Publicaciones académicas
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Esta colección incluye artículos de profesores de la Pontificia Universidad Católica de Chile, publicados en revistas nacionales y extranjeras.
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Browsing Publicaciones académicas by browse.metadata.categoriaods "03 Salud y bienestar"
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- ItemCollaborative health resources management model(IEOM Society, 2021) Gutierrez, Janus, Amaru Leonhardt; Tabilo, Macarena Paz Navarro; Klapp Belmar Mathias Alberto© IEOM Society Inweternational.In Chile, rural population faces long access times to specialized health services, as these tend to be concentrated in regional capitals. Against this background, the present study proposes the establishment of a Collaborative Health Resources Management Model, based on the practice of sharing hospital resources between medical centers, allowing daily transfers of doctors and medical equipment within a hospital network. The objective is to meet local demand and increase rural accessibility to healthcare, in terms of reducing patient transfers between hospitals and access times. To compare the current and proposed scenarios, an Integer Optimization Model with a Network Structure is formulated. The case study is focused on urology specialty in Zona del Reloncaví, a rural area located in southern Chile, on which it is concluded that allowing the mobility of hospital resources, specifically doctors and equipment, is optimal, as the average number of patient transfers and the average access time are reduced by 95.6% and 83%, respectively. By applying this model, hospitals are able to stretch their limited capital budgets by jointly purchasing equipment, providing network-wide access to resources needed for expanding healthcare accessibility.
- ItemImplementation of Integrated Care of Patients with Non-Cancer Chronic Pain in Chile: Advances and Challenges(UBIQUITY PRESS LTD, 2025) Zamorano Pichard, Paula Francisca; Varela Yuraszeck, Teresita Ines; Salvatierra Matzner, Isidora; Silva, Leonardo; Lucero, Victor; Figueroa, Denisse; Salazar, Sheila; Casas, Pia; Castro, Nidia; Montecinos, Pablo; Salinas, FranciscoThe impact of chronic non-cancer pain on individuals is complex, multidimensional, and with healthcare needs that challenge fragmented healthcare systems. There have been significant advances in generating scientific evidence, ministerial guidelines, and even laws in Chile. However, there is still a considerable gap that remains in the implementation in clinical practice. Despite this, clinical teams have implemented three pilot programs in different countries. This perspective discusses these pilots, their implementation process, acquired knowledge, and the challenge of advancing toward scaling up.
- ItemNoninvasive pathway for stratifying fibrosis in suspected metabolic dysfunction and alcohol-associated liver disease (MetALD)(2025) Diaz Piga, Luis Antonio; Tavaglione, Federica; Mittal, Nikita; Bettencourt, Ricki; Amangurbanova, Maral; Johnson, Amy; Marti-Aguado, David; Tincopa, Monica; Loomba, Ria; Khan-Riches, Asma; Madamba, Egbert; Siddiqi, Harris; Richards, Lisa; Sirlin, Claude B.; Ajmera, Veeral; Loomba, RohitBackground: Metabolic dysfunction and alcohol-associated liver disease (MetALD) may increase liver fibrosis progression, but data on screening are scarce. We aimed to assess the performance of noninvasive tests (NITs) for detecting significant fibrosis in individuals with suspected MetALD.Methods: This is a cross-sectional study of prospectively enrolled adults identified as overweight or obese. We included adults with suspected MetALD defined by ≥1 of 5 cardiometabolic criteria and self-reported alcohol use within MetALD ranges or lower self-reported alcohol use but with phosphatidylethanol (PEth) levels ≥25 ng/mL. Clinical assessment included contemporaneous magnetic resonance elastography (MRE) and vibration-controlled transient elastography (VCTE). Significant fibrosis was defined as MRE ≥3.14 kPa (or VCTE ≥7.6 kPa if MRE was missing). Analyses included AUROCs.Results: Among 617 individuals screened, we identified 97 (15.7%) with suspected MetALD. The mean age was 50.6±12.8 years, 67% were men, the mean body mass index was 31.4±6.5 kg/m2, 12.4% had diabetes, and 8% had significant fibrosis. Fibrosis-4 ≥1.3 demonstrated good performance for significant fibrosis (AUROC: 0.78, 95% CI: 0.58–0.98, sensitivity 80%, specificity 76%, positive predictive value 17%, and negative predictive value 98%). VCTE ≥8 kPa also had good performance (AUROC: 0.85, 95% CI: 0.66–1.00, sensitivity 80%, specificity 91%, positive predictive value 36%, and negative predictive value 99%). A stepwise approach using fibrosis-4 followed by VCTE yielded a low false negative rate (2% misclassified as low risk).Conclusions: A clinical care algorithm utilizing a stepwise approach with fibrosis-4 and VCTE shows adequate performance in detecting significant fibrosis in individuals with suspected MetALD.
- ItemPercepciones respecto al uso de medios de comunicación masiva por médicos de familia y residentes de medicina familiar en Chile(2025) Mora Melanchthon, Isabel; Lopez Galvez, Jorge; Condeza Dall'Orso, Ana Rayen; Araya López, AbelardoLos medios de comunicación masiva son considerados agentes de salud y afectan la toma de decisiones de la población. Los médicos estamos llamados a educar a la población frente a los mensajes de salud y, los médicos familiares en particular, podríamos tener un papel crucial en base a habilidades propias de la especialidad. Este estudio buscó indagar en las percepciones de médicos de familia y residentes de la especialidad respecto a los medios de comunicación masiva y su participación en los mismos. Materiales y métodos: estudio descriptivo de corte transversal de carácter cuantitativo a través de una encuesta electrónica autoaplicada en médicos familiares y residentes de todo Chile en septiembre 2021. Resultados: 301 personas contestaron la encuesta, destacando 69% mujeres y 35% residentes; el 77,74% se desempeñaba en el sistema público de salud de manera total o predominante. Las principales vías de información en temáticas de salud para los encuestados fueron redes sociales y portales de noticias; el 88% estuvo de acuerdo en que los medios pueden ser importantes aliados en promover la salud en la población; y un 48,5% ha participado en medios, la mayoría entre 1 a 5 veces. Los encuestados consideraron que las redes sociales son más accesibles y amigables para entregar mensajes de salud, mientras que los medios más tradicionales son preferidos en términos de impacto y credibilidad. Si bien se observó buena disposición a participar en los medios, esto mejoraría si existiera capacitación previa. Conclusión: Estudios futuros podrían profundizar en el rol del médico de familia en el uso de medios de comunicación masiva para la entrega de mensajes en salud a la población, valorar percepciones de los usuarios frente al uso de medios y reflexionar sobre posibles mecanismos de capacitación en este tema
- ItemPhysical Activity in Immersive Virtual Reality: A Scoping Review(2023) Espoz Lazo, Sebastián IgnacioPhysical activity has benefits for health, but many adolescents are inactive. However, video games such as Immersive Virtual Reality (IVR) have grown in popularity as a leisure activity among young people, allowing them to manipulate objects in virtual environments increasing the practice of physical activity. The evidence indicates that the interest in physical activity through IVR is greater than in traditional methods, and different experiences have been reported. However, few studies indicate the sample evaluated, the effects found, or the IVR instruments used. Due to this, is the aim of this study is to identify the publications referring to IVR and physical activity, characterize them, and present the obtained main findings. For this, the guidelines described in the PRISMA-ScR for scoping reviews were applied. After the use of the inclusion and exclusion criteria, eight articles were included. Results show evidence regarding physiological outcomes, perceptual variables, interest and enjoyment, and psychological effects regarding physical activity through IVR. Additionally, the use of different devices and their prescriptions are explored. It is concluded that there is interest from the scientific community for the practice of physical activity through IVR, as well as for its application for the maintenance of active habits. This is important as it positions IVR as a method that can be a more experiential and effective way to develop and maintain a healthy lifestyle.
- ItemPsychotherapeutic Process in Adults with Depressive and Anxiety Symptoms Who Report Childhood Maltreatment: A Scoping Review(2025) Vaccarezza, Stephanie; Labbé, Nicolás; López, Alberto; Mundt, Adrian P.; Errázuriz, PaulaExtensive research exists regarding the impact of childhood maltreatment (CM) on depression and anxiety in adulthood. Still, its effect on the psychotherapeutic process, particularly symptomatic change and working alliance, remains unclear. Evaluating studies on the impact of CM on the psychotherapeutic process can help identify research gaps. This study aimed to conduct a scoping review of studies on the psychotherapeutic process in individual psychotherapy of adults with symptoms of depression and anxiety who report CM. The study followed the JBI Scoping Review Methodology. Searches were conducted in October 2022 across eight databases for peer-reviewed articles, books, and gray literature. Eligible studies examined the psychotherapeutic process in individual psychotherapy of adults with depression and/or anxiety who reported CM. A narrative method was employed to analyze and synthesize the studies. A total of 39 studies were included, consisting of 35 scientific articles and four doctoral dissertations. Most were randomized controlled trials evaluating different psychotherapeutic approaches, primarily cognitive-behavioral, interpersonal, and psychodynamic therapies. Patients with CM responded to psychotherapies for anxiety and depression, but showed higher symptom levels at both the beginning and end of treatment, along with delayed responses. A strong working alliance was essential for outcomes across different psychotherapeutic approaches. Psychotherapies for anxiety and depression in patients with CM should focus on building a strong working alliance and consider additional time for treatment responses. Future psychotherapy research on people with CM should report on the processes, including the working alliance. More studies assessing personality, anxiety, therapists’ perspectives, and employing qualitative methodologies are needed
- ItemPublic Health Policies and Strategies to Prevent Alcohol-Related Morbidity and Mortality(2025) El Zibaoui, Roba; Diaz Piga, Luis Antonio; Idalsoaga Ferrer, Francisco Javier; Arab Verdugo, Juan PabloAbstract Purpose of Review Alcohol consumption significantly contributes to global morbidity and mortality, particularly in individuals with alcohol-associated liver disease (ALD). This review aims to evaluate the effectiveness of public health policies in reducing alcohol-related harm, focusing on SAFER initiatives and World Health Organization (WHO) “best buys.” Recent Findings Key strategies to reduce the affordability of alcohol, such as alcohol taxation, minimum unit pricing, and legislation, have proven effective in reducing alcohol consumption and ALD-related deaths. However, their success varies across different regions and populations. Innovative approaches to further mitigate alcohol-related harm are also explored. Summary The review highlights the need for more robust, evidence-based public health policies to address alcohol-related diseases. A comprehensive, focused approach is essential to mitigate the global alcohol epidemic and its consequences, with an emphasis on policy refinement and greater understanding of alcohol-related harm.