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OBJECTIVES To explore the perceptions of residents regarding their health and well-being in areas of personal and collective life, in relation to the experience of urban transformation originated by the Program for the Recovery of Neighborhoods in Chile “Quiero mi Barrio” (PQMB). METHODS Qualitative study conducted in eight neighborhoods, which were subject to interventions between 2012–2015, located in seven communes of Chile: Arica, Renca, Padre Las Casas, Villarrica, Castro, Ancud. Eighteen focus groups and 27 interviews were conducted between 2018 and 2019. A content analysis was carried out following the social determinants of health approach. RESULTS Material conditions of neighborhood infrastructure and psychosocial determinants were the main emerging and predominant categories in the residents’ narratives. The new or improved infrastructure enhances sports and playing practices, as well as contributes to the feeling of safety and to the improvement of walkable spaces, support networks, socialization and dynamization of social organization. However, neglected aspects were visualized. The program had limitations of structural character that operate locally, such as aging, individual lifestyles that limit participation, and contexts of insecurity, especially in neighborhoods victims of drug trafficking. CONCLUSIONS The urban changes originated by the PQMB included improvements in neighborhood infrastructure and in the psychosocial environment, which are perceived by residents as beneficial aspects and promoters of collective wellbeing. However, global phenomena, and those related to the program, limit its scope and have repercussions on the perception of overall wellbeing of the residents in the neighborhoods. To go deeper into how this or other state neighborhood programs may or may not favor equitable access of different social groups, or which works may be better used by the groups, is an aspect that enhances the integral action with other sectors and local actors in the territories.

BACKGROUND: Environmental risk assessments and interventions to mitigate environmental risks are essential to protect public health. While the objective measurement of environmental hazards is important, it is also critical to address the subjective perception of health risks. A population’s perception of environmental health hazards is a powerful driving force for action and engagement in safety and health behaviors and can also inform the development of effective and more sustainable environmental health policies. To date, no instruments are available to assess risk perception of environmental health hazards in South America even though there are many concerning issues in the region, including mining. OBJECTIVE: We aimed to adapt and validate an environmental health risk perception questionnaire in a Chilean population affected by mining activity among other risks frequently reported in Latin American countries and included the collection of information on trust on public information sources. METHODS: We adapted an Australian risk perception questionnaire for validation in an adult population from a Chilean mining community. This adaptation included two blinded translations (direct, inverse), a pre-test study (n = 20) and a review by environmental health experts. Principal Component Analyses (PCA) was used to identify factors within major domains of interest. The Bartlett test of sphericity, Kaiser-Meyer-Olkin (KMO) measure and the Cronbach α test were used to assess the instrument’s validity and reliability. The instrument was pilot tested in 205 adults from a mining community in Chañaral. RESULTS: The final adapted questionnaire proved to be a good instrument to measure risk perception in a community chronically exposed to mining waste. For community risks, four factors explained 59.4% of the variance. “Global Issues” (30.2%) included air pollution, contamination of mining, ozone layer depletion and vector diseases. For personal risks, the first two components explained 59.5% of the variance, the main factor (36.7%) was “unhealthy behaviors within the household”. For trust in information, the first factor (36.2%) included as main sources “Media and authorities”. The Cronbach α ranged between 0.68 and 0.75, and the KMO test between 0.7 to 0.79 for community and personal risks and trust. CONCLUSIONS: The final questionnaire is a simple, reliable and useful instrument that can assist in evaluating environmental health risk perceptions in Latin American countries.

La Promoción de la Salud (PS) es una función esencial de la salud pública que se ha puesto en tensión frente a la pandemia de la COVID-19, dado que los discursos y estrategias basados en la prevención y curación de la enfermedad han invisibilizado las condiciones de vida e inequidad que son centrales para la PS. La salud colectiva latinoamericana plantea cuestionamientos prácticos y epistemológicos sobre las acciones ante la epidemia en los países del Sur Global, proponiendo enfoques alternativos al paradigma biomédico y a lo que este entiende como PS. Desde la salud colectiva, la PS tiene como elementos centrales la autonomía de las comunidades, la importancia de sus saberes, y el fomento de acciones colectivas territoriales. Este artículo, a través de una cronología crítica de la pandemia en dos territorios, describe situaciones documentadas que ponen en evidencia el despliegue de condiciones esenciales de posibilidad para una PS desde la salud colectiva, es decir, el papel de la justicia social en la organización comunitaria, la perspectiva territorial y los procesos emancipatorios y de construcción de autonomía. Los casos analizados corresponden a un territorio insular del sur de Chile y a una comuna urbana de la capital del país, elaborados mediante el involucramiento directo de los investigadores y una revisión documental y de prensa. Sus antecedentes y contextualización evidencian las modalidades concretas que toma la PS durante la pandemia en dos contextos con características diversas, permitiendo identificar desafíos y arribar a aprendizajes iniciales sobre el desarrollo de una PS territorialmente situada.

Vulnerability assessments are commonly based on complex indices that may be inappropriate for characterizing risks in small groups of people exposed to environmental hazards. The aim was to present a multivariate and geostatistical approach to explore human health risks at the individual, household and community level. First, biological and socioeconomic characteristics from 179 children were used in a cluster analysis to find groups and identify vulnerability profiles. Then, both the exposure of children to arsenic and lead in soils and their accessibility to community resources were assessed using a geospatial analysis. The results identified three vulnerability profiles among children that were not in agreement with the environmental exposure and deficit of community resources. The proposed approach helps optimize strategies to manage both environmental and social risks based on the vulnerability of the exposed population.

In this work the improved version of an engineering model which accounts for rotational augmentation effects by means of computational fluid dynamics (CFD) calibration is explored and discussed. Based on an analysis of the NREL Phase VI wind turbine, the novel modeling is presented, which uses as base line the formulation proposed by Chaviaropoulos and Hansen. The model is calibrated based on CFD simulations using OpenFOAM. The corresponding correction of the two dimensional polars is straightforward implemented within MoWiT, an in-house software for load calculation. The novel formulation results in improved lift and drag coefficients prediction in all considered cases, reducing the deviation with respect to the rotating CFD cases down to few percent. The optimal configuration including the correction for tip effects of Shen shows better agreements at the very tip of the blade. Furthermore the range of applicability for large wind turbine rotor blades based on a virtual$$10\,\hbox {MW}$$10MWrotor model is discussed.

Between 1984 and 1998, people living in Arica were involuntarily exposed to metal-containing waste stored in the urban area. The study aims to determine whether children who lived near the waste disposal site during early childhood experienced negative effects on their cognitive development. The cognitive performance was assessed using the Wechsler Intelligence Scale for Children. The exposure variable was defined by the year of birth in three categories: (1) Pre-remediation (born before 1999); (2) During-remediation (born between 1999 and 2003); and (3) Post-remediation (born after 2003). In the crude analysis, a difference of 10 points in the IQ average was observed between the group born in the pre- (81.9 points) and post-remediation period (91.1 points). The difference between both groups was five times higher as compared to children of similar age and socioeconomic status in other cities of Chile. This result could be related with a period of high potential for exposure to this contaminated site.

Between 1938 and 1975, the city of Chañaral, located in the north of Chile, received 200 megatons of unregulated mining waste, which created an artificial beach 10 kilometers long and covering an area larger than 4 kmTo determine the prevalence of exposure to metals by dust from mine tailings in Chañaral, a city located in the northern mining area of Chile.The level of urinary metals in a representative sample of adults from Chanaral was determined.Urinary levels of total arsenic (44.6 μg/L), inorganic arsenic (17.0 μg/L) and nickel (2.8 μg/L) were higher than in other areas of Chile. Levels of copper (17.9 μg/L), mercury (1.6 μg/L) and lead (0.9 μg/L) exceeded international values. Of the total subjects, 67.5%, 30.4%, 29.4%, 16.9%, 13.2 and 9.3% presented with high levels of copper, nickel, total arsenic, inorganic arsenic, mercury and lead, respectively.Thirty-one years after suspension of the discharge of mining waste, the local population in this area remains exposed to metals from the mine tailings. Surveillance and remedial actions addressing the Chañaral mine tailings are needed.

Background: Chile has recently been reclassified by the World Bank from an upper-middle-income country to a high-income country. There has been great progress in the last 20 to 30 years in relation to air and water pollution in Chile. Yet after 25 years of unrestrained growth, there remain clear challenges posed by air and water pollution, as well as climate change. Objective: The aim of this study was to review environmental health in Chile. Methods: In late 2013, a 3-day workshop on environmental health was held in Santiago, Chile, bringing together researchers and government policymakers. As a follow-up to that workshop, here we review the progress made in environmental health in the past 20 to 30 years and discuss the challenges of the future. We focus on air and water pollution and climate change, which we believe are among the most important areas of environmental health in Chile. Results: Air pollution in some cities remains among the highest in the continent. Potable water is generally available, but weak state supervision has led to serious outbreaks of infectious disease and ongoing issues with arsenic exposure in some regions. Climate change modeling in Chile is quite sophisticated, and a number of the impacts of climate change can be reasonably predicted in terms of which areas of the country are most likely to be affected by increased temperature and decreased availability of water, as well as expansion of vector territory. Some health effects, including changes in vector-borne diseases and excess heat mortality, can be predicted. However, there has yet to be an integration of such research with government planning. Conclusions: Although great progress has been made, currently there are a number of problems. We suspect that the Chilean experience in environmental health may be of some use for other Latin American countries with rapid economic development.

Contexto: Chile presenta una tendencia secular hacia una sostenida mejoria en los principales indicadores materno-infantiles. Su situacion constituye una experiencia positiva a nivel de la region de Latino-America y el Caribe. Sin embargo, esta tendencia se ha estancado en los ultimos diez anos lo que produce una situacion inestable y preocupante desde el punto de vista de la salud publica materna. Esto motiva una reunion de expertos a nivel nacional e internacional para proponer estrategias para el alto nivel politico orientadas a alcanzar los Objetivos 4 y 5 del Milenio. Conclusion: Este documento de consenso sobre mortalidad materna, sugiere un enfrentamiento en dos ejes: primero, enfrentar la nueva realidad epidemiologica desde la etapa pre-concepcional, esto incluye considerar la alta prevalencia de obesidad, hipertension arterial, diabetes, hiperlipidemias e hipotiroidismo en la poblacion, y por otro lado reforzar la seguridad de la asistencia del embarazo, parto y puerperio en los lugares mas alejados y mas vulnerables del pais. Es necesario focalizar las intervenciones en los grupos de mayor riesgo vital (edades extremas de la vida fertil y portadoras de enfermedades medico-quirurgicas severas, que se reflejan en el aumento proporcional de las causas indirectas de muerte materna), reforzar las actividades de auditorias de mortalidad/near miss, asi como controlar el aumento alarmante de la tasa de partos por cesareas.

Resumen: Objetivo: Describir los intereses, preferencias tematicas y aprendizajes en el campo de la salud publica que emergen de escolares chilenos tras una experiencia de indagacion cientifica escolar. Material y metodos: Estudio exploratorio de caracter cualitativo, realizado en 29 grupos de investigacion escolar del proyecto Salud Con-Ciencia en tu Barrio, basado en un analisis de contenido de textos y narrativas de los estudiantes. Resultados: Los estudiantes priorizan la situacion de animales abandonados, el manejo de la basura y la seguridad e infraestructura urbana visualizando el rol de los actores sociales y el impacto positivo/negativo en la comunidad, y valorando el conocimiento obtenido a traves de la observacion de barrios e interaccion con vecinos. Conclusiones: La indagacion cientifica escolar en el contexto barrial aporta estrategias didacticas para la promocion de la salud local y desarrolla nociones basicas de salud comuntaria y motivacion en los estudiantes por vincularse con la realidad socioambiental de sus barrios.

OBJETIVO: Identificar dimensiones residenciales que caractericen el ambiente fisico y social en los campamentos de Chile y construir tipologias que permitan elaborar perfiles con esos atributos residenciales distintivos. METODOS: Se estudio el universo de campamentos (n = 122) de la Region Metropolitana (Chile) a partir del Catastro Nacional de Campamentos realizado por la fundacion "Un Techo para Chile" en 2007. Se recolecto informacion proveniente de informantes clave sobre las comunidades y los lugares de emplazamiento, variables que fueron modeladas empleando un analisis factorial para identificar dimensiones residenciales, las que a su vez fueron refinadas con la tecnica de agrupamientos de k-medias. RESULTADOS: El analisis factorial destaco tres dimensiones subyacentes: respuesta social local, ambiente extracomunitario y servicios basicos. Las variables centrales en la formacion de esas categorias fueron la existencia de proyectos habitacionales, el area urbana y el acceso a electricidad, respectivamente. El analisis de agrupamientos genero cuatro perfiles que combinaron las tres dimensiones: perfil urbano con baja precariedad de servicios basicos (n = 30), perfil urbano-rural con alto potencial de respuesta social local (n = 32), perfil urbano con alta amenaza ambiental (n = 43) y perfil rural con bajo potencial de respuesta social local (n = 17). CONCLUSIONES: Las dimensiones residenciales formadas son consistentes con el modelo teorico revisado y sugieren indicadores relevantes para el seguimiento de estas comunidades. La identificacion de perfiles permite dimensionar la heterogeneidad de realidades residenciales contribuyendo a la priorizacion de dominios de deficit o riesgos que pueden estar presentes en cada grupo, para con ello profundizar en su investigacion y oportunidades de accion.

Introduction: Neurodevelopmental effects have been reported associated to lead and arsenic exposure. Such effects have been unexplored in children living near to a remediated area contaminated with...

ResumenIntroducciónIntervenciones habitacionales destinadas a superar la pobreza pueden generar cambios en la situación de salud de la población infantil, modificando factores de riesgo en el entorno físico y social de niños y niñas. El objetivo fue identificar indicadores de salud ambiental infantil susceptibles de ser modificados con la reubicación de familias desde campamentos a vivienda social.Sujetos y métodoEstudio transversal en niños de 2-8 años. Se comparó dos grupos de familias provenientes de campamentos. Un grupo fueron familias reubicadas en viviendas sociales entre 2001 y 2002 (n = 115). El otro grupo corresponde a niños cuyas familias permanecieron en campamentos (n = 88) de la zona poniente de Santiago. Se recolectó información sobre: características socioeconómicas, ambiente intradomiciliario y de barrios, y eventos en salud: síntomas respiratorios, accidentabilidad y cuidado materno infantil. Se emplearon pruebas de x2, Fisher y Mann-Whitney para la comparación de los grupos.ResultadosSe identifican diferencias entre los grupos comparados en relación a la tenencia de mascotas, presencia de hongos/humedad en el hogar, tipo de combustibles utilizados y problemas de seguridad percibidos en los barrios (p

Housing interventions aimed at overcoming poverty can lead to changes in the health status of children by modifying risk factors in their physical and social environmentthe aim was to identify children's environmental health factors to change with the relocation of families from slums to public housing.A cross-sectional study was conducted in children ages 2-8 years old of families relocated to public housing (n=115) who were compared to children residing in slums (n=88) in Santiago, Chile. Family socioeconomic characteristics, indoor environment and neighborhoods were collected. It was included respiratory symptoms, accidents and maternal-child care of children. χ2, Fisher and Mann-Whitney test were used to compare groups.There were differences in households related to pets keeping, presence of humidity/molds in homes, types of fuels, and perceived safety problems in neighborhoods (p0.05). The families from slums reported higher tenancy of pets (73.8% v/s 32.2%%), humidity/molds in homes (43.,2% v/s 18.3%), use of wood for heating (39.8% v/s 0.0%), compared with families of public housing. Residents of public housing perceived more safety problems in neighborhood, and children have more asthma related symptoms and have lower diversity of accidents in home.Among the factors studied, indoor air quality and safety in neighborhoods could be linked to changes from the relocation of families. This reinforces the need to deepen the positive and negative influences of residential mobility of these groups focused on child welfare perspective.

One largely unstudied benefit of relocating families from slums to public housing is the potential improvement in indoor air quality (IAQ). We compared families that moved from slums to public housing with those that remained living in slums in Santiago, Chile in terms of fine particulate matter (PM2.5) as main indicator of change. A cross-sectional study of 98 relocated families and 71 still living in slums was carried out, obtaining indoor and outdoor samples by a Personal Environmental Monitor. Home characteristics, including indoor air pollution sources were collected through questionnaires. Multivariate regression models included the intervention (public housing or slum), indoor pollution sources, outdoor PM2.5 and family characteristics as predictors. Indoor PM2.5 concentrations were higher in slums (77.8 μg m−3 [SD = 35.7 μg m−3]) than in public housing (55.7 μg m−3 [SD = 34.6 μg m−3], p

Background and Aims: Housing interventions, as rehousing/relocation of families from deprived to improved houses, can impact public health through reducing several risk factors. One of the potentia...

To identify residential parameters that characterize the physical and social environment in Chile's irregular settlements, and to construct typologies that will allow to develop profiles with those distinctive residential attributes.The study examined the universe of irregular settlements (n = 122) in Chile's Metropolitan Region, based on the 2007 national inventory of irregular settlements conducted by the "Un Techo para Chile" foundation. Information about the communities and their locations was obtained from key informants, and these variables were modeled using factor analysis to identify residential parameters, which were then refined by k-means clustering.The factor analysis pointed to three underlying parameters: local social response, the environment beyond the community, and basic services. The key variables shaping these categories were the existence of housing projects, the urban area involved, and access to electricity. The cluster analysis generated four profiles that combined the three parameters: an urban profile with relatively reliable basic services (n = 30), an urban-rural profile with high potential for local social response (n = 32), an urban profile with a high level of environmental threat (n = 43), and a rural profile with low potential for local social response (n = 17).The residential parameters formed are consistent with the revised theoretical model and suggest relevant indicators for monitoring these communities. Definition of the profiles facilitates assessment of the heterogeneity of residential situations, which helps in the prioritization of areas with deficits or risks that may be present in each cluster. This, in turn, opens the door to further investigation and to exploring opportunities for action.

Petcoke is a remnant of the oil refining process that contains Ni and other heavy metals. Undesired human exposure to these compounds may result from petcoke combustion in plants located in the vicinity of the cities.To compare levels of urinary Ni in schoolchildren residing in cities exposed and not exposed to petcoke pollution.A cross sectional study was done in schoolchildren aged 7 to 8 years old in two cities in northern Chile: Mejillones (n = 59), near to a petcoke plant, and Tocopilla (n = 56) as the reference city. First, morning urinary samples were collected and urinary Ni was determined by Atomic Absorption Spectrometry. Socioeconomic and environmental exposure information of families was obtained applying a questionnaire to parents. Multiple linear regression was performed to identify other variables that may explain urinary Ni differences among the cities.Median level of Ni was higher in Mejillones (4.9 fig/L) than in Tocopilla (3.9 fig/L). Residing in the exposed city was the most important explaining factor (B = 0.26; IC 0.107 - 0.428). Additionally years of residency was associated with urinary Ni (B = 0.03; IC 0.004 - 0.060).Urinary Ni in schoolchildren is higher in the city exposed to petcoke emissions. The difference does not imply that there are concrete hazards for the population's health. However, it warns about the existence of a higher exposure in places where petcoke is used.

Background: Petcoke is a remmant of the oil refiningprocess that contains Ni and other heavy metáis. Undesired human exposure to these compounds may result from petcoke combustión in plants located in the vicinity ofthe cities. Aim: To compare levéis of urinary Ni in schoolchildren residing in cities exposed and not exposed to petcoke pollution. Material and methods: A cross sectional study was done in schoolchildren aged 7 to 8 years oíd in two cities in northern Chile: Mejillones (n = 59), near to a petcoke plant and Tocopilla (n = 56) as the reference city. First, morning urinary samples were collected and urinary Ni was determined by Atomic Absorption Spectrometry. Socioeconomic and environmental exposure information of families was obtained applying a questionnaire to parents. Múltiple linear regression was performed to identify other variables that may explain urinary Ni differences among the cities. Results: Median level of Ni was higher in Mejillones (4.9 fig/L) than in Tocopilla (3.9 fig/L). Residing in the exposed city was the most important explaining factor (B = 0.26; IC 0.107 - 0.428). Additionally years of residency was associated with urinary Ni (B = 0.03; IC 0.004 - 0.060). Conclusions: Urinary Ni in schoolchildren is higher in the city exposed to petcoke emissions. The difference does not imply that there are concrete hazards for the population s health. However, it warns about the existence of a higher exposure in places where petcoke is used.