Fernando Vio’s research while affiliated with University of Santiago Chile and other places

Unlabelled: The importance of Primary Health Care to resolve people's demand is increasing. For that purpose, trained personnel are required throughout the country. Aim: to know a model of continuing education for nursing technicians in rural health posts, methodology, results and future perspectives. Methods: description of the methodology and results of the Training Program in Health Promotion and Local Development in 536 nursing technicians from 201 rural communities in 16 Health Services. The modality was 150 hours (120 remote and 30 in-person), except for the years 2020 and 2021 when it was only remote due to COVID-19. The Moodle platform version 3.5.1 of the virtual classroom of the INTA, University of Chile was used, and the presencial event was in the host city of each Health Service. The contents were organized into modules and units, with permanent tutorial support and evaluation of learning, the complete program and students´satisfaction. Results: The approval of the Course was 93% and the average final grade was 6.3 out of 7. The follow-up survey showed that 73% achieved some job change; 72% applied what they learned and implemented their final work, with satisfaction close to 100%. Conclusion: this modality allows us to reach the most remote places in the country to train and support the work of nursing technicians.

Whole grains are a fundamental food category for the human diet and represent an invaluable source of carbohydrates, proteins, fibers, phytochemicals, minerals and vitamins. Many studies have shown that consumption of whole grains is linked to a lower risk of chronic non-communicable diseases. However, several of its positive health effects seem to disappear when grains are refined. The research question is what would be the effect of whole grains in the prevention of Chronic Non-Communicable Diseases. This article describes the positive effects of whole grain consumption in these diseases.To this end, a narrative description is made that reviews the available background on: a) epidemiological situation in Chile and its relationship with diet; b) consumption of whole grains in the world and in Chile; and c) the effect of whole grain consumption on reducing the risk of cardiovascular disease. obesity, type 2 diabetes, and cancer. The general background is very encouraging for a positive effect of whole grain consumption on certain diseases, especially those of metabolic origin. However, the uncertainty of some negative associations deserves further attention.

Background: Intersectoral health promotion initiatives in Chile to address obesity and non- communicable diseases have had a long history in Chile, but also a high degree of changes in their design, implementation, and financing. Aim: To analyze the “Choose a Healthy Lifestyle” enacted by Law 20,670 under Sabatier's “Advocacy Coalition Framework” (ACF), addressing the political discussion and its execution in the subsequent governing coalitions (2011-2022). Material and Methods: The ACF components are the following: external events, coalitions, policy subsystem (health promotion), and policy brokers. Policy change and learning occurs when a certain level of conflict exists between coalitions. We carried out a bibliographic and literature review, including history of the Law and notes in the media. Results: We identified two coalitions. The first is pro-individual freedom and aims to solve the problem with education and health promotion. The second one defines the problem as structural and related to social determinants and health inequity. The first coalition launched the “Choose Healthy Liferstyle” program in 2011 when they were in executive power. After criticism from the opposition and the participation of policy brokers, the Program was institutionalized with an intersectoral vision. The lack of permanent financing affected the continuity of the policy, especially after a change in the governing coalition. Conclusions: Law 20,670 falls within the ACF. However, policy learning slowed down because the problem involved social aspects, conflict between deep beliefs of both coalitions, and lack of permanent funding, thus affecting the continuity of the policy.

RESUMEN En los últimos 50 años medicina y salud han experimentado cambios profundos. Algunos son propios de su ámbito, como la medicina basa-da en evidencias, la bioética, la salud como un derecho y la medicina traslacional; otros son desarrollos técnicos y culturales. El desarrollo científico y tecnológico ha impactado en enfermedades infecciosas, el desarrollo de vacunas y fármacos e inmunoterapia, la imagenología, la genómica y los equipos robotizados, con avances en prevención y tratamiento, pero ha traído dificultades y consecuencias éticas y económicas. Algunos cambios, como la informática médica, la telemedicina y la inteligencia artificial, no han alcanzado suficiente desarrollo. La medicina preventiva debe impulsar campañas contra la obesidad, el consumo de tabaco, drogas, alcohol, sobre la importancia de las vacunas y la pesquisa precoz de enfermedades en etapas asintomáticas. Los costos elevados de tratamientos o procedimientos diagnósticos podrían ser cubiertos por un seguro estatal. La epidemia de coronavirus ha mostrado la precariedad laboral de una proporción de la población sin previsión de salud ni de vejez. El Estado debiera exigir el cumplimento de las leyes laborales, incluidas las obligaciones previsionales. En esta transición, resultan relevantes los controles de calidad que deben ser externos a las instituciones acreditadoras y plenamente autónomos. Áreas con menor progreso son la resolución de listas de espera, acceso amplio a nuevas tecnologías y tratamientos, manejo del dolor y cuida-dos paliativos, disponibilidad de órganos para trasplantes, prevención y manejo de adicciones y enfermedades mentales, prevención y control de pandemias, reducción de errores y accidentes en establecimientos de salud, domésticos o laborales.

libro trata acerca de los mensajes nutricionales y saludables sobre frutas y verduras permitidos en distintas reglamentaciones, para contribuir a la promoción del consumo de frutas y verduras. Este texto, además, se ha editado en conmemoración al Año Internacional de Frutas y Verduras 2021, de manera de ser un aporte a las actividades de promoción que se están realizando en los distintos países, a fin de que la población tome conciencia de la importancia del consumo de estos nutritivos alimentos en la salud de las personas y, también, en el cuidado del medio ambiente.

Background: A massive open online course (MOOC) is an online course aimed at unlimited participation and open access via the Web. Aim: To assess the MOOC experience for teaching nutrition, healthy food consumption, physical activity and health promotion to prevent obesity. Material and Methods: Two MOOC courses, (one with two versions), are described with the registration and evaluation instruments such as surveys carried out at the beginning and at the end of the courses. Effective participants in the three versions were 17.456, 11.121 in MOOC1, 2.351 in MOOC1 second version and 3.984 in MOOC2. Their median age was 31 years, 82% were women, 60% were professionals and 12% were foreigners. Results: In the final evaluation of the three courses, 85% to 99% qualified as “very good” or “good” all the surveyed topics. Thirty five percent of participants reported having lack of time, 11% reported problems with internet connectivity and 3.9%, personal or work problems. Conclusions: This is the first experience with MOOC in health and nutrition to prevent obesity in Chile. Considering the good results and positive evaluation of these courses, we estimate that they are an important tool to prevent obesity and chronic diseases in Chile, Latin America and other regions of the world.