Percepción de adultos mayores chilenos en relación a la salud y el ejercicio físico en pandemia Covid-19 (Perception of Chilean older adults in relation to health and physical exercise in pandemic Covid-19)

El propósito de este artículo es comprender el significado que le otorgan adultos mayores de la zona central de Chile al periodo de la pandemia Covid-19 respecto a la salud y al ejercicio físico. Desde el punto de vista metodológico, la investigación se inscribe en la perspectiva del paradigma interpretativo-comprensivo, a través de metodología cualitativa. Se entrevistó a 17 adultos mayores en dos ocasiones, año 2020 año 2021, las entrevistas se realizaron vía Skipe o video llamada producto de las restricciones impuestas por la autoridad sanitaria, para evitar el contacto físico con los entrevistados. Los hallazgos del estudio dicen relación con los efectos adversos en términos psicosociales, que ha experimentado la población de adultos mayores producto del confinamiento, por otro lado, a pesar de la pandemia, los adultos mayores han mantenido hábitos saludables. En conclusión, se propone profundizar en estudios que permitan mostrar el impacto negativo del encierro en los adultos mayores y de esta manera influir para que el Estado asuma una mejor dirección en las políticas públicas dirigidas a este grupo etario. Abstract. The purpose of this article is to understand the meaning given by elderly adults in central Chile to the period of the Covid-19 pandemic concerning health and physical exercise. From the methodological perspective, the research is inscribed in the perspective of the interpretative-comprehensive paradigm, through the qualitative methodology. Seventeen seniors were interviewed on two occasions; the year 2020, the year 2021, the interviews were performed via Skype or video call due to the restrictions imposed by the sanitary authority, to avoid physical contact with the interviewees. The results of the study are related to the adverse effects in psychosocial terms that the elderly population has experienced as a result of the confinement, oppositely, despite the pandemic, the seniors have maintained healthy lifestyles. In conclusion, this study proposes further studies to show the negative impact of confinement on elderly adults and, as follows, influence the State to assume a better direction in public policies aimed at this age group.

Development and Evaluation of a Set of Spike and Receptor Binding Domain-Based Enzyme-Linked Immunosorbent Assays for SARS-CoV-2 Serological Testing

The implementation and validation of anti-SARS-CoV-2 IgG serological assays are reported in this paper. S1 and RBD proteins were used to coat ELISA plates, and several secondary antibodies served as reporters. The assays were initially validated with 50 RT-PCR positive COVID-19 sera, which showed high IgG titers of mainly IgG1 isotype, followed by IgG3. Low or no IgG2 and IgG4 titers were detected. Then, the RBD/IgG assay was further validated with 887 serum samples from RT-PCR positive COVID-19 individuals collected at different times, including 7, 14, 21, and 40 days after the onset of symptoms. Most of the sera were IgG positive at day 40, with seroconversion happening after 14–21 days. A third party conducted an additional performance test of the RBD/IgG assay with 406 sera, including 149 RT-PCR positive COVID-19 samples, 229 RT-PCR negative COVID-19 individuals, and 28 sera from individuals with other viral infections not related to SARS-CoV-2. The sensitivity of the assay was 99.33%, with a specificity of 97.82%. All the sera collected from individuals with infectious diseases other than COVID-19 were negative. Given the robustness of this RBD/IgG assay, it received approval from the sanitary authority in Mexico (COFEPRIS) for production and commercialization under the name UDISTEST-V2G®.

A statistical analysis for the epidemiological surveillance of COVID-19 in Chile

Background: The emergence of COVID-19 so far and in the immediate future has brought significant uncertainties that negatively impact institutions and individuals in developing and planning their activities worldwide. The uncertainty of the effectiveness of vaccines has forced the authorities to adopt different protocols, the most relevant of which is the isolation of people through quarantine to avoid contagion, drastically affecting our way of life. For this reason, it is crucial to evaluate the effectiveness of quarantines. Objective: To analyze the spread of the disease in Chile according to the quarantines decreed by the sanitary authority. Methods: Inferential study to estimate the trend changes in COVID-19 cases and their basic and instantaneous reproduction numbers, which allows us to evaluate the decreed measures and establish vaccination policies. Results: According to the data obtained until 03 March 2021 of confirmed COVID-19 cases disaggregated at a regional level in Chile, we observe a heterogeneous spread in most Chilean regions. When incorporating the dynamic quarantines decreed, effectiveness is detected in most regions, except in some few of them. Conclusion: Our results indicate that we are unable to identify the measures in the step-by-step protocols partly responsible for non-compliance with quarantines. However, our specific findings that can be extrapolated to daily practice and enlighten the ways of other countries are as follows. On the one hand, a measure that has been effective in curbing the spread of the disease is the strict early quarantine as detected in some Chilean regions. Therefore, indexes are needed to measure the mobility of citizens. On the other hand, as time passes without stopping infections, quarantines lose effectiveness even if the estimated instantaneous reproduction number is small and stable. In addition, other factors can cause this number to not be within the expected ranges which must be further studied. Also, we have estimated the basic reproduction number whose value confirms the suitability of the pandemic declaration.

“Nudge” in Lucca’s Hospital: separate waste collection improvement and cigarettes dumping reduction

Background Positive behaviour and user's collaboration improved by using choices orientation techniques; in Lucca's Hospital (North-West Tuscany Sanitary Authority) this approach has improved separate waste collection execution and has decreased cigarettes dumping in commons areas. Objectives Phase 1 (May 2019): amendment of choices architecture recyclable waste bins in commons areas and into the wards were boosted, with “islands” clearly visible from any point of common paths; in the transit areas were installed exclusively multi-material and paper bins, equipped with signs that clearly indicate which products deliver; residual waste bins were allowed exclusively in certain points.ashtrays at the hospital entrances were eliminated and replaced with signage indicating smoking cessation benefits and the presence of areas “put your cigarette out” along the structure approach routes. Phase 2 (scheduled for May 2020): “nudge” action Spreading in community (using press and social-media) and locally (using poster) of the slogan “In San Luca we are taking a step forward: don't lag behind!”. This message stimulate the perception of an ongoing change to join. Results A decrease in residual waste collection and in instances of non-compliance in separate waste collection was detected. Decorum in the outdoor environments improved, with a reduction of user's reports and extra-cleaning interventions. Conclusions The described actions have improved user's collaboration, management efficiency of waste disposal and cleaning service, perceived quality and cost. Key messages Imitating a social model appears to be successful motivator of virtuous behaviours. Choices architecture and “nudge” techniques may improve citizens’ care pathways governance.

New Poor Law Medical Care in the Local Health Economy

The Poor Law Amendment Act (1834) failed to address sickness as a major reason for the increasing levels of pauperism and yet has been credited with setting the scene for the development of the National Health Service in 1948. This investigation analysing the poor law medical services of Birmingham and Wolverhampton demonstrates that the influence of the New Poor Law in their development was significant in the latter, but had little immediate effect in the former. However, in both towns the medical service played a crucial part in the control of infectious disease, particularly at times of local outbreaks or national epidemics. This role within the local community involved close collaboration with the relevant sanitary authority, in some cases with the provision of joint isolation facilities and policies. Overall, the poor law medical services in both locations were important elements in the lives of the poor even in the early days after the Act and comprised significant components of the medical landscape of each town. Although the medicalization of English workhouses was not a late nineteenth century phenomenon, they became the single most important institutional setting for the provision of medical care by the early twentieth century.