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Semir-González C, Ferrer-Urbina R, Suazo-Navarro C, Flores-Denegri C, Bolados D, Rosales J, Sepúlveda-Páez G. Development of a Scale to Measure Healthy Behaviors in Spanish-Speaking University Students. Int J Environ Res Public Health 2023; 20:2627. [PMID: 36767993 PMCID: PMC9915417 DOI: 10.3390/ijerph20032627] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 01/26/2023] [Accepted: 01/28/2023] [Indexed: 06/18/2023]
Abstract
Chronic non-communicable diseases (NCDs) are a public health problem that affect the quality of life and well-being of people, especially the youth, who have been identified as a high-risk population. Physical inactivity is a key risk factor for NCDs, and an unhealthy diet is a significant driver of NCDs. On the other hand, physical exercise and healthy habits are effective methods of prevention. Although there are scales that measure different behaviors related to NCDs, most of them have been developed in another language (e.g., English) or only focus on one aspect of NCDs. The present study aimed to develop a scale to assess healthy behaviors (i.e., healthy eating and physical exercise) in Spanish-speaking university students, using an instrumental design, with a sample of 369 Chilean university students between 18 and 25 years of age. The results presented show evidence of validity through an exploratory structural equation model (ESEM), reliability estimation through McDonald's omega and Cronbach's alpha, evidence of invariance by sex, and evidence of validity in relation to other variables with an SEM model. It is concluded that the Healthy Behavior Scale, consisting of nine items to measure healthy eating and physical exercise, is a brief instrument with evidence of reliability and validity (CFI = 0.998; TLI = 0.995; and RMSEA = 0.063) for application in a Spanish-speaking university population, offering potential applications in research instruments, screening studies, and the development of new studies for other contexts.
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Rada I, Oyarte M, Cabieses B. A comparative analysis of health status of international migrants and local population in Chile: a population-based, cross-sectional analysis from a social determinants of health perspective. BMC Public Health 2022; 22:1329. [PMID: 35820866 PMCID: PMC9277854 DOI: 10.1186/s12889-022-13709-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 06/07/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND During recent decades intraregional migration has increased in Latin America. Chile became one of the main receiving countries and hosted diverse international migrant groups. Evidence have suggested a healthy migrant effect (HME) on health status, but it remains scarce, controversial and needs to be updated. This study performed a comprehensive analysis verifying the existence of HME and its association with social determinants of health (SDH). METHODS We analyzed data from the Chilean National Socioeconomic Characterization Survey (CASEN, version 2017). Unadjusted prevalence of health status indicators such as negative self-perceived health, chronic morbidity, disability, and activity limitations were described in both international migrants and local population. Adjusted associations between these outcomes and sets of demographics, socioeconomic, access to healthcare, psychosocial and migration-related SDH were tested using multivariate logistic regression in each population. The HME for each health outcome was also tested using multivariate logistic regression and sequentially adjusting for each set of SDH (ref = Chilean). RESULTS International migrants had lower unadjusted prevalence of all health indicators compared to Chileans. That is, unadjusted analysis revealed an apparent HME in all health outcomes. Age, unemployment, and health care system affiliation were associated with health outcomes in both populations. Psychosocial determinants were both risk and protective for the analysed health outcomes. After adjustment for each set of SDH, the immigrant health advantage was only significant for chronic morbidity. Being migrant was associated with 39% lower odds of having chronic diseases compared to locals (OR: 0.61; 95% CI: 0.44-0.84; P = 0.0003). For all other outcomes, HME disappeared after adjusting by SDH, particularly unemployment, type of health system and psychosocial factors. CONCLUSIONS Testing the HME in Chile revealed an advantage for chronic morbidities that remained significant after adjustment for SDH. This analysis shed light on health disparities between international migrants and local population in the Latin American region, with special relevance of unemployment, type of health system and psychosocial SDH. It also informed about differential exposures faced during migration process that could dissolve the HME over time. Evidence from this analytical approach is useful for informing health planning and intersectoral solutions from a SDH perspective.
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Affiliation(s)
- Isabel Rada
- Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina, Clínica Alemana, Universidad del Desarrollo, Av. Plaza 680, Las Condes, Región, Metropolitana, Chile
| | - Marcela Oyarte
- Instituto de Salud Pública de Chile, Subdepartamento Innovación, Desarrollo, Transferencia Tecnológica y ETESA, Departamento Agencia Nacional de Dispositivos Médicos, Innovación y Desarrollo, Santiago, Región Metropolitana, Chile
| | - Báltica Cabieses
- Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina, Clínica Alemana, Universidad del Desarrollo, Av. Plaza 680, Las Condes, Región, Metropolitana, Chile.
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Seron P, Lanas F. The urgent need of public policies for promoting cardiovascular health in Latin-American women. Lancet Reg Health Am 2021; 4:100114. [PMID: 36776711 PMCID: PMC9903792 DOI: 10.1016/j.lana.2021.100114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 10/21/2021] [Accepted: 10/22/2021] [Indexed: 11/17/2022]
Affiliation(s)
- Pamela Seron
- Internal Medicine Department, Medicine Faculty, Universidad de La Frontera.,Corresponding author: Internal Medicine Department, Medicine Faculty, Universidad de La Frontera, Temuco, Chile. Claro Solar #115, Temuco Chile. Phone: 56-45-2325765
| | - Fernando Lanas
- Internal Medicine Department, Medicine Faculty, Universidad de La Frontera
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Madero-Cabib I, Bambs C. Association between Lifetime Tobacco Use and Alcohol Consumption Trajectories and Cardiovascular and Chronic Respiratory Diseases among Older People. Int J Environ Res Public Health 2021; 18:11275. [PMID: 34769792 DOI: 10.3390/ijerph182111275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 10/21/2021] [Accepted: 10/24/2021] [Indexed: 11/16/2022]
Abstract
Background: We identify representative types of simultaneous tobacco use and alcohol consumption trajectories across the life course and estimate their association with cardiovascular and chronic respiratory diseases (CVDs and CRDs) among older people in Chile. Methods: We used data from a population-representative, face-to-face and longitudinal-retrospective survey focused on people aged 65–75 (N = 802). To reconstruct trajectory types, we employed weighted multichannel sequence analysis. Then, we estimated their associations with CVDs and CRDs through weighted logistic regression models. Results: Long-term exposure to tobacco use and alcohol consumption across life are associated with the highest CVD and CRD risks. Long-term nonsmokers and nondrinkers do not necessarily show the lowest CVDs and CRDs risks if these patterns are accompanied by health risk factors such as obesity or social disadvantages such as lower educational levels. Additionally, trajectories showing regular consumption in one domain but only in specific periods of life, whether early or late, while maintaining little or no consumption across life in the other domain, lead to lower CVDs or CRDs risks than trajectories indicating permanent consumption in both domains. Conclusions: A policy approach that considers CVDs and CRDs as conditions that strongly depend on previous individual experiences in diverse life domains can contribute to the improved design and evaluation of preventive strategies of tobacco use and alcohol consumption across the life course.
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Villalobos Dintrans P, Browne J, Madero-Cabib I. It Is Not Just Mortality: A Call From Chile for Comprehensive COVID-19 Policy Responses Among Older People. J Gerontol B Psychol Sci Soc Sci 2021; 76:e275-e280. [PMID: 32735013 PMCID: PMC7454906 DOI: 10.1093/geronb/gbaa092] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Indexed: 11/16/2022] Open
Abstract
Objective Provide a synthesis of the COVID-19 policies targeting older people in Chile, stressing their short- and long-term challenges. Method Critical analysis of the current legal and policy measures, based on national-level data and international experiences. Results Although several policies have been enacted to protect older people from COVID-19, these measures could have important unintended negative consequences in this group’s mental and physical health, as well as financial aspects. Discussion A wider perspective is needed to include a broader definition of health—considering financial scarcity, access to health services, mental health issues, and long-term care—in the policy responses to COVID-19 targeted to older people in Chile.
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Affiliation(s)
| | - Jorge Browne
- Sección de Geriatría, Departamento de Medicina Interna, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Ignacio Madero-Cabib
- Instituto de Sociología & Departamento de Salud Pública, Pontificia Universidad Católica de Chile, Santiago, Chile.,Millennium Nucleus for the Study of the Life Course and Vulnerability (MLIV), Santiago, Chile
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Caamaño-Navarrete F, Latorre-Román PÁ, Párraga-Montilla JA, Álvarez C, Delgado-Floody P. Association between Creativity and Memory with Cardiorespiratory Fitness and Lifestyle among Chilean Schoolchildren. Nutrients 2021; 13:nu13061799. [PMID: 34070541 PMCID: PMC8227713 DOI: 10.3390/nu13061799] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 05/15/2021] [Accepted: 05/21/2021] [Indexed: 12/15/2022] Open
Abstract
The objective was to investigate the association between creativity and memory with cardiorespiratory fitness (CRF; i.e., CFR classification and V˙O2max); lifestyle parameters (i.e., physical activity (PA), sleep duration, screen time (ST), and food habits); and anthropometric measures (i.e., body mass index (BMI), waist circumference (WC)) among Chilean schoolchildren. A total of 248 schoolchildren (137 boys, 111 girls, 11.80 ± 1.17 and 11.58 ± 1.09 years, respectively) participated in the cross-sectional study. Creativity, memory, concentration, and selective attention and lifestyle (PA, ST, sleep duration, and Mediterranean diet (MD) adherence) were measured using a standard questionnaire. CRF (measured by the 20 m shuttle run test and expressed as maximum oxygen consumption (V˙O2max) and anthropometric measures (BMI and WC) were also included. Creativity showed a positive association with V˙O2max (mL/kg/min) (β; 0.209, 95% CI; 0.02-0.40, p = p < 0.05) and MD Adherence (score) (β; 0.206, 95% CI; 0.01; 0.74, p = p < 0.05). Long-term memory reported a positive association with CRF (β; 1.076, 95% CI; 0.02-2.13, p = p < 0.05). An increase in CRF levels, together with healthy food habits and normal nutritional status, should be a target for community- and school-based interventions to promote cognitive development in creativity and memory among schoolchildren.
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Affiliation(s)
| | - Pedro Á. Latorre-Román
- Department of Didactics of Music, Plastic and Corporal Expression, University of Jaén, 23071 Jaén, Spain; (P.Á.L.-R.); (J.A.P.-M.)
| | - Juan A. Párraga-Montilla
- Department of Didactics of Music, Plastic and Corporal Expression, University of Jaén, 23071 Jaén, Spain; (P.Á.L.-R.); (J.A.P.-M.)
| | - Cristian Álvarez
- Quality of Life and Wellness Research Group API4, Laboratory of Human Performance, Department of Physical Activity Sciences, Universidad de Los Lagos, Osorno 5290000, Chile;
| | - Pedro Delgado-Floody
- Department of Physical Education, Sport and Recreation, Universidad de La Frontera, Temuco 478000, Chile
- Correspondence: ; Tel.: +56-962489239
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Madero-Cabib I, Azar A, Bambs C. Lifetime employment, tobacco use, and alcohol consumption trajectories and cardiovascular diseases in old age. SSM Popul Health 2021; 13:100737. [PMID: 33553569 PMCID: PMC7848642 DOI: 10.1016/j.ssmph.2021.100737] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 10/30/2020] [Accepted: 01/16/2021] [Indexed: 12/19/2022] Open
Abstract
Despite the great advances of life course epidemiology studies during the last decade in understanding the general health effects of employment trajectories, research has yet to evaluate the effects of employment trajectories along with other major risk factors, such as tobacco and alcohol consumption, on cardiovascular diseases (CVDs)-the main cause of deaths worldwide. This is highly relevant, since health advantages in one domain (e.g., being a permanent formal full-time worker) may offset health disadvantages in other domains (e.g., being a regular smoker or alcohol consumer); conversely, disadvantages in both domains may interact, leading to even greater health risks. Considering these knowledge gaps, this research has two main objectives: (1) to reconstruct simultaneous employment, tobacco use, and alcohol consumption trajectories over the life course (from birth to old age) and (2) to measure the association between these trajectories and CVD in old age. Drawing on a rich and comprehensive life history dataset and using multichannel sequence and regression analyses, we analyzed a cohort of individuals aged 65-75 in Chile, a Latin American country with high social inequalities and scarce research on this matter. Our study shows that following a trajectory of formal employment together with no tobacco and alcohol use reduces CVD risk by 36 percentage points relative to a similar employment trajectory but with regular tobacco and alcohol use. Even with an employment trajectory characterized by constant informal employment or permanent inactivity, a life course free of regular tobacco and alcohol use shows protective effects against CVD. This study stresses the importance of health policies that consider CVD as a condition that strongly depends on individual experiences in multiple life domains and across different life stages.
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Affiliation(s)
- Ignacio Madero-Cabib
- Instituto de Sociología & Departamento de Salud Pública, Pontificia Universidad Católica de Chile, Santiago, Chile
- Millennium Nucleus for the Study of the Life Course and Vulnerability (MLIV), Chile
| | - Ariel Azar
- Millennium Nucleus for the Study of the Life Course and Vulnerability (MLIV), Chile
- Department of Sociology, The University of Chicago, Chicago, IL, USA
| | - Claudia Bambs
- Departamento de Salud Pública, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- Advanced Center for Chronic Diseases(ACCDiS), Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
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Vandenberg B, O'Brien K. Commentary on Paraje et al. : The untapped potential of price in preventing alcohol initiation. Addiction 2021; 116:495-496. [PMID: 33210406 DOI: 10.1111/add.15306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 10/23/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Brian Vandenberg
- Behavioural Sciences Research Laboratory, School of Social Sciences, Monash University, Australia
| | - Kerry O'Brien
- Behavioural Sciences Research Laboratory, School of Social Sciences, Monash University, Australia
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Passi-Solar Á, Margozzini P, Mindell JS, Ruiz M, Valencia-Hernandez CA, Scholes S. Hypertension care cascade in Chile: a serial cross-sectional study of national health surveys 2003-2010-2017. BMC Public Health 2020; 20:1397. [PMID: 32928176 PMCID: PMC7490861 DOI: 10.1186/s12889-020-09483-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 08/31/2020] [Indexed: 11/16/2022] Open
Abstract
Background Trend data on hypertension prevalence and attainment indicators at each step of the care cascade (awareness, treatment, control) are required in Chile. This study aims to quantify trends (2003–2017) in prevalence and in the proportion of individuals with hypertension attaining each step of the care cascade among adults aged 17 years or older, and to assess the impact of lowering the blood pressure (BP) thresholds used to define elevated BP on these indicators. Methods We used data from 2003, 2010, and 2017 Chilean national health surveys. Each year we assessed levels of (1) mean systolic (SBP) and diastolic (DBP) blood pressure, (2) hypertension prevalence (BP ≥ 140/90 mmHg or use of antihypertensive treatment), and (3) awareness, treatment, and control. Logistic regression on pooled data was used to assess trends in binary outcomes; linear regression was used to assess trends in continuous SBP and DBP. We compared levels of hypertension prevalence using two sources to ascertain antihypertensive treatment (self-reported versus medicine inventory). The 2017 American College of Cardiology/American Heart Association (ACC/AHA) guidelines were used to re-define hypertension using lower thresholds (BP ≥ 130/80 mmHg). Results Hypertension prevalence was 34.0, 32.0 and 30.8% in 2003, 2010 and 2017, respectively. Levels of treated- and controlled-hypertension were significantly higher in 2017 than in 2003 (65% versus 41% for treatment, P < 0.001; 34% versus 14% for control, P < 0.001), while levels of awareness were stable (66% versus 59%, P = 0.130). Awareness, treatment, and control levels were higher among females in 2003, 2010, and 2017 (P < 0.001). Mean SBP and DBP decreased over the 15-year period, except for SBP among females on treatment. Adopting the 2017 ACC/AHA guidelines would increase hypertension prevalence by 17 and 55% in absolute and relative terms, respectively. Conclusions Chile has experienced a positive population-wide lowering in blood pressure distribution which may be explained partly by a significant rise in levels of treated- and controlled-hypertension since 2003. Lowering the thresholds used to define elevated BP would substantially increase the financial public health challenge of further improving attainment levels at each step of the care cascade. Innovative and collaborative strategies are needed to improve hypertension management, especially among males.
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Affiliation(s)
- Álvaro Passi-Solar
- Research Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, UK.,Department of Public Health, School of Medicine, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, CP 88330077, Santiago, Chile
| | - Paula Margozzini
- Department of Public Health, School of Medicine, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, CP 88330077, Santiago, Chile.
| | - Jennifer S Mindell
- Research Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, UK
| | - Milagros Ruiz
- Research Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, UK
| | - Carlos A Valencia-Hernandez
- Research Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, UK
| | - Shaun Scholes
- Research Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, UK
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Crespo R, Alvarez C, Hernandez I, García C. A spatially explicit analysis of chronic diseases in small areas: a case study of diabetes in Santiago, Chile. Int J Health Geogr 2020; 19:24. [PMID: 32576179 PMCID: PMC7310447 DOI: 10.1186/s12942-020-00217-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 06/15/2020] [Indexed: 01/25/2023] Open
Abstract
Background There is a strong spatial correlation between demographics and chronic diseases in urban areas. Thus, most of the public policies aimed at improving prevention plans and optimizing the allocation of resources in health networks should be designed specifically for the socioeconomic reality of the population. One way to tackle this challenge is by exploring within a small geographical area the spatial patterns that link the sociodemographic attributes that characterize a community, its risk of suffering chronic diseases, and the accessibility of health treatment. Due to the inherent complexity of cities, soft clustering methods are recommended to find fuzzy spatial patterns. Our main motivation is to provide health planners with valuable spatial information to support decision-making. For the case study, we chose to investigate diabetes in Santiago, Chile. Methods To deal with spatiality, we combine two statistical techniques: spatial microsimulation and a self-organizing map (SOM). Spatial microsimulation allows spatial disaggregation of health indicators data to a small area level. In turn, SOM, unlike classical clustering methods, incorporates a learning component through neural networks, which makes it more appropriate to model complex adaptive systems, such as cities. Thus, while spatial microsimulation generates the data for the analysis, the SOM method finds the relevant socio-economic clusters. We selected age, sex, income, prevalence of diabetes, distance to public health services, and type of health insurance as input variables. We used public surveys as input data. Results We found four significant spatial clusters representing 75 percent of the whole population in Santiago. Two clusters correspond to people with low educational levels, low income, high accessibility to public health services, and a high prevalence of diabetes. However, one presents a significantly higher level of diabetes than the other. The second pair of clusters is made up of people with high educational levels, high income, and low prevalence of diabetes. What differentiates both clusters is accessibility to health centers. The average distance to the health centers of one group almost doubles that of the other. Conclusions In this study, we combined two statistical techniques: spatial microsimulation and selforganising maps to explore the relationship between diabetes and socio-demographics in Santiago, Chile. The results have allowed us to corroborate the importance of the spatial factor in the analysis of chronic diseases as a way of suggesting differentiated solutions to spatially explicit problems. SOM turned out to be a good choice to deal with fuzzy health and socioeconomic data. The method explored and uncovered valuable spatial patterns for health decision-making. In turn, spatial microsimulation.
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Affiliation(s)
- Ricardo Crespo
- Departamento de Ingeniería Geográfica, Universidad de Santiago de Chile, Avenida Libertador Bernardo O'Higgins, 3363, Estación Central, Santiago, Chile.
| | - Claudio Alvarez
- Departamento de Ingeniería Geográfica, Universidad de Santiago de Chile, Avenida Libertador Bernardo O'Higgins, 3363, Estación Central, Santiago, Chile
| | - Ignacio Hernandez
- Departamento de Ingeniería Geográfica, Universidad de Santiago de Chile, Avenida Libertador Bernardo O'Higgins, 3363, Estación Central, Santiago, Chile
| | - Christian García
- Facultad de Ciencias Médicas, Universidad de Santiago de Chile, Santiago, Chile
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