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1.
Recurso na Internet em Espanhol, Francês, Português | LIS - Localizador de Informação em Saúde | ID: lis-48430

RESUMO

Alertando que a COVID-19 representa um sério risco para mulheres grávidas na América Latina e no Caribe, a diretora da Organização Pan-Americana da Saúde (OPAS), Carissa F. Etienne, pediu aos países que priorizem gestantes e lactantes na vacinação contra a doença.


Assuntos
COVID-19/prevenção & controle , Vacinas contra COVID-19 , Gestantes , Lactente , América Latina
2.
Recurso na Internet em Inglês, Espanhol, Português | LIS - Localizador de Informação em Saúde | ID: lis-48417

RESUMO

A diretora da Organização Pan-Americana da Saúde (OPAS), Carissa F. Etienne, alertou que 75% da população da América Latina e do Caribe ainda não foi totalmente vacinada contra a COVID-19 e informou que a OPAS está acelerando sua campanha para expandir o acesso às vacinas em toda a região.


Assuntos
América Latina/etnologia , Região do Caribe/etnologia , Vacinas , COVID-19/etnologia , Organização Pan-Americana da Saúde
3.
Rev Med Chil ; 149(2): 171-177, 2021 Feb.
Artigo em Espanhol | MEDLINE | ID: mdl-34479260

RESUMO

BACKGROUND: The number of patients waiting for a lung transplant worldwide greatly exceeds the number of available donors. Ex vivo lung perfusion is a useful tool that allows marginal donor lungs to be evaluated and reconditioned for a successful lung transplantation. AIM: To describe the first Chilean and Latin American experience in ex vivo lung perfusion for marginal donor lungs before transplantation. MATERIAL AND METHODS: Descriptive analysis of all ex vivo lung perfusion conducted for marginal donor lungs at a private clinic, from April 2019 to October 2020. High risk donor lungs and rejected lungs from other transplantation centers were included. The "Toronto Protocol" was used for ex vivo lung perfusion. Donor lung characteristics and recipient outcomes were studied. RESULTS: During the study period, five ex vivo lung perfusions were performed. All lungs were reconditioned and transplanted. No complications were associated. There were no primary graft dysfunctions and only one chronic allograft dysfunction. There was no mortality during the first year. The median arterial oxygen partial pressure/fractional inspired oxygen ratio increased from 266 mm Hg in the donor lung to 419 after 3 hours of ex vivo lung perfusion (p = 0.043). CONCLUSIONS: ex vivo lung perfusion is a safe and useful tool that allows marginal donor lungs to be reconditioned and successfully transplanted.


Assuntos
Transplante de Pulmão , Circulação Extracorpórea , Humanos , América Latina , Pulmão/cirurgia , Perfusão , Doadores de Tecidos
4.
Rev Med Chil ; 149(4): 591-597, 2021 Apr.
Artigo em Espanhol | MEDLINE | ID: mdl-34479347

RESUMO

PAHO/WHO proposes to implement the role of Advanced Practice Nurse (APN) in Latin America, to reduce gaps in coverage and access to health care. For this purpose, it is necessary to train nursing professionals with an expanded role, which allows them to collaborate in the diagnosis, treatment, and monitoring of people with specific diseases, under established protocols and clinical guidelines and within consolidated interdisciplinary health teams in a cost-effective way. One of the areas with the greatest coverage deficit in Latin America is adult oncology, with inequality in care opportunities for these patients. Part of the premature deaths attributable to this disease are due to the lack of access to timely diagnosis and treatment. As a contribution to the reduction of this gap, a training program of Advanced Nursing Practice was developed, addressing the most urgent needs in the field of oncology. The necessary competencies were defined to develop a professional-level master's degree program, considering prevention, early detection, diagnosis, treatment, and monitoring of people with oncological diseases at different levels of care. A program of this kind is an opportunity to reduce the access gap and coverage of health care for people with cancer, improving their quality of life and their survival.


Assuntos
Prática Avançada de Enfermagem , Adulto , Humanos , América Latina , Qualidade de Vida
5.
Rev Peru Med Exp Salud Publica ; 38(2): 318-325, 2021.
Artigo em Espanhol | MEDLINE | ID: mdl-34468583

RESUMO

Reports of infection and/or disease caused by non-tuberculous mycobacteria (NTM) are becoming increasingly frequent. This scope review describes the epidemiological and clinical trend of infection/disease caused by NTM in Latin America. OVID MEDLINE, Embase and LILACS databases were explored for relevant articles. After filtering, we included 44 articles, representing an overall population of 2,826 subjects diagnosed with NTM infection and disease; the majority of the publications included subjects from Brazil and Colombia (75%), cross-sectional studies were the most common (36.6%), most subjects were male (61.3%) and the median age of subjects was 40.1 years. Disease by NTM was reported in 37 publications, extrapulmonary presentation was the most frequent (54%), main comorbidities were other pulmonary diseases, HIV, cystic fibrosis, diabetes and malnutrition, as reported in 13 studies; tuberculosis diagnosis previous to NTM disease was reported in 15 articles. Aesthetic procedures were reported in 12 articles while clinical procedures were reported in 3 articles. Several NTM species were reported, being Mycobacterium avium (52%), M. abscessus (34%), M. chelonae (18%), M. fortuitum (16%) and M. kansasii (9.1%) the most frequent. Culture and molecular testing were the main methods for diagnosis and identification. Scientific literature on NTM from Latin American countries is scarce. There is an urgent need to conduct studies on the frequency and clinical impact of NTM infections, in order to accurately identify the current morbidity and mortality associated with NTM in Latin American. It is also important to strengthen the local diagnostic capacity and the existing networks focused on studying NTM.


Assuntos
Infecções por Mycobacterium não Tuberculosas , Tuberculose , Adulto , Estudos Transversais , Humanos , América Latina/epidemiologia , Masculino , Infecções por Mycobacterium não Tuberculosas/diagnóstico , Infecções por Mycobacterium não Tuberculosas/epidemiologia , Micobactérias não Tuberculosas , Tuberculose/diagnóstico , Tuberculose/epidemiologia
6.
An. psicol ; 37(2): 253-264, mayo-sept. 2021. tab, graf
Artigo em Inglês | IBECS | ID: ibc-202549

RESUMO

Ambivalent sexism is a multidimensional construct composed of two elements: hostile sexism and benevolent sexism. The main aim of this study is to analyse the acceptance of ambivalent sexist attitudes in a sample of future teachers from Spain and Latin America. The research is based on a quantitative methodological strategy. The sample is composed of 2798 trainee teachers, and their mean age is 22.62 years (SD = 6.23), they were residing in seven countries: Spain, El Salvador, Nicaragua, Colombia, Chile, Argentina and Mexico. The data collection technique was the structured questionnaire. The results show that ambivalent sexist attitudes exist to a varying degree in future teachers of every country. The assumption of sexism varies significantly between men and women and among countries. There seems to be a relationship between levels of sexism with indices of gender inequality and human development. Education institutions are not exempt from obstacles and gender bias that impede the attainment of equality between women and men. Sexist attitudes of teachers can be transmitted through the education system and the socialization process, so including gender issues in initial and in service teacher training plans is essential


El sexismo ambivalente es un constructo multidimensional compuesto por dos componentes: el sexismo hostil y el sexismo benévolo. El objetivo de este estudio ha sido analizar la aceptación de las actitudes sexistas ambivalentes en una muestra de futuros y futuras docentes de España y Latinoamérica. En la investigación participaron 2798 docentes en formación con una edad media de 22.62 años (DE = 6.23) que residían en siete países: España, El Salvador, Nicaragua, Colombia, Chile, Argentina y México. Los resultados muestran que las actitudes sexistas están presentes, con diferentes grados de aceptación, en el profesorado en formación de todos los países. La aceptación del sexismo varía significativamente entre hombres y mujeres y entre los países de la muestra. Parece existir una relación entre los niveles de sexismo y los índices de desigualdad de género y desarrollo humano. Las actitudes sexistas del profesorado pueden transmitirse a través del sistema educativo y de los procesos de socialización, por lo que es fundamental incluir la perspectiva de género en los planes de formación inicial y continua del profesorado


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Professores Escolares/estatística & dados numéricos , Capacitação de Professores , Sexismo/estatística & dados numéricos , Estudos Transversais , Inquéritos e Questionários , Fatores Sexuais , Sexismo/psicologia , Professores Escolares/psicologia , Valores de Referência , Hostilidade , Empatia , Espanha , América Latina
7.
Recurso na Internet em Inglês, Espanhol, Português | LIS - Localizador de Informação em Saúde | ID: lis-48320

RESUMO

A rede coordenada pela OPAS detectou a presença de pelo menos uma “variante de preocupação” em 47 países e territórios e todas as quatro em 11 deles. Diretora da OPAS diz que medidas de saúde pública continuam fundamentais e exige maior acesso à vacina para combater as variantes


Assuntos
SARS-CoV-2 , América Latina , Região do Caribe , COVID-19
8.
Recurso na Internet em Inglês, Espanhol, Francês, Português | LIS - Localizador de Informação em Saúde | ID: lis-48321

RESUMO

Uma pesquisa recente conduzida pela Organização Pan-Americana da Saúde/Organização Mundial da Saúde (OPAS/OMS) indica que a pandemia de COVID-19 afetou o diagnóstico e o tratamento das infecções virais por hepatite B e C na América Latina e no Caribe, o que tem freado o avanço na meta de eliminar essas doenças infecciosas até 2030


Assuntos
COVID-19 , Interrupção de Serviços e de Abastecimento , Hepatite Viral Humana , América Latina , Região do Caribe , Hepatite B , Hepatite C
9.
Recurso na Internet em Inglês, Espanhol, Português | LIS - Localizador de Informação em Saúde | ID: lis-48322

RESUMO

A diretora da Organização Pan-Americana da Saúde (OPAS), Carissa F. Etienne, informou nesta quarta-feira (11) que o organismo internacional utilizará seu Fundo Rotatório para ajudar os países da América Latina e do Caribe a adquirir vacinas suficientes para controlar a transmissão da COVID-19.


Assuntos
Vacinas , COVID-19 , América Latina/epidemiologia , Região do Caribe/epidemiologia , Organização Pan-Americana da Saúde
10.
BMJ Open ; 11(8): e044920, 2021 08 02.
Artigo em Inglês | MEDLINE | ID: mdl-34341032

RESUMO

OBJECTIVE: We aimed to estimate the association between informal employment and mortality in Latin America and the Caribbean (LAC) by comparing welfare state regimes. DESIGN: Ecological study using time-series cross-sectional analysis of countries. Informality was estimated from household surveys by the Center for Distributive, Labor and Social Studies in collaboration with the World Bank, and the adult mortality rates for 2000-2016 were obtained from the WHO databases. Countries were grouped by welfare state regimes: state productivist, state protectionist and familialist. We calculated the compound annual growth rate for each country and performed linear regression between the informality and the adult mortality rates stratified by sex and welfare state regime. SETTING: Seventeen countries from LAC with available data on informality and adult mortality rates for 2000-2016. PRIMARY OUTCOME MEASURE: The association between informality and mortality by welfare state regime. RESULTS: Between 2000 and 2016, mortality rates decreased an average 1.3% per year and informal employment rates 0.5% per year. We found a significant positive association between informality and mortality rates (women: R2=0.48; men: R2=0.36). The association was stronger among the state regime countries (women: R2=0.58; men: R2=0.77), with no significant association among the familialist countries. CONCLUSION: Informal employment negatively impacts population health, which is modified by welfare state regimes. Addressing informal employment could be an effective way to improve population health in LAC. However, linkage with public health and labour market agendas will be necessary.


Assuntos
Emprego , Seguridade Social , Adulto , Região do Caribe , Estudos Transversais , Países em Desenvolvimento , Feminino , Humanos , América Latina/epidemiologia , Masculino
11.
Nutrients ; 13(8)2021 Aug 11.
Artigo em Inglês | MEDLINE | ID: mdl-34444914

RESUMO

There is little data on the experience of managing pediatric Intestinal Failure (IF) in Latin America. This study aimed to identify and describe the current organization and practices of the IF teams in Latin America and the Caribbean. An online survey was sent to inquire about the existence of IF teams that managed children on home parenteral nutrition (HPN). Our questionnaire was based on a previously published European study with a similar goal. Twenty-four centers with pediatric IF teams in eight countries completed the survey, representing a total number of 316 children on HPN. The median number of children on parenteral nutrition (PN) at home per team was 5.5 (range 1-50). Teams consisted of the following members: pediatric gastroenterologist and a pediatric surgeon in all teams, dietician (95.8%), nurse (91.7%), social worker (79.2%), pharmacist (70.8%), oral therapist (62.5%), psychologist (58.3%), and physiotherapist (45.8%). The majority of the centers followed international standards of care on vascular access, parenteral and enteral nutrition, and IF medical and surgical management, but a significant percentage reported inability to monitor micronutrients, like vitamins A (37.5%), E (41.7%), B1 (66.7%), B2 (62.5%), B6 (62.5%), active B12 (58.3%); and trace elements-including zinc (29.2%), aluminum (75%), copper (37.5%), chromium (58.3%), selenium (58.3%), and manganese (58.3%). Conclusion: There is wide variation in how IF teams are structured in Latin America-while many countries have well-established Intestinal rehabilitation programs, a few do not follow international standards. Many countries did not report having an IF team managing pediatric patients on HPN.


Assuntos
Gastroenterologia/estatística & dados numéricos , Enteropatias/terapia , Equipe de Assistência ao Paciente/estatística & dados numéricos , Pediatria/estatística & dados numéricos , Padrões de Prática Médica/estatística & dados numéricos , Adolescente , Região do Caribe , Criança , Pré-Escolar , Feminino , Gastroenterologia/métodos , Humanos , Lactente , Recém-Nascido , América Latina , Masculino , Nutrição Parenteral no Domicílio/estatística & dados numéricos , Pediatria/métodos , Inquéritos e Questionários
12.
BMJ Open ; 11(8): e047779, 2021 08 19.
Artigo em Inglês | MEDLINE | ID: mdl-34413102

RESUMO

OBJECTIVES: Latin America and the Caribbean (LAC) countries have made important progress towards achieving the Sustainable Development Goal (SDG) targets related to health (SDG3) at the national level. However, vast within-country health inequalities remain. We present a baseline of health inequalities in the region, against which progress towards the SDGs can be monitored. SETTING: We studied 21 countries in LAC using data from Demographic and Health Surveys and Multiple Indicator Cluster Survey carried out from 2011 to 2016 PARTICIPANTS: The surveys collect nationally representative data on women and children using multistage sampling. In total, 288 207 women and 195 092 children made part of the surveys in the 21 countries. OUTCOME MEASURES: Five health intervention indicators were studied, related to reproductive and maternal health, along with adolescent fertility and neonatal and under-five mortality rates. Inequalities in these indicators were assessed through absolute and relative measures. RESULTS: In most countries, subnational geographical health gradients were observed for nearly all women, child, and adolescent (WCA) indicators. Coverage of key interventions was higher in urban areas and among the richest, compared with rural areas and poorer quintiles. Analyses by woman's age showed that coverage was lower in adolescent girls than older women for family planning indicators. Pro-urban and pro-rich inequalities were also seen for mortality in most countries. CONCLUSIONS: Regional averages hide important health inequalities between countries, but national estimates hide still greater inequalities between subgroups of women, children and adolescents. To achieve the SDG3 targets and leave no one behind, it is essential to close health inequality gaps within as well as between countries.


Assuntos
Disparidades nos Níveis de Saúde , Desenvolvimento Sustentável , Adolescente , Idoso , Região do Caribe , Criança , Estudos Transversais , Feminino , Disparidades em Assistência à Saúde , Humanos , Recém-Nascido , América Latina/epidemiologia , Fatores Socioeconômicos
13.
Artigo em Inglês | MEDLINE | ID: mdl-34444349

RESUMO

BACKGROUND: Environmental risk assessments and interventions to mitigate environmental risks are essential to protect public health. While the objective measurement of environmental hazards is important, it is also critical to address the subjective perception of health risks. A population's perception of environmental health hazards is a powerful driving force for action and engagement in safety and health behaviors and can also inform the development of effective and more sustainable environmental health policies. To date, no instruments are available to assess risk perception of environmental health hazards in South America even though there are many concerning issues in the region, including mining. OBJECTIVE: We aimed to adapt and validate an environmental health risk perception questionnaire in a Chilean population affected by mining activity among other risks frequently reported in Latin American countries and included the collection of information on trust on public information sources. METHODS: We adapted an Australian risk perception questionnaire for validation in an adult population from a Chilean mining community. This adaptation included two blinded translations (direct, inverse), a pre-test study (n = 20) and a review by environmental health experts. Principal Component Analyses (PCA) was used to identify factors within major domains of interest. The Bartlett test of sphericity, Kaiser-Meyer-Olkin (KMO) measure and the Cronbach α test were used to assess the instrument's validity and reliability. The instrument was pilot tested in 205 adults from a mining community in Chañaral. RESULTS: The final adapted questionnaire proved to be a good instrument to measure risk perception in a community chronically exposed to mining waste. For community risks, four factors explained 59.4% of the variance. "Global Issues" (30.2%) included air pollution, contamination of mining, ozone layer depletion and vector diseases. For personal risks, the first two components explained 59.5% of the variance, the main factor (36.7%) was "unhealthy behaviors within the household". For trust in information, the first factor (36.2%) included as main sources "Media and authorities". The Cronbach α ranged between 0.68 and 0.75; and the KMO test between 0.7 to 0.79 for community and personal risks and trust. CONCLUSIONS: The final questionnaire is a simple, reliable and useful instrument that can assist in evaluating environmental health risk perceptions in Latin American countries.


Assuntos
Saúde Ambiental , Percepção , Austrália , Chile , América Latina , Reprodutibilidade dos Testes , Inquéritos e Questionários
14.
BMJ Open ; 11(8): e047925, 2021 08 09.
Artigo em Inglês | MEDLINE | ID: mdl-34373303

RESUMO

OBJECTIVES: We developed (a) a survey to investigate the knowledge of childhood health experts on public policies and behavioural insights (BI), as well as its use in Latin American and the Caribbean countries (LACs), and (b) an intervention (randomised controlled trial) to test the influence of nudges on the effect of a simulated public health programme communication. PARTICIPANTS AND SETTINGS: A total of 2003 LACs childhood health professionals participated in the study through a Hispanic online platform. PRIMARY AND SECONDARY OUTCOMES: We used regression models analysing expertise-related information, individual differences and location. We extracted several outcome variables related to (a) 'Public Policy Knowledge Index' based on the participants' degree of knowledge on childhood health public policies and (b) BI knowledge, perceived effectiveness and usefulness of a simulated public programme communication. We also analysed a 'Behavioural Insights Knowledge Index' (BIKI) based on participants' performance in BI questions. RESULTS: In general, health professionals showed low BI knowledge (knowledge of the term BI: χ2=210.29, df=1 and p<0.001; BIKI: χ2=160.5, df=1 and p<0.001), and results were modulated by different factors (age, academic formation, public policy knowledge and location). The use of BI principles for the communication of the public programme revealed higher impact and clarity ratings from professionals than control messages. CONCLUSIONS: Our findings provide relevant knowledge about BI in health professionals to inform governmental and non-governmental organisations' decision-making processes related with childhood public policies and BI designs.


Assuntos
Comportamentos Relacionados com a Saúde , Política Pública , Governo , Humanos , América Latina , Inquéritos e Questionários
15.
Blood Adv ; 5(15): 3032-3046, 2021 08 10.
Artigo em Inglês | MEDLINE | ID: mdl-34374748

RESUMO

BACKGROUND: Venous thromboembolism (VTE) is a common disease in Latin American settings. Implementing international guidelinn Aes in Latimerican settings requires additional considerations. OBJECTIVE: The purpose of our study was to provide evidence-based guidelines about managing VTE for Latin American patients, clinicians, and decision makers. METHODS: We used the Grading of Recommendations, Assessment, Development and Evaluation (GRADE)-ADOLOPMENT method to adapt recommendations from 2 American Society of Hematology (ASH) VTE guidelines (Treatment of VTE and Anticoagulation Therapy). ASH and local hematology societies formed a guideline panel comprised of medical professionals from 10 countries in Latin America. Panelists prioritized 18 questions relevant for the Latin American context. A knowledge synthesis team updated evidence reviews of health effects conducted for the original ASH guidelines and summarized information about factors specific to the Latin American context (ie, values and preferences, resources, accessibility, feasibility, and impact on health equity). RESULTS: The panel agreed on 17 recommendations. Compared with the original guideline, 4 recommendations changed direction and 1 changed strength. CONCLUSIONS: This guideline adolopment project highlighted the importance of contextualization of recommendations suggested by the changes to the original recommendations. The panel also identified 2 implementation priorities for the region: expanding the availability of home treatment and increasing the availability of direct oral anticoagulants (DOACs). The guideline panel made a conditional recommendation in favor of home treatment for individuals with deep venous thrombosis and a conditional recommendation for either home or hospital treatment for individuals with pulmonary embolism. In addition, a conditional recommendation was made in favor of DOACs over vitamin K antagonists for several populations.


Assuntos
Embolia Pulmonar , Tromboembolia Venosa , Anticoagulantes/uso terapêutico , Medicina Baseada em Evidências , Humanos , América Latina/epidemiologia , Embolia Pulmonar/tratamento farmacológico , Tromboembolia Venosa/tratamento farmacológico
16.
Blood Adv ; 5(15): 3047-3052, 2021 08 10.
Artigo em Inglês | MEDLINE | ID: mdl-34374749

RESUMO

BACKGROUND: From 2017 to 2020, the American Society of Hematology (ASH) collaborated with 12 hematology societies in Latin America to adapt the ASH guidelines on venous thromboembolism (VTE). OBJECTIVE: To describe the methods used to adapt the ASH guidelines on venous thromboembolism. METHODS: Each society nominated 1 individual to serve on the guideline panel. The work of the panel was facilitated by the 2 methodologists. The methods team selected 4 of the original VTE guidelines for a first round. To select the most relevant questions, a 2-step prioritization process was conducted through an on-line survey and then through in-person discussion. During an in-person meeting in Rio de Janeiro, Brazil, from 23 April through 26 April 2018, the panel developed recommendations using the ADOLOPMENT approach. Evidence about health effects from the original guidelines was reused, but important data about resource use, accessibility, feasibility, and impact in health equity were added. RESULTS: In the guideline accompanying this paper, Latin American panelists selected 17 questions from an original pool of 49. Of the 17 questions addressed, substantial changes were introduced for 5 recommendations, and remarks were added or modified for 12 recommendations. CONCLUSIONS: By using the evidence from an international guideline, a significant amount of work and time were saved; by adding regional evidence, the final recommendations were tailored to the Latin American context. This experience offers an alternative to develop guidelines relevant to local contexts through a global collaboration.


Assuntos
Hematologia , Tromboembolia Venosa , Brasil , Medicina Baseada em Evidências , Humanos , América Latina/epidemiologia , Tromboembolia Venosa/tratamento farmacológico
17.
Artigo em Inglês | MEDLINE | ID: mdl-34360226

RESUMO

The population in Latin America is ageing, and there is an inevitable demand for long-term care services. However, there are no comparative analyses between Latin American countries of the dependency situation of older adults. This study aims to calculate and compare percentages of older adults who need help performing the activities of daily living in six Latin American nations. The study is observational, transversal, and cross-national and uses microdata drawn from national surveys conducted in Argentina (n = 3291), Brazil (n = 3903), Chile (n = 31,667), Colombia (n = 17,134), Mexico (n = 7909), and Uruguay (n = 4042). Comparable indicators of the need for help in performing the basic and instrumental activities of daily living were calculated. The percentages of older adults in need of help for basic activities of daily living ranged from 5.8% in Argentina to 11% in Brazil; for instrumental activities of daily living, from 13.8% in Mexico to 35.7% in Brazil; and combined, from 18.1% in Argentina to 37.1% in Brazil. Brazil thus has the highest indicators, followed by Colombia. The results warn of the frail physical condition of older people and the high potential demand for long-term care services. The information provided could be useful for further research on and planning for long-term care needs in Latin American and middle-income countries.


Assuntos
Atividades Cotidianas , Assistência de Longa Duração , Idoso , Argentina/epidemiologia , Brasil , Humanos , América Latina , México
18.
Lancet ; 398(10304): 951-952, 2021 09 11.
Artigo em Inglês | MEDLINE | ID: mdl-34391503
19.
Nutrients ; 13(8)2021 Jul 27.
Artigo em Inglês | MEDLINE | ID: mdl-34444728

RESUMO

This study aimed to describe the current practices in the diagnosis and dietary management of phenylketonuria (PKU) in Latin America, as well as the main barriers to treatment. We developed a 44-item online survey aimed at health professionals. After a pilot test, the final version was sent to 25 practitioners working with inborn errors of metabolism (IEM) in 14 countries. Our results include 22 centers in 13 countries. Most countries (12/13) screened newborns for PKU. Phenylalanine (Phe) targets at different ages were very heterogeneous among centers, with greater consistency at the 0-1 year age group (14/22 sought 120-240 µmol/L) and the lowest at >12 years (10 targets reported). Most countries had only unflavored powdered amino acid substitutes (10/13) and did not have low-protein foods (8/13). Only 3/13 countries had regional databases of the Phe content of foods, and only 4/22 centers had nutrient analysis software. The perceived obstacles to treatment were: low purchasing power (62%), limited/insufficient availability of low-protein foods (60%), poor adherence, and lack of technical resources to manage the diet (50% each). We observed a heterogeneous scenario in the dietary management of PKU, and most countries experienced a lack of dietary resources for both patients and health professionals.


Assuntos
Dieta , Fenilcetonúrias/dietoterapia , Fenilcetonúrias/diagnóstico , Adulto , Criança , Gerenciamento Clínico , Rotulagem de Alimentos , Alimentos Formulados , Pessoal de Saúde , Inquéritos Epidemiológicos , Humanos , Lactente , Recém-Nascido , América Latina , Triagem Neonatal , Fenilalanina/análise , Fenilalanina/sangue
20.
An Acad Bras Cienc ; 93(4): e20191454, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34378757

RESUMO

The beginning of the concept of architectural monument in Colombia is in the laws from the late XIX century and early XX century. We recompose the international context through the technic of aero photography, used by the Military Geographical Institute during the Second World War and the consequent tensions between U.S. and the powerful nations of the axis in relation to Colombia and Brazil in Latin America. The Liberal Party emerges like an ideology that tried to reorganise the country through the establishment of education and control the soil. This party negotiated a pact to stop the Colombian-Peruvian war 1932-1933, and signed the Roerich Pact in 1935 to protect the monuments. Therefore, the 1942 plan is the end of a process of mapping the national territory and the generation of criteria about cultural heritage in the first half of XX century, and the base to study how it affected the protection of architectural monuments up to date.


Assuntos
Arquitetura , Brasil , Colômbia , Humanos , América Latina
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