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- ItemThe socioeconomic distribution of life expectancy and healthy life expectancy in Chile(BioMed Central Ltd, 2023) Espinoza, Manuel A.; Severino Suárez, Rodrigo Alfredo; Balmaceda, Carlos; Abbott, Tomás; Cabieses, Báltica© 2023, BioMed Central Ltd., part of Springer Nature.Background: Life expectancy (LE) has usually been used as a metric to monitor population health. In the last few years, metrics such as Quality-Adjusted-Life-Expectancy (QALE) and Health-Adjusted-Life- Expectancy (HALE) have gained popularity in health research, given their capacity to capture health related quality of life, providing a more comprehensive approach to the health concept. We aimed to estimate the distribution of the LE, QALEs and HALEs across Socioeconomic Status in the Chilean population. Methods: Based on life tables constructed using Chiang II´s method, we estimated the LE of the population in Chile by age strata. Probabilities of dying were estimated from mortality data obtained from national registries. Then, life tables were stratified into five socioeconomic quintiles, based on age-adjusted years of education (pre-school, early years to year 1, primary level, secondary level, technical or university). Quality weights (utilities) were estimated for age strata and SES, using the National Health Survey (ENS 2017). Utilities were calculated using the EQ-5D data of the ENS 2017 and the validated value set for Chile. We applied Sullivan´s method to adjust years lived and convert them into QALEs and HALEs. Results: LE at birth for Chile was estimated in 80.4 years, which is consistent with demographic national data. QALE and HALE at birth were 69.8 and 62.4 respectively. Men are expected to live 6.1% less than women. However, this trend is reversed when looking at QALEs and HALEs, indicating the concentration of higher morbidity in women compared to men. The distribution of all these metrics across SES showed a clear gradient in favour of a better-off population-based on education quintiles. The absolute and relative gaps between the lowest and highest quintile were 15.24 years and 1.21 for LE; 18.57 HALYs and 1.38 for HALEs; and 21.92 QALYs and 1.41 for QALEs. More pronounced gradients and higher gaps were observed at younger age intervals. Conclusion: The distribution of LE, QALE and HALEs in Chile shows a clear gradient favouring better-off populations that decreases over people´s lives. Differences in LE favouring women contrast with differences in HALEs and QALEs which favour men, suggesting the need of implementing gender-focused policies to address the case-mix complexity. The magnitude of inequalities is greater than in other high-income countries and can be explained by structural social inequalities and inequalities in access to healthcare.
- ItemWording effects in assessment: missing the trees for the forest(2022) Ponce Cisternas Fernando Patricio; Torres Irribarra, David; Verges, Álvaro; Arias, Victor B.This article examines wording effects when positive and negative worded items are includedin psychological assessment. Wordings effects have been analyzed in the literature usingstatistical approaches based on population homogeneity assumptions (i.e. CFA, SEM), com-monly adopting the bifactor model to separate trait variance and wording effects. This art-icle presents an alternative approach by explicitly modeling population heterogeneitythrough a latent profile model, based on the idea that a subset of individuals exhibits word-ing effects. This kind of mixture model allows simultaneously to classify respondents, sub-stantively characterize the differences in their response profiles, and report respondents’results in a comparable manner. Using the Rosenberg’s self-esteem scale data from the LISSPanel (N¼6,762) in three studies, we identify a subgroup of participants who respond dif-ferentially according to item-wording and examine the impact of its responses in the esti-mation of the RSES measurement model, in terms of global and individual fit, under one-factor and bifactor models.The results of these analyses support the interpretation of wording effects in terms of a the-oretically-proposed differential pattern of response to positively and negatively wordeditems, introducing a valuable tool for examining the artifactual or substantive interpretationsof such wording effects.
- ItemMechanical characterization of the emphysematous rat lung(2023) Villa Barros, Benjamín; Hurtado Sepúlveda, Daniel; Pontificia Universidad Católica de Chile. Escuela de IngenieríaLos modelos animales han sido utilizados ampliamente para evaluar el irreversible crecimiento de los espacios aéreos alveolares y comprender la fisiopatología del enfisema. Mientras que la respuesta mecánica pulmonar a estos cambios morfológicos ha sido documentada en la literatura, la caracterización mecánica del tejido enfisematoso ha sido poco investigada hasta la fecha. En este trabajo, estudiamos la respuesta mecánica del tejido y las características morfológicas alveolares de los pulmones a partir de un modelo animal de enfisema inducido por elastasa. Analizamos el comportamiento no lineal del tejido utilizando modelos constitutivos hiperelásticos adecuados a partir de los cuales caracterizamos los parámetros del material. Analizamos más a fondo el efecto de la dosis de elastasa en las propiedades estructurales y materiales y estudiamos su conexión con la compliance respiratoria. En particular, mostramos que si bien la compliance pulmonar en los grupos inducidos por elastasa no difiere del grupo de Control, existen diferencias significativas en el comportamiento mecánico y la morfometría del tejido. Además, nuestros resultados sugieren que durante el desarrollo temprano del enfisema, los parámetros del material tisular son más sensibles al agrandamiento alveolar que a la compliance pulmonar. Nuestros hallazgos resaltan la importancia de evaluar la mecánica tisular en los pulmones enfisematosos, ya que los parámetros materiales pueden representar un indicador prometedor para detectar el inicio de la remodelación del enfisema durante las primeras etapas de la enfermedad.
- ItemIntercultural Education in Chile: A Discussion Map(Springer, 2023) Morawietz, Liliana; Treviño, Ernesto; Villalobos, CristóbalThis first chapter addresses three distinct aspects of Bilingual Intercultural Education (EIB, by the Spanish acronym). The first section provides a brief overview of the recent history of EIB during the last two decades in Chile, outlining its main policies and describing the major milestones and advances, as well as its various challenges, in order to demonstrate the development path that EIB has followed in the country.
- ItemWillingness to pay for social housing attributes: a case study from Chile(2002) Greene, Margarita; Ortúzar, Juan de DiosIn the past 25 years social housing programmes in Chile have taken three basic forms. During the military regime the traditional basic housing and a neighbourhood upgrading programme operated, while in 1990 the new democratic authorities added the progressive housing line of action. As there was scope for improving these programmes, a research project was set up with the aim of first identifying, and then finding, the relative importance of social housing attributes for different types of dwellers. Three surveys were considered in the project: a two-wave Delphi survey to specialists in the field and a focus group survey to current and potential beneficiaries, in order to identify the most relevant housing attributes, and a stated-preference survey to a sample of five types of social housing dwellers. With the latter data discrete choice models were estimated, which allowed the relative weight of (and subjective valuation, or willingness to pay for) each such attribute to be determined. The methodological features of the project are presented and its main results are discussed.