders., Conclusions: Coordination between actors is crucial to implement regional protocols that respond to current migration phenomena and migrants' health needs. Health policies using a human rights approach are urgently required to respond to migrants' healthcare needs at borders in South America., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Objective: To identify which social determinants of health explain the gap in the remaining teeth between men and women., Methods: A secondary analysis of data from the Chilean National Health Survey (CNHS) 2016-2017 was performed on the number of remaining teeth in adults. The explanatory variables were organized into structural and intermediate social determinants of health according to the WHO framework. The contribution of both groups and the contribution of each individual explanatory variable to the remaining teeth gap was estimated using the Blinder-Oaxaca decomposition analysis., Results: The predicted average number of remaining teeth for men was 23.4 and 21.0 for women, thus a mean difference of 2.4 teeth. 49.8% of the inequality between men and women was due to the different distribution (endowments) of the predictors in the model. Among them, structural determinants of health, namely education level (15.8%) and employment status (17.8%), contributed the most. Intermediate determinants had no relevant contribution to explain the gap., Conclusions: Results revealed that the difference in the mean number of remaining teeth between men and women was mainly explained by two structural determinants: education level and employment status. The lack of explanatory power of intermediate determinants and the large explanatory power of structural determinants means that tackling oral health inequity in Chile requires strong political commitment. The role of intersectoral and intersectional public policies to address gender inequalities in oral health in Chile is discussed., (© 2023 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

This article estimates the value of a statistical life (VSL) for Chile under the hedonic wage method while accounting for individual risk preferences. Two alternative measures of risk aversion are used. First, risk aversion is directly measured using survey measures of preferences over hypothetical gambles, and second, over observed individual behaviors that may proxy for risk preferences, such as smoking status, are used. I reconcile the results with a theoretical model of economic behavior that predicts how the wage-risk tradeoff changes as risk aversion differs across individuals. The VSL estimates range between 0.61 and 8.68 million dollars. The results using smoking behavior as a proxy for risk attitudes are consistent with previous findings. However, directly measuring risk aversion corrects the wage-risk tradeoff estimation bias in the opposite direction. The results are robust to other observed measures of risk aversion such as drinking behavior and stock investments. Results suggest that, consistent with the literature that connects smoking behavior with labor market outcomes, smoking status could be capturing poor health productivity effect in addition to purely risk preferences., (© 2019 Society for Risk Analysis.)

Studies on social programs reveal the absence of a cross-sectional perspective capable of identifying common aspects that improve the living conditions of their participants while also contributing to poverty alleviation. To detect such elements, we examined the transformations in the experiences and meanings associated with poverty and its alleviation by conducting semistructured interviews and focus groups with participants and intervention team members that implemented six social programs in Chile and Peru. We conducted a descriptive and relational analysis guided by Grounded Theory, which revealed three overarching elements: notions of poverty, notions of the overcoming of poverty, and changes necessary for overcoming poverty. Lastly, based on a complex view of poverty and considering the contributions of community psychology, we propose that interventions in this field must create meaningful relational spaces that restore participants' objective and subjective rights, such as the right to dream., (© 2022 Wiley Periodicals LLC.)

Non-standard forms of employment, such as self-employment, are among the most prevalent routes for older people to access the workforce. While the financial benefits of any form of self-employment in later life have been widely acknowledged, less is known about their impact on health. This study explores the association between self-employment and 16 health outcomes among older people with different social stratification characteristics in Chile, a developing country experiencing rapid population ageing. We rely on a rich representative life history survey of Chilean men and women between the ages 65 and 75 years (N = 802) living in the capital Santiago, weighted sequence analysis to reconstruct employment histories and weighted regression analysis to measure the association between self-employment and health in later life. All our analyses are adjusted by both individual lifetime health indicators and employment trajectories. Our results show that being self-employed relative to not working is positively associated with health in seven out of 16 outcomes. More surprisingly, those in a self-employment position seem to enjoy better health outcomes, particularly among the less educated and lower-income levels. These stratified associations raise questions about how these individuals enjoy better health despite facing adverse social conditions., (© 2023 Foundation for the Sociology of Health & Illness.)

This paper presents an integrative case study of Chile's national strategy of research, development, and innovation (R&D+i) for disaster resilience and progress towards developing the institutional conditions necessary for its successful implementation. The paper covers the period between 2016 and 2021, concentrating on the work of the Chilean Commission of R&D+i for Resilience to Disasters of Natural Origin (CREDEN). Through an analysis of the official records of the initiative at all of its stages, and 29 semi-structured interviews with CREDEN members and stakeholders, we aim to present a successful example of strengthening the role of science and technology in disaster risk reduction. Chile's experience is particularly interesting because its strategy focused on R&D+i and proposed developing an industry of scientific-based technological solutions for disaster resilience. The study also illustrates how strategic interaction between academia, state, and industry can be a key factor in aligning knowledge production to tackle current socio-technical challenges., (© 2022 The Authors Disasters © 2022 ODI.)

One of the challenges of school climate policies has been to promote dialogical conflict resolution by reducing punitive practices and encouraging student participation. However, exclusionary punitive practices are still being used, and in Chile, they are considered acceptable forms of conflict resolution. In this study, we analyzed the association between students' reports of punitive and democratic school climate in a sample of 2459 eighth graders (mean age = 13.56, SD = 0.84) from 128 Chilean schools. Multilevel analyses showed that a higher perception of punitive practices and higher academic performance were associated with a higher perception of an inclusive, democratic, and peaceful school climate. The perception of a higher school-level frequency of punishment was associated with a higher perception of an inclusive and democratic school climate. We discuss the implications of these findings for an authoritarian school culture., (© 2022 Wiley Periodicals LLC.)

Research has stressed the importance of the family domain for the individual's well-being, but the heterogeneity/homogeneity of satisfaction with family life between and within families have not previously assessed. This study identifies family profiles based on the level of family life satisfaction in mother-father-adolescent triads and determines whether profiles differ in terms of the three family members' perceived family support, importance assigned to the family, both parents' work-life balance and mental health, and the household's economic situation. The sample was composed of 303 families of different-sex dual-earner parents with one child aged between 10 and 17 years, from Temuco, Chile. A Latent Profile Analysis was used to identify three profiles: Families with low family satisfaction (17.80%), Families with medium family satisfaction (68.14%), and Families with high family satisfaction (14.06%). Profiles also differed in the three family members' perceived family support and importance assigned to the family, both parents' work-life balance and mental health, and in the household's income. Mothers, fathers, and adolescents in these profiles also differed from one another in these variables. The main variable related to the family members' satisfaction with family life was the parents' mental health problems. Family life satisfaction in dual-earner couples with adolescent children is heterogenous, and these profiles draw attention to indicators of parent-child well-being. Families with lower levels of family satisfaction require particular attention in research and interventions, as these families may report a lower household income, and the parents may experience higher rates of depression, anxiety, and stress, and diverging levels of work-life balance., (© 2021 Family Process Institute.)

Background: We compared different econometric specifications to model the use of medical services in Chile, focussing on visits to general practitioners and specialist physicians., Methods: The evaluated models are the Poisson, Negative Binomial, Zero Inflated Poisson and Negative Binomial, two-step Hurdle model, sample-selection Poisson, and Latent Class model. These models were estimated using Chilean data for the years 2009 and 2015, separated by gender., Results: Unlike previous literature that supported the use of the latent class model, our results show that the latent class model is not always the model with the best goodness of fit. Furthermore, the model with the best fit is not necessarily the model with the best predictive power. For instance, depending on the year and medical services, either the latent class model or the sample-selection Poisson model performs better than the other models. The results also show that the selection of the econometric model may have implications for the estimated influence that variables such as age, income, or affiliation to the public versus private sector have on the use of medical services., Conclusion: Using Chilean data, we have tested that the selection of an econometric method to model the use of medical services is not a problem with a unique answer. We recommend performing a sensitivity analysis of goodness of fit and predictive power between gender, healthcare services, or different years of datasets in future applications to be sure about the best model specification in each context., (© 2022 John Wiley & Sons Ltd.)

Using a representative sample, we explored the relationship of organizational (ORA), non-organizational (NORA), and intrinsic religiosity (IR) with depressive and anxious symptomatology and loneliness in Chilean older people, and examined mediating mechanisms. Structural Equation Modeling showed a direct effect between ORA and reduced depressive symptomatology and between IR and anxious symptomatology; for indirect effects, the relationship between ORA and depressive and anxious symptomatology was mediated by friends' social support network, while that between IR and the three outcomes studied was mediated by the family support network and resilience. NORA was not associated with any of the outcomes or mediating variables., (© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

This paper researches the existence of economies of scale and scope in the Chilean water and sewerage industry using a translog cost function approach over the period 2010-2017. It also provides estimates of productivity growth and its determinants, technical change and scale effect. The results suggest that on average, the water industry operates under increasing economies of scale, which implies that further increases in water companies' scale of operations may be cost beneficial. Economies of scope between water and sewerage services were found for the average company, which suggests that the joint provision of these services may lead to cost savings. An average annual productivity increase of 2.5% was reported with scale effect being the major driver. Full private companies performed better than concessionary and public water companies. The results of our study can be of greater interest to the policy-makers who want to make decisions on introducing policy reforms such as mergers, unbundling of the water and sewerage supply chain, or developing incentives to improve companies' productivity., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Perchlorate (ClO 4 ) has been identified as a persistent environmental contaminant of concern. Perchlorate exposure is a potential health concern because it interferes with hormone production by thyroid gland. Food (fruits and vegetables) and drinking water are an important source of human exposure to perchlorate. However, little is known about the occurrence of perchlorate in Chile. The purpose of this study was to determine the occurrence of perchlorate in 145 samples (soil, drinking water, surface water, groundwater, fertilizers, fruits and vegetables) collected across Chile and estimate associated exposure to consumers. Our results show that perchlorate was detected in soil (median: 22.2 ng g - ) has been identified as a persistent environmental contaminant of concern. Perchlorate exposure is a potential health concern because it interferes with hormone production by thyroid gland. Food (fruits and vegetables) and drinking water are an important source of human exposure to perchlorate. However, little is known about the occurrence of perchlorate in Chile. The purpose of this study was to determine the occurrence of perchlorate in 145 samples (soil, drinking water, surface water, groundwater, fertilizers, fruits and vegetables) collected across Chile and estimate associated exposure to consumers. Our results show that perchlorate was detected in soil (median: 22.2 ng g -1 ), drinking water (median: 3.0 ng mL -1 ), fruits (median: 0.91 ng g -1 fresh weight [FW]), lettuce (median: 5.0 ng g -1 FW) and chard (median: 4.15 ng g -1 FW). Interestingly, perchlorate concentrations detected in drinking water from three regions (Serena, Copiapo and Illapel) exceeded the USEPA interim drinking water health advisory level of 15 ng mL -1 . Median concentrations of perchlorate in non-nitrogenous fertilizers (3.1 mg kg -1 ) were higher than those in nitrogenous fertilizers (1.3 mg kg -1 ). Estimated daily intake (EDI) of perchlorate via drinking water was lower than the USEPA's reference dose (7000 ng kg -1 ). The EDI of perchlorate via vegetables (chard and lettuce) produced in northern Chile was three times higher than those produced in other regions. The results of this study provide information about perchlorate sources in Chile, which will be helpful in modifying current regulations.-1 ). The EDI of perchlorate via vegetables (chard and lettuce) produced in northern Chile was three times higher than those produced in other regions. The results of this study provide information about perchlorate sources in Chile, which will be helpful in modifying current regulations., (© 2020. Springer Nature B.V.)

The material discarded by past mining extractive activities is exposed to the action of different environmental agents and constitutes the beginning of a problem that, inevitably, involves the population and the conditions of the environment where it is deposited. Bearing this in mind, a study of the Copaquilla-Chile valley was carried out with a focus on the socio-environmental conflict produced by the accumulation of abandoned mining waste in its vicinity. The objectives were to identify the role of the different actors and the main causes that originated the conflict and to characterize the physical-natural factors that conditioned the susceptibility and physical vulnerability of the studied environment. The methodological approach combined a set of qualitative and quantitative techniques, using participatory action research techniques (PAR) and multi-criteria evaluation models (MCE) through a geographic information system (GIS). The evaluation of the study area revealed quite severe levels in terms of the indices of susceptibility to processes of mass removal and vulnerability of the aquifer, which led us to infer that the morpho-climatic and hydrogeological characteristics of the sector generated the appropriate conditions to produce large damage to the complex socio-ecological system of the Copaquilla territory. This study generated participatory material, a chronology of the conflict, a database of the physical environment of the Copaquilla valley interpreted in thematic cartographies, and physicochemical soil and water samples to monitor contamination levels., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

The geochemical stability, in terms of potential mobility and derived ecological and human health risks of potentially toxic elements (PTEs), of diverse fresh and old porphyry Cu-mine tailings from Chile was assessed through an integrated methodology comprising four interrelated investigation levels: (1) chemical composition and contamination degree of tailings by PTEs, (2) mineralogical characterization by X-ray diffraction and quantitative automated mineralogy analysis by scanning electron microscopy (QEMSCAN ® ), (3) partitioning and potential mobility of PTEs within the tailings by a sequential extraction procedure (SEP) and leaching tests, and (4) ecological risk assessment (ERA) and human health risk assessment (HHRA). According to pollution indices, Cu, As, Pb, and Mo are most concerning PTEs present in the tailings. SEP shows that major portion of the PTEs are strongly fixed as residual fraction, and thus are poorly mobilizable and bioavailable. Among the PTEs, Cu, As, and Mo were identified as the PTEs most prone to mobilization. Leaching tests show that a low fraction of PTEs is water-leachable. Seawater enhances Mn and As leaching, while process water increases the leaching of Cu, Mn, and Mo. Phosphate particularly promotes leaching of As and Cu, whereas it does not mobilize or even immobilize Pb in the tailings. ERA suggests that mainly old tailings pose a very high potential risk for ecological receptors (PERI = 663-3356), mostly due to Cu and As. HHRA indicates that the old tailings pose higher potential non-carcinogenic and carcinogenic health risks, while the risk decreases in the order ingestion > dermal > inhalation for both children and adults. Non carcinogenic and carcinogenic HHRA points to As as the main PTE of concern via ingestion pathway in the tailings. Overall, the results revealed that particularly old tailings, containing mixed slag-tailings, pose considerable risks to the environment and human health due to potential PTEs mobilization and this aspect requires scrutiny for proper tailings management, including storage, sealing, and eventual tailings reprocessing and/or site rehabilitation after closure., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH, DE part of Springer Nature.)

Providing care for older people who have support needs is mainly a familial and female responsibility in Chile. Despite Chile's development level, the participation of females in the workforce lags behind (at around 50%), and 72% of female carers of an older relative are not in the labour force. This paper explores the reasons why in Latin America adult children remain out of the labour force while caring for an older parent or parent-in-law who has support needs. It draws on 30 in-depth interviews of family carers from low- to high-income households. The interviews were carried out in Chile in 2017, and were analysed using an inductive thematic analysis to identify core themes related to the subjects' reasons for remaining out of the labour force. Four factors hinder the combination of paid work and caring for a parent or parent-in-law with support needs: (a) externalised care was too expensive; (b) finding non-precarious, flexible work was difficult; (c) their perception of femininity or womanhood conflicted with the idea of combining care and paid work; and (d) they experienced a lack of public and/or social support., (© 2020 John Wiley & Sons Ltd.)

Assessing the productivity change of water companies provides relevant information for both water regulators and companies' managers. Past research has illustrated that different indicators and indexes have been applied although not all of them are equally reliable. Thus, this study evaluates the total factor productivity (TFP) change and its drivers employing the Luenberger-Hicks-Moorsteen productivity indicator (LHMPI) including, for the first time, quality of service variables as undesirable outputs. Moreover, unlike the previous studies, LHMPI was decomposed into three drivers; namely technical change, technical efficiency change and scale efficiency change. Our empirical application conducted on a sample of Chilean water companies over 2007-2018 embracing full private water companies (FPWCs) and concessionary water companies (CWCs). Results evidenced that, on average, TFP increased at an annual rate of 2.2%, mainly due to outputs rise. The main driver of productivity growth was scale efficiency change suggesting that adjustments in the water companies' scale of operations could lead to lower operational costs. It was also evidenced that FPWCs performed better than CWCs over the period analyzed., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)