Macarena Hirmas

• Master in Public Health
• Professor at Universidad del Desarrollo

Arsenic chronic exposure, particularly in its inorganic form, represents a significant public health concern. This study was conducted in Arica, the northernmost city in the country, whose inhabitants have been exposed to inorganic arsenic both naturally through drinking water and anthropogenically due to a toxic waste disposal site. We explored ch...

Objectives Comprehensively map and summarize digital health initiatives for the elderly and caregivers. Methods Scoping review between April and May 2022 based on Joanna Briggs methodology. Databases used included PubMed, Cochrane Library, CINAHL Plus, and Web of Science, along with grey literature and hand searches. Two reviewers independently co...

Objective: This systematic review aims to clarify COVID-19’s impact on the onset of T2D in adults. Material and methods: Following PRISMA guidelines, this systematic review sourced data from multiple databases from 2019 to April 20th, 2023. Two reviewers handled screening, with a third-party resolving disagreement. The focus was on COVID-19 cases...

Introducción: El envejecimiento poblacional representa un avance en las condiciones de vida y conlleva desafíos para los sistemas sanitarios. La salud digital, usando tecnologías de información, es clave para cerrar brechas y lograr cobertura universal, especialmente en poblaciones vulnerables como las personas mayores. El objetivo de este trabajo...

Introducción El envejecimiento es un fenómeno global estimándose que 2 mil millones de personas tendrán 60 años o más (22% de la población) en 2050, reflejando mejoras en las condiciones de vida y salud. Sin embargo, presenta desafíos en acceso a atención y equidad de servicios sanitarios. La salud digital, basada en tecnologías de información y co...

Introducción La pandemia de COVID-19 que surgió en Wuhan, China a fines de 2019, se extendió rápidamente por todo el mundo con casi 680 millones de casos y 6,9 millones de muertes en la actualidad. Los más afectados fueron los trabajadores de la salud con al menos tres veces más riesgo de contraer la enfermedad que la comunidad en general. La mayor...

Introducción La telemedicina se ha instalado como una valiosa herramienta para brindar atención médica a distancia en todo el mundo, y Chile no ha sido una excepción. En el contexto de la pandemia de COVID-19, esta modalidad de atención ha experimentado un acelerado crecimiento, transformando la prestación de servicios de salud. Si bien, Chile ha p...

Introducción Existe un aumento creciente de evidencia desde la pandemia del COVID-19. Globalmente, este virus a cobrado más de 7 millones de vidas. A pesar que la Organización Mundial de la Salud (OMS), en mayo del presente año, declarara que la pandemia de COVID-19, ya no era una emergencia de salud pública internacional, la evidencia sostiene que...

Introducción: Los seguros complementarios de salud cubren los costos que la institución previsional no absorbe. Este mercado crece año a año en Chile, especialmente los seguros colectivos. Sin embargo, existe escasa evidencia que describa cómo perciben los usuarios la gestión relacionada al reembolso. El objetivo de este estudio es caracterizar la...

Si bien, las conclusiones son preliminares, se evidencian diversas iniciativas de salud digital para personas mayores y cuidadores. Los temas identificados muestran las TIC desempeñando un rol relevante en el cuidado y monitoreo, facilitando el acceso a la atención médica, mejorando la salud mental, promoviendo el envejecimiento activo y la calidad...

The elderly's relationship with technology is limited, except for those who used digital devices for work. Technology is seen as a facilitator for daily tasks, including healthcare. Concerns mainly revolve around fraud, scams, misuse of personal information, and fear of device damage, widening the digital gap. O B J E C T I V E To understand experi...

Objective: Identify barriers and facilitators in access to medicines for diabetes, hypertension, and dyslipidemia, considering patient, health provider, and health system perspectives. Methods: Scoping review based on Joanna Briggs methodology. The search considered PubMed, Cochrane Library, CINAHL, Academic Search Ultimate, Web of Science, SciELO...

Background The COVID-19 pandemic that emerged in Wuhan, China at the end of 2019, spread rapidly around the world with almost 600 million cases and 6.3 million deaths today. The most affected were health workers with at least three times the risk of contracting the disease than the general community. Most studies on seroprevalence in health workers...

Introduction: Older adults are at a higher risk of severe illness and death from COVID-19. This vulnerability increases in those who live in long-term care facilities due to overcrowding, greater physical dependence, and contact with health workers. Evidence on the impact of the pandemic on these establishments in lowand middle-income countries ha...

Introducción: La pandemia de COVID-19 surgida en China a fines de 2019, se extendió rápidamente por el mundo, con casi 600 millones de casos y 6,3 millones de fallecidos en la actualidad. Los más afectados fueron los trabajadores de la salud con al menos tres veces más riesgo que la comunidad general de contraer la enfermedad. La mayoría de los est...

Introduction The extent of the population’s exposure to tobacco imagery across all genres of regular TV programming and the contribution of each of these genres is unknown, except for UK broadcast channels. The objective of this study is to estimate the exposure of young people to tobacco imagery on Chilean prime-time television and the programme s...

Background Syphilis, together with other sexually transmitted infections, remains a global public health problem that is far from controlled. People deprived of liberty are a vulnerable population. Control activities in prisons rely mostly on passive case detection, despite the existence of affordable alternatives that would allow switching to acti...

BACKGROUND: Syphilis, together with other sexually transmitted infections, remains a global public health problem that is far from being controlled. People deprived of liberty are one of the vulnerable population. Control activities in prisons rely mostly on passive case detection, despite the existence of affordable alternatives that would allow s...

Objective To assess the national level of compliance with the Chilean comprehensive smoke-free legislation by observing healthcare facilities, education centres, government offices, hospitality venues and private workplaces, by type of area within workplaces and public places: enclosed, semiopen and open. Methodology In this cross-sectional observ...

Introduction The aim of the study is to assess the national level of compliance with the Chilean smoke-free legislation in the urban public transportation system. Material and Methods In this cross-sectional observational study, we studied a national representative sample of 475 vehicles obtained through a two-stage cluster sampling design in 2018...

Resumen Objetivo: Conocer la percepción de informantes clave pertenecientes a la red de Atención Primaria de Salud en Chile, respecto al proceso de gestión asistencial y el impacto del progra-ma nacional de Garantías Explícticas en Salud (GES) sobre la entrega de ayudas técnicas a personas mayores. Materiales y métodos: Un estudio cualitativo basad...

Objetivo: Conocer la percepción de informantes clave pertenecientes a la red de Atención Primaria de Salud en Chile, respecto al proceso de gestión asistencial y el impacto del programa nacional de Garantías Explícitas en Salud (GES) sobre la entrega de ayudas técnicas a personas mayores. Materiales y métodos: Un estudio cualitativo basado en análi...

INTRODUCTION Population aging is a worldwide phenomenon. It is estimated that by 2050, one of five persons will be aged ≥60 years. In Chile, 15.8% of the population is now aged ≥60 years, and this figure will reach 30.7% by 2050. In 2006, a national program was implemented to provide assistive devices to older adults aged ≥65 years with limited mob...

An outbreak of meningococcal disease with a case-fatality rate of 30% and caused by predominantly serogroup W of Neisseria meningitidis began in Chile in 2012. This outbreak required a case–control study to assess determinants and risk factors for infection. We identified confirmed cases during January 2012−March 2013 and selected controls by rando...

INTRODUCTION Health systems are one determinant of health; their role is to facilitate timely and equitable access to quality services. The way in which a health system is organized can profoundly affect achievement of its objectives. The main feature of the Chilean health system is the coexistence of a public health insurance program (based on a s...

Percepciones que tienen informantes clave de la red de atención respecto al proceso de gestión asistencial del GES Órtesis en sus distintas etapas y al impacto que tiene en las personas mayores

SETTING: Contact investigation of tuberculosis (TB) patients in Chilean prisons. OBJECTIVE : 1) To estimate TB incidence and the prevalence of latent tuberculous infection (LTBI) among prisoners and their contacts; and 2) to determine factors associated with disease transmission. DESIGN: Cross-sectional study conducted in 46 prisons (51% of the tot...

Introduction: Meningococcal disease (MD) is a major global problem because of its case fatality rate and sequels. Since 2012 cases of serogroup W have increased in Chile, with nonspecific clinical presentation, high case fatality rate and serious consequences. Objective: To characterize the evolution and outcome of MD cases between January 2012...

Objetivo. Analizar barreras y facilitadores de acceso a control prenatal en adolescentes urbanas de 15-19 años en Santiago, Chile. Material y métodos. Estudio cualitativo con 17 madres adolescentes basado en la teoría fundamentada. Se realizaron 11 entrevistas semiestructuradas y un grupo focal. Resultados. La negación y ocultamiento del embarazo e...

Introducción: La tuberculosis (TB) sigue siendo importante en Chile y el mundo. Los grupos de riesgo son las personas VIH+, los migrantes y los privados de libertad (PPL), en quienes se centra este estudio. Se estima que la incidencia de TB en PPL en Chile es 15 a 30 veces mayor que en población general, pudiendo constituir un reservorio. En otros...

Objective: To determine whether health care access barriers and facilitators cut across different populations, countries, and pathologies, and if so, at which stages of health care access they occur most frequently. Methods: A qualitative systematic review of literature published between 2000 and 2010 was undertaken drawing on six international...

OBJECTIVE: To determine whether health care access barriers and facilitators cut across different populations, countries, and pathologies, and if so, at which stages of health care access they occur most frequently. METHODS: A qualitative systematic review of literature published between 2000 and 2010 was undertaken drawing on six international sou...

The overall aim of this study is to develop a methodology to assess equity and access to care in health systems through a combination of quantitative and qualitative analysis measuring effective coverage of one prevalent tracer condition, trough three complementary studies. This paper report on the supply side assessment, based in a clinical chart...

Background: Based on the Tanahashi framework we developed a methodology to assess equity in access to care in health systems through a combination of quantitative and qualitative analysis measuring effective coverage using one prevalent tracer conditions subjected to program as the main outcome indicator. The study was done in Chile, a country with...

Barriers And Facilitators To Health Care Access: A Qualitative Systematic Review

Introducción: La esquizofrenia es una enfermedad mental que genera discapacidad, afectando la calidad de vida de la per-sona y de sus cuidadores. Las investigaciones demuestran que un menor tiempo de psicosis no tratada durante el primer episo-dio se asocia con un mejor pronóstico. Objetivo: En este trabajo se describe el diseño y evaluación de pro...

The increase in expenses of the health care system caused by sick leaves, especially those granted to mothers with children of less than one year of age with severe diseases, is a topic of concern. To describe the rates of sick leaves granted to mothers with children of less than one year of age with severe diseases from 2004 to 2008. Analysis of d...

MACARENA HIRMAS (2) y MARÍA SOL PASTORINO (2) RESUMEN Objetivo: Describir las propiedades psicométricas de un cuestionario para medir riesgos psicosociales en el trabajo, aplicado a una muestra chilena de trabajadores del rubro servicios. Material y método: Se comenzó con un proceso de adaptación semántica, para posteriormente aplicarlo a una muest...

ABSTRACT The increase in expenses of the health care system caused by sick leaves, especially those granted to mothers with children of less than one year of age with severe diseases, is a topic of concern. To describe the rates of sick leaves granted to mothers with children of less than one year of age with severe diseases from 2004 to 2008. Anal...

20% of Chileans report to have suffered from a mental health problem during the past year. The relation between work related psychosocial factors and mental disorder is not sufficiently known in Chile. The purpose of this study is to determine a possible association between psycho social factors at the workplace and intensity of emotional distress....

Los grandes documentos de referencia de la promoción de la salud (tales como la Carta de Bangkok) han ido enfatizando cada vez más a lo largo de las sucesivas reuniones internacionales los aspectos políticos de la promoción, entre los cuales se halla, por ejemplo el énfasis en empoderar a las comunidades y la superación de las inequidades y desigua...