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1.
Braz. j. biol ; 81(4): 867-871, Oct.-Dec. 2021. tab
Artículo en Inglés | LILACS-Express | LILACS | ID: biblio-1153428

RESUMEN

Abstract Chagas disease (CD) is considered a typical low-income population sickness of the developing countries in Latin America. Given the historical relevance of CD in individuals in southern Rio Grande do Sul (RS) State, Brazil, the aim of this study was to identify the knowledge of the CD and its vectors by cardiac patients, and the prevalence of anti-T cruzi antibodies in these individuals in Pelotas, city located in Rio Grande do Sul (RS) state, Brazil. The subjects with cardiac disease were submitted to a semi-structured questionnaire as well as two serological tests in order to detect anti-T. cruzi IgG antibodies. Of the individuals that born in municipalities showing the highest triatomine infestation rates in recent decades, 81.8% were able to recognize the vector insect (p = 0.0042; OR = 5.9), and 83.3% reported either themselves or someone in their families to have CD (p = 0.043, OR = 5.2). Of the 54 patients submitted to serological analysis, only 01 patient (1.9%) was positive for anti-T. cruzi antibodies, a 55 year old man from the rural area of Canguçu county. This study provides support for the evaluation to be extended to other cardiology centers, given the importance of Chagas disease in Brazil.


Resumo A doença de Chagas (DC) é considerada uma doença típica da população de baixa renda dos países em desenvolvimento da América Latina. Dada a relevância histórica da DC em indivíduos do sul do Estado do Rio Grande do Sul (RS), o objetivo deste estudo foi identificar o conhecimento da doença de Chagas (DC) e seus vetores em pacientes cardíacos, e a prevalência de anticorpos anti-T cruzi nesses indivíduos, em Pelotas, cidade localizada no Rio Grande do Sul (RS), Brasil. Os pacientes cardiopatas foram submetidos a um questionário semiestruturado, e também a dois testes sorológicos para detecção de anticorpos anti-T. cruzi IgG. Dos indivíduos que nasceram em municípios com as maiores taxas de infestação por triatomíneos nas últimas décadas, 81,8% foram capazes de reconhecer o inseto vetor (p = 0,0042; OR = 5,9), e 83,3% relataram que eles próprios ou alguém em suas famílias tem DC (p = 0,043, OR = 5,2). Dos 54 pacientes submetidos à análise sorológica, apenas 01 paciente (1,9%) foi positivo para anticorpos anti-T.cruzi, um homem de 55 anos da área rural do município de Canguçu. Este estudo fornece subsídios para que a avaliação seja estendida a outros centros de cardiologia, devido à importância da doença de Chagas no Brasil.

2.
Podium (Pinar Río) ; 16(1): 308-322,
Artículo en Español | LILACS-Express | LILACS | ID: biblio-1155077

RESUMEN

RESUMEN A medida que la población envejece, aumenta la prevalencia de enfermedades crónicas y discapacitantes. Cuba es uno de los países más envejecidos de América Latina; está previsto sea hacia el 2050 uno de los más envejecidos del mundo. El costo de las enfermedades y su impacto en el estado funcional son mayores en los pacientes de edad avanzada que en personas más jóvenes. La elevada prevalencia de múltiples enfermedades no transmisibles en adultos mayores es un importante desafío para los proveedores de servicios de salud. La actividad física de los adultos mayores como una forma de vida saludable tiene gran trascendencia en la sociedad, pues la práctica del ejercicio y el deporte promueve la prevención, el tratamiento y la rehabilitación de enfermedades no transmisibles. El objetivo de esta investigación es incrementar los conocimientos sobre la repercusión de los cambios del envejecimiento en la funcionabilidad del adulto mayor, que permita incidir en su bienestar desde la actividad física. Se realizó una revisión bibliográfica mediante búsquedas electrónicas y en bibliotecas de revistas médicas nacionales y extranjeras indexadas en SciELO, Imbiomed y Pubmed en un horizonte de diez años en idioma español e inglés. Se consultaron artículos científicos y libros de textos con información relacionada con envejecimiento poblacional y actividad física, actividad física y enfermedades no transmisibles. Se puede concluir que la actividad física terapéutica es un acto profesional sanitario, que permite al individuo alcanzar la mayor capacidad funcional posible, logrando su máxima autonomía, a los efectos de posibilitar su mayor integración a la sociedad.


RESUMO À medida que a população envelhece, a prevalência de doenças crónicas e deficiências aumenta. Cuba é um dos países mais antigos da América Latina; em 2050 espera-se que seja um dos mais antigos do mundo. O custo das doenças e o seu impacto no estado funcional são mais elevados em pacientes mais velhos do que em pessoas mais jovens. A elevada prevalência de múltiplas doenças não transmissíveis em adultos mais velhos é um grande desafio para os prestadores de cuidados de saúde. A atividade física dos adultos mais velhos como um estilo de vida saudável é de grande importância na sociedade, uma vez que a prática de exercício e esporte promove a prevenção, tratamento e reabilitação de doenças não transmissíveis. O objetivo desta investigação é aumentar o conhecimento sobre a repercussão das mudanças do envelhecimento na funcionalidade dos adultos mais velhos, o que permite influenciar o seu bem-estar através da atividade física. Foi realizada uma revisão bibliográfica através de pesquisas electrónicas e em bibliotecas de revistas médicas nacionais e estrangeiras indexadas em SciELO, Imbiomed e Pubmed num horizonte de dez anos em língua espanhola e inglesa. Foram consultados artigos científicos e livros escolares com informações relacionadas com o envelhecimento da população e a atividade física; atividade física e doenças não transmissíveis. Pode-se concluir que a atividade física terapêutica é um ato profissional de saúde, que permite ao indivíduo atingir a maior capacidade funcional possível, alcançando a máxima autonomia, a fim de tornar possível uma melhor integração na sociedade.


ABSTRACT As the population ages, the prevalence of chronic and disabling diseases increases. Cuba is one of the oldest countries in Latin America, is expected to be one of the oldest in the world by 2050. The cost of diseases and their impact on functional status are higher in elderly patients than in younger people. The high prevalence of multiple Chronic Noncommunicable Diseases in older adults is a major challenge for health service providers. The physical activity of older adults as a healthy way of life has great significance in society, since the practice of exercise and sports promotes the prevention, treatment and rehabilitation of noncommunicable diseases. The objective of our investigation is to increase knowledge about the impact of aging changes on the functionality of the elderly, which can influence their well-being from physical activity. A literature review was carried out through electronic searches and in libraries of national and foreign medical journals indexed in SciELO, Imbiomed and Pubmed in a 10-year horizon in Spanish and English. Thesis on completion of studies and textbooks with information related to population aging and physical activity, physical activity and noncommunicable diseases were consulted. As a conclusion, we can say that the Therapeutic physical activity is a professional health act, which allows the individual to achieve the greatest possible functional capacity, to achieve maximum autonomy, in order to enable their greater integration into society.

3.
Artículo en Inglés | PAHO-IRIS | ID: phr-53563

RESUMEN

[ABSTRACT]. Objective. To describe the current status of regulatory reliance in Latin America and the Caribbean (LAC) by assessing the countries’ regulatory frameworks to approve new medicines, and to ascertain, for each country, which foreign regulators are considered as trusted regulatory authorities to rely on. Methods. Websites from LAC regulators were searched to identify the official regulations to approve new drugs. Data collection was carried out in December 2019 and completed in June 2020 for the Caribbean countries. Two independent teams collected information regarding direct recognition or abbreviated processes to approve new drugs and the reference (trusted) regulators defined as such by the corresponding national legislation. Results. Regulatory documents regarding marketing authorization were found in 20 LAC regulators’ websites, covering 34 countries. Seven countries do not accept reliance on foreign regulators. Thirteen regulatory authorities (Argentina, Colombia, Costa Rica, Dominican Republic, Ecuador, El Salvador, Guatemala, Mexico, Panama, Paraguay, Peru, Uruguay, and the unique Caribbean Regulatory System for 15 Caribbean States) explicitly accept relying on marketing authorizations issued by the European Medicines Agency, United States Food and Drug Administration, and Health Canada. Ten countries rely also on marketing authorizations from Australia, Japan, and Switzerland. Argentina, Brazil, Chile, and Mexico are reference authorities for eight LAC regulators. Conclusions. Regulatory reliance has become a common practice in the LAC region. Thirteen out of 20 regulators directly recognize or abbreviate the marketing authorization process in case of earlier approval by a regulator from another jurisdiction. The regulators most relied upon are the European Medicines Agency, United States Food and Drug Administration, and Health Canada.


[RESUMEN]. Objetivo. Describir el estado actual de la utilización de las decisiones de autoridades regulatorias de otras jurisdicciones en América Latina y el Caribe mediante la evaluación de los marcos regulatorios nacionales para la aprobación de nuevos medicamentos y establecer los organismos regulatorios extranjeros que se consideran autoridades regulatorias confiables para cada país. Métodos. Se realizaron búsquedas en los sitios web de las autoridades regulatorias de América Latina y el Caribe para identificar las regulaciones oficiales para la aprobación de nuevos medicamentos. La recopilación de datos se llevó a cabo en diciembre del 2019 y se completó en junio del 2020 para los países del Caribe. Dos equipos independientes recopilaron información sobre el reconocimiento directo o los procedimientos abreviados para la aprobación de nuevos medicamentos y los autoridades regulatorias de referencia (confiables) así definidos en la legislación nacional correspondiente. Resultados. Se encontraron documentos regulatorios sobre la aprobación de nuevos productos en los sitios web de veinte organismos regulatorios de América Latina y el Caribe, que abarcaban 34 países. Siete países no aceptan la utilización de decisiones de autoridades regulatorias extranjeras. Trece autoridades regulatorias (Argentina, Colombia, Costa Rica, Ecuador, El Salvador, Guatemala, México, Panamá, Paraguay, Perú, República Dominicana, Uruguay y el sistema regulador único para quince Estados del Caribe) aceptan de manera explícita confiar las decisiones para aprobación de nuevos medicamentos emitidas por la Agencia Europea de Medicamentos, la Administración de Alimentos y Medicamentos de Estados Unidos y Salud Canadá. Diez países aceptan también utilizar las autorizaciones para la comercialización de Australia, Japón y Suiza. Argentina, Brasil, Chile y México son autoridades de referencia para ocho autoridades regulatorias en la región. Conclusiones. La utilización de las decisiones de autoridades regulatorias de otras jurisdicciones se han convertido en una práctica común en América Latina y el Caribe. Trece de veinte autoridades regulatorias reconocen directamente o abrevian el proceso de aprobación de nuevos medicamentos en caso de que hayan recibido previamente la aprobación por parte de un organismo regulatorio de otra jurisdicción. La Agencia Europea de Medicamentos, la Administración de Alimentos y Medicamentos de Estados Unidos y Salud Canadá son las autoridades regulatorias de otras jurisdicciones en las cuales los reguladores de América Latina y el Caribe confían más.


[RESUMO]. Objetivo. Descrever a prática atual de uso de decisões regulatórias de outras jurisdições na América Latina e no Caribe (ALC) mediante avaliação os marcos regulatórios dos países para aprovação de novos medicamentos e verificar, para cada país, quais entidades reguladoras estrangeiras são consideradas autoridades reguladoras de confiança por cada país. Métodos. Foi realizada uma pesquisa nos sites das autoridades reguladoras da ALC para identificar as regulamentações oficiais para aprovação de novos medicamentos. A coleta de dados foi feita em dezembro de 2019 e concluída em junho de 2020 para os países do Caribe. Dois grupos independentes coletaram informações sobre o reconhecimento direto ou o procedimento abreviado para aprovação de novos medicamentos e as autoridades reguladoras de referência (de confiança) definidas como tal pela respectiva legislação nacional. Resultados. Documentos regulatórios relacionados à aprovação de novos produtos foram obtidos de 20 sites de órgãos reguladores da ALC, abrangendo 34 países. Sete países não admitem o uso de decisões regulatórias de entidades reguladoras externas. Treze autoridades reguladoras (na Argentina, Colômbia, Costa Rica, El Salvador, Equador, Guatemala, México, Panamá, Paraguai, Peru, República Dominicana, Uruguai e o Sistema Regulador do Caribe unificado para 15 Estados caribenhos) admitem explicitamente a admissibilidade de decisões regulatórias para aprovação de novos medicamentos de outras jurisdições, quais sejam: Agência Europeia de Medicamentos (EMA), Agência Reguladora de Alimentos e Medicamentos (FDA) dos EUA e Health Canada. Dez países também aceitam decisões para autorização de comercialização da Austrália, Japão e Suíça. Argentina, Brasil, Chile e México são autoridades de referência para oito agências reguladoras. Conclusões. O uso de decisões regulatórias de outras jurisdições tornou-se prática comum na América Latina e Caribe. Treze das 20 agências reguladoras reconhecem diretamente ou abreviam o procedimento de aprovação de novos medicamentos no caso de tal aprovação já haver sido concedida por uma autoridade reguladora de outra jurisdição. A EMA, a FDA e a Health Canada são as autoridades estrangeiras nas quais as agências reguladoras da América Latina e Caribe mais confiam.


Asunto(s)
Preparaciones Farmacéuticas , Agencias Gubernamentales , Aprobación de Drogas , United States Food and Drug Administration , Organización Panamericana de la Salud , América Latina , Región del Caribe , Preparaciones Farmacéuticas , Agencias Gubernamentales , Aprobación de Drogas , Organización Panamericana de la Salud , América Latina , Región del Caribe , Preparaciones Farmacéuticas , Agencias Gubernamentales , Aprobación de Drogas , Organización Panamericana de la Salud , Región del Caribe
4.
Natl Vital Stat Rep ; 70(2): 1-51, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33814033

RESUMEN

Objectives-This report presents 2019 data on U.S. births according to a wide variety of characteristics. Trends in fertility patterns and maternal and infant characteristics are described and interpreted. Methods-Descriptive tabulations of data reported on the birth certificates of the 3.75 million births that occurred in 2019 are presented. Data are presented for maternal age, livebirth order, race and Hispanic origin, marital status, tobacco use, prenatal care, source of payment for the delivery, method of delivery, gestational age, birthweight, and plurality. Selected data by mother's state of residence and birth rates by age are also shown. Trend data for 2010 through 2019 are presented for selected items. Trend data by race and Hispanic origin are shown for 2016-2019. Results-A total of 3,747,540 births were registered in the United States in 2019, down 1% from 2018. The general fertility rate declined from 2018 to 58.3 births per 1,000 women aged 15-44 in 2019. The birth rate for females aged 15-19 fell 4% between 2018 and 2019. Birth rates declined for women aged 20-34 and increased for women aged 35-44 for 2018-2019. The total fertility rate declined to 1,706.0 births per 1,000 women in 2019. Birth rates declined for both married and unmarried women from 2018 to 2019. The percentage of women who began prenatal care in the first trimester of pregnancy rose to 77.6% in 2019; the percentage of all women who smoked during pregnancy declined to 6.0%. The cesarean delivery rate decreased to 31.7% in 2019 (Figure 1). Medicaid was the source of payment for 42.1% of all births in 2019. The preterm birth rate rose for the fifth straight year to 10.23% in 2019; the rate of low birthweight was essentially unchanged from 2018 at 8.31%. Twin and triplet and higher-order multiple birth rates both declined in 2019 compared with 2018.


Asunto(s)
Tasa de Natalidad/tendencias , Adolescente , Adulto , Certificado de Nacimiento , Orden de Nacimiento , Tasa de Natalidad/etnología , Peso al Nacer , Grupos de Población Continentales/estadística & datos numéricos , Parto Obstétrico/economía , Parto Obstétrico/métodos , Femenino , Edad Gestacional , Hispanoamericanos/estadística & datos numéricos , Humanos , Recién Nacido , Masculino , Estado Civil/etnología , Estado Civil/estadística & datos numéricos , Edad Materna , Persona de Mediana Edad , Madres/estadística & datos numéricos , Progenie de Nacimiento Múltiple/estadística & datos numéricos , Embarazo , Atención Prenatal/estadística & datos numéricos , Uso de Tabaco/epidemiología , Uso de Tabaco/etnología , Estados Unidos/epidemiología , Adulto Joven
5.
Natl Vital Stat Rep ; 70(1): 1-18, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33814036

RESUMEN

Objectives-This report presents complete period life tables for each of the 50 states and the District of Columbia by sex based on age-specific death rates in 2018. Methods-Data used to prepare the 2018 state-specific life tables include 2018 final mortality statistics; July 1, 2018 population estimates based on the 2010 decennial census; and 2018 Medicare data for persons aged 66-99. The methodology used to estimate the state-specific life tables is the same as that used to estimate the 2018 national life tables, with some modifications. Results-Among the 50 states and the District of Columbia, Hawaii had the highest life expectancy at birth, 81.0 years in 2018, and West Virginia had the lowest, 74.4 years. Life expectancy at age 65 ranged from 17.5 years in Kentucky to 21.1 years in Hawaii. Life expectancy at birth was higher for females in all states and the District of Columbia. The difference in life expectancy between females and males ranged from 3.8 years in Utah to 6.2 years in New Mexico.


Asunto(s)
Esperanza de Vida/tendencias , Tablas de Vida , Mortalidad/tendencias , Adolescente , Adulto , Distribución por Edad , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Grupos Étnicos/estadística & datos numéricos , Femenino , Hispanoamericanos/estadística & datos numéricos , Humanos , Lactante , Recién Nacido , Esperanza de Vida/etnología , Masculino , Persona de Mediana Edad , Mortalidad/etnología , Distribución por Sexo , Estados Unidos/epidemiología , Adulto Joven
6.
Artículo en Inglés | MEDLINE | ID: mdl-33809240

RESUMEN

The coronavirus disease 2019 (COVID-19) epidemic in the United States has disproportionately impacted communities of color across the country. Focusing on COVID-19-attributable mortality, we expand upon a national comparative analysis of years of potential life lost (YPLL) attributable to COVID-19 by race/ethnicity (Bassett et al., 2020), estimating percentages of total YPLL for non-Hispanic Whites, non-Hispanic Blacks, Hispanics, non-Hispanic Asians, and non-Hispanic American Indian or Alaska Natives, contrasting them with their respective percent population shares, as well as age-adjusted YPLL rate ratios-anchoring comparisons to non-Hispanic Whites-in each of 45 states and the District of Columbia using data from the National Center for Health Statistics as of 30 December 2020. Using a novel Monte Carlo simulation procedure to perform estimation, our results reveal substantial racial/ethnic disparities in COVID-19-attributable YPLL across states, with a prevailing pattern of non-Hispanic Blacks and Hispanics experiencing disproportionately high and non-Hispanic Whites experiencing disproportionately low COVID-19-attributable YPLL. Furthermore, estimated disparities are generally more pronounced when measuring mortality in terms of YPLL compared to death counts, reflecting the greater intensity of the disparities at younger ages. We also find substantial state-to-state variability in the magnitudes of the estimated racial/ethnic disparities, suggesting that they are driven in large part by social determinants of health whose degree of association with race/ethnicity varies by state.


Asunto(s)
Grupos Étnicos , District of Columbia , Disparidades en el Estado de Salud , Hispanoamericanos , Humanos , Esperanza de Vida , Estados Unidos/epidemiología
7.
Rev Esp Salud Publica ; 952021 Apr 09.
Artículo en Español | MEDLINE | ID: mdl-33833213

RESUMEN

BACKGROUND: In the attempt to reactivate the economy after several months of the pandemic generated by COVID-19, several South American countries have been forced to attenuate the restriction measures created to prevent contagion, leaving all the responsibility to citizens to safeguard their lives. Faced with this situation, the objective of the work was to promote good prevention practices against COVID-19 in the general population to avoid the collapse of the public health system. METHODS: An exploratory review on prevention measures against COVID-19 was carried out in the databases Elsevier, Pubmed, Wiley, Scopus, Scielo and, in general, in academic Google, to obtain gray information. RESULTS: The role of seven individual protection and prevention measures and barriers to stop the advance of community infections by COVID-19 were described and analyzed. Studies showed that the use of preventive measures can play a critical role in containing the pandemic. However, they can also provide a false security of protection, predisposing to neglect the correct use and handling of all containment measures. CONCLUSIONS: Given the drastic rise in infections and deaths from COVID-19 in Latin America, it becomes necessary to continue with biosecurity campaigns so that citizens are clear that prevention is an integrated process and that the use of one measure does not replace another.

9.
Hist. ciênc. saúde-Manguinhos ; 28(1): 293-300, mar. 2021. graf
Artículo en Español | LILACS-Express | LILACS | ID: biblio-1154305

RESUMEN

Resumen Este artículo tiene como propósito poner al alcance de investigadores y estudiantes información sobre archivos digitales de bibliotecas en América Latina y en el extranjero. Su contenido está orientado para aquellos interesados en historia de la salud, con énfasis en Perú y Chile.


Abstract This article aims to provide researchers and students with information on digital archives in libraries in Latin America and elsewhere. It is aimed at those interested in health history, focusing on Peru and Chile.

10.
Hist. ciênc. saúde-Manguinhos ; 28(1): 233-253, mar. 2021.
Artículo en Inglés | LILACS-Express | LILACS | ID: biblio-1154321

RESUMEN

Abstract This paper argues that many of the foundations and trends that led to the rise in obesity and other diet-related health problems in Latin America began to develop in the late nineteenth century. The tendency towards presentism in the nutrition transition literature provides a much abbreviated and limited history of changes in diet and weight. Whereas medical and nutrition researchers have tended to emphasize the recent onset of the crisis, a historical perspective suggests that increasingly global food sourcing prompted changes in foodways and a gradual "fattening" of Latin America. This paper also provides a methodological and historiographic exploration of how to historicize the nutrition transition, drawing on a diverse array of sources from pre-1980 to the present.


Resumo Este trabalho argumenta que fundamentos e tendências que levaram ao aumento da obesidade e de outros problemas de saúde relacionados à alimentação na América Latina começaram a surgir no final do século XIX. A propensão ao presentismo na literatura sobre transição nutricional produz uma história abreviada e limitada das mudanças em alimentação e peso. Embora pesquisadores médicos e nutricionistas enfatizem a recente instalação da crise, uma perspectiva histórica sugere que fontes alimentares crescentemente globalizadas resultaram em mudanças na alimentação e em gradual "aumento de gordura" na população latino-americana. O artigo propõe ainda a exploração metodológica e historiográfica de como historicizar a transição nutricional recorrendo a fontes pré-1980 até o momento.

11.
Hist Cienc Saude Manguinhos ; 2828(1): 293-300, 2021.
Artículo en Español | MEDLINE | ID: mdl-33787706

RESUMEN

This article aims to provide researchers and students with information on digital archives in libraries in Latin America and elsewhere. It is aimed at those interested in health history, focusing on Peru and Chile.

12.
J Environ Manage ; 286: 112251, 2021 May 15.
Artículo en Inglés | MEDLINE | ID: mdl-33677339

RESUMEN

Forest and Landscape Restoration (FLR) has been defined as a planned process that aims to regain ecological functionality and enhance human well-being in degraded landscapes. Several governments and organizations worldwide rose to the challenge of halting degradation and restoring landscapes. Commitments are ambitious, thus a synthesis of current experiences with and strategies for implementation is important to inform future actions. To guide successful implementation, the Global Partnership on FLR put forward six principles, namely, the conservation and enhancement of ecosystems at landscape scales, the restoration of multiple functions, the engagement of multiple stakeholders, with allowances for context dependency and adaptive management. Non-governmental organizations, acting globally, regionally and (or) at national and local scales, play a fundamental role in supporting governments fulfill their commitments. Therefore, we gathered the perceptions of actors within non-governmental organizations engaged in FLR across countries in Asia, Africa and Latin America about what FLR is and their perceived challenges and strategies for implementation. We employed the six principles of FLR to organize and evaluate the responses. Results show that the principles of landscape scale, ecosystem conservation and enhancement, and multi stakeholder engagement are all considered by interviewees as core components of an FLR program. Yet several restoration projects shared by interviewees still required further evidence of a landscape vision, and the integration of actors beyond local communities and the environmental government sectors. Context dependency was evident in the clear incorporation of local natural resource governance norms, such as tribal and community management in project structure, yet few projects appeared to be designed by local actors. The principle of "adaptive management" was mostly missing from the responses, perhaps because most projects had not had sufficient time to learn from intervention outcomes. Key financial challenges for FLR implementation were the short duration and availability of funding, high-up front costs and few short-term returns. To overcome these challenges, promising strategies relate to the development of tangible economic returns for local actors engaged in productive restorative actions that are planned alongside conservation and ecological restoration actions in the landscape. The challenges of negotiating actions with a multitude of actors and the lack of supportive policies highlighted in the interviews require organizations to focus efforts on leveraging the enactment and enforcement of legislations that look beyond jurisdictional boundaries and support landscape management with clear, long term incentive mechanisms and cross-sectoral collaboration. In addition, implementation can be further supported with the scientifically robust sharing of results on how different FLR projects move forward in meeting the social and environmental objectives of a successful, integrative restoration of degraded landscapes.


Asunto(s)
Conservación de los Recursos Naturales , Ecosistema , África , Asia , Bosques , Gobierno , Humanos , América Latina , Percepción
13.
BMC Pregnancy Childbirth ; 21(1): 247, 2021 Mar 24.
Artículo en Inglés | MEDLINE | ID: mdl-33761892

RESUMEN

BACKGROUND: Coronavirus disease (COVID-19) has been associated with adverse pregnancy outcomes. Due to the lack of effective treatments for COVID-19, it becomes imperative to assess the geographical differences and trends in the current clinical care and outcomes of COVID-19 in pregnant women. METHODS: A PubMed search was performed to screen articles reporting therapeutics and outcomes of confirmed COVID-19 in pregnant women prior to August 27, 2020. We performed searches, quality assessments of eligible studies, extracted and reported data according to PRISMA guidelines. Meta-analyses and cumulative meta-analyses of proportions were performed for estimating each outcome and their pattern over time respectively. RESULTS: One thousand two hundred thirty nine pregnant women with COVID-19 from 66 studies were analyzed. In case series analysis reflecting average-risk patients, the proportion of oxygen support, antibiotics, antivirals, and plasma therapy administration except for hydroxychloroquine was substantially higher in Asian studies (55, 78, 80, 6, and 0%) compared to the US (7, 1, 12, 0, and 7%) or European (33, 12, 14, 1, and 26%) studies, respectively. The highest preterm birth and the average length of hospital stay (35%, 11.9 days) were estimated in Asian studies compared to the US studies (13%, 9.4 days) and European studies (29%, 7.3 days), respectively. Even in case reports reflecting severe cases, the use of antivirals and antibiotics was higher in Asian studies compared to the US, Latin American, and European studies. A significant decline in the use of most therapeutics along with adverse outcomes of COVID-19 in pregnant women was observed. CONCLUSIONS: Geographical differences in therapeutic practice of COVID-19 were observed with differential rates of maternal and clinical outcomes. Minimizing the use of some therapeutics particularly antibiotics, antivirals, oxygen therapy, immunosuppressants, and hydroxychloroquine by risk stratification and careful consideration may further improve maternal and clinical outcomes.


Asunto(s)
Antibacterianos/uso terapéutico , Antivirales/uso terapéutico , /terapia , Hidroxicloroquina/uso terapéutico , Complicaciones Infecciosas del Embarazo/tratamiento farmacológico , Complicaciones Infecciosas del Embarazo/epidemiología , Respiración Artificial , Adulto , Asia/epidemiología , Cesárea , Europa (Continente)/epidemiología , Femenino , Humanos , Inmunización Pasiva , Recién Nacido , América Latina/epidemiología , Tiempo de Internación , Embarazo , Complicaciones Infecciosas del Embarazo/virología , Resultado del Embarazo , Nacimiento Prematuro , Resultado del Tratamiento , Estados Unidos/epidemiología , Adulto Joven
14.
Nat Med ; 27(3): 373-375, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33664489
15.
J Racial Ethn Health Disparities ; 8(2): 280-282, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33742351

RESUMEN

With Black and Hispanic communities across the USA experiencing more detrimental negative effects from the COVID-19 pandemic as compared with other demographic groups, the virus has exposed the racial and ethnic disparities in treatment and care that public health experts have been grappling with for years. This paper explains how the systematic collection of racial and ethnic data gleaned from COVID-19 testing in underserved communities can be used to better understand this pandemic and inform measures within our control to prevent the spread of disease in the future.


Asunto(s)
Afroamericanos , Disparidades en el Estado de Salud , Disparidades en Atención de Salud/etnología , Hispanoamericanos , /diagnóstico , Control de Enfermedades Transmisibles , Servicios de Salud Comunitaria , Redes Comunitarias , Accesibilidad a los Servicios de Salud , Humanos , Pobreza , Áreas de Pobreza , Estados Unidos
16.
PLoS Biol ; 19(3): e3001167, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33684102

RESUMEN

As the vaccines against COVID are slowly becoming available, we need to consider the paradox of why so many people of color are dying from the disease yet cannot get the vaccinations. Concerns focus on vaccine refusal but lack of access is the bigger problem.


Asunto(s)
Afroamericanos/psicología , Hispanoamericanos/psicología , Racismo/psicología , Negativa a la Vacunación/etnología , /epidemiología , /metabolismo , Humanos , Pandemias , Estados Unidos/epidemiología , Vacunación/métodos , Vacunación/psicología , Negativa a la Vacunación/psicología , Negativa a la Vacunación/tendencias
18.
Reprod Health ; 18(1): 66, 2021 Mar 22.
Artículo en Inglés | MEDLINE | ID: mdl-33752712

RESUMEN

BACKGROUND: The partograph is the most commonly used labour monitoring tool in the world. However, it has been used incorrectly or inconsistently in many settings. In 2018, a WHO expert group reviewed and revised the design of the partograph in light of emerging evidence, and they developed the first version of the Labour Care Guide (LCG). The objective of this study was to explore opinions of skilled health personnel on the first version of the WHO Labour Care Guide. METHODS: Skilled health personnel (including obstetricians, midwives and general practitioners) of any gender from Africa, Asia, Europe and Latin America were identified through a large global research network. Country coordinators from the network invited 5 to 10 mid-level and senior skilled health personnel who had worked in labour wards anytime in the last 5 years. A self-administered, anonymous, structured, online questionnaire including closed and open-ended questions was designed to assess the clarity, relevance, appropriateness of the frequency of recording, and the completeness of the sections and variables on the LCG. RESULTS: A total of 110 participants from 23 countries completed the survey between December 2018 and January 2019. Variables included in the LCG were generally considered clear, relevant and to have been recorded at the appropriate frequency. Most sections of the LCG were considered complete. Participants agreed or strongly agreed with the overall design, structure of the LCG, and the usefulness of reference thresholds to trigger further assessment and actions. They also agreed that LCG could potentially have a positive impact on clinical decision-making and respectful maternity care. Participants disagreed with the value of some variables, including coping, urine, and neonatal status. CONCLUSIONS: Future end-users of WHO Labour Care Guide considered the variables to be clear, relevant and appropriate, and, with minor improvements, to have the potential to positively impact clinical decision-making and respectful maternity care.

19.
Rev Panam Salud Publica ; 45, mar. 2021https://doi.org/10.26633/RPSP.2021.41.
Artículo en Inglés | PAHO-IRIS | ID: phr-53334

RESUMEN

[ABSTRACT]. This article describes the main models for embedding research and the successful experiences and challenges faced in joint work by researchers and decisionmakers who participated in the Embedding Research for the Sustainable Development Goals (ER-SDG) initiative, and the experience of the Technical Support Center. In June 2018, funding was granted to 13 pre-selected research projects from 11 middle- and low-income countries in Latin America and the Caribbean (Argentina, Bolivia, Brazil, Colombia, Dominican Republic, Ecuador, Guatemala, Guyana, Haiti, Paraguay, and Peru). The projects focused on the system-, policy-, or programlevel changes required to improve health and build on the joint work of researchers and decisionmakers, with a view to bringing together evidence production and decision-making in health systems and services. The Technical Support Center supported and guided the production of quality results useful for decision-making. This experience confirmed the value of initiatives such as ER-SDG in consolidating bridges between research on the implementation of health policies, programs, and systems, and the officials responsible for operating health-related programs, services, and interventions. It highlighted the importance of both respecting and taking advantage of each context—and the specific arrangements and patterns in the relationships between researchers and decisionmakers—through incentives for embedded research.


[RESUMEN]. En este artículo se describen los principales modelos de integración, las experiencias de éxito y los retos del trabajo conjunto de los investigadores y los tomadores de decisiones participantes en la iniciativa Incorporación de la Investigación para Avanzar en el Cumplimiento de los Objetivos de Desarrollo Sostenible (ER-SDG), y la experiencia del Centro de Apoyo Técnico (CAT). En junio de 2018 se otorgó financiamiento, previa selección, a 13 proyectos de investigación de 11 países de ingresos medios y bajos de América Latina y el Caribe (Argentina, Bolivia, Brasil, Colombia, Ecuador, Guatemala, Guyana, Haití, Paraguay, Perú y República Dominicana). Los proyectos debían estar centrados en los cambios que se requieren a nivel de sistema, políticas o programas para mejorar la salud y basarse en el trabajo conjunto de investigadores y tomadores de decisiones, a fin de acercar la generación de evidencias a la toma de decisiones en los sistemas y servicios de salud. El CAT apoyó y orientó la producción de resultados de calidad y de utilidad para la toma de decisiones. La experiencia confirmó el valor de iniciativas como ER-SDG en la consolidación de puentes entre el mundo de la investigación sobre implementación de políticas, programas y sistemas de salud, y el mundo de los funcionarios encargados de operar esos programas, servicios e intervenciones relacionadas con la salud. Se resalta la necesidad de respetar y aprovechar cada contexto, y los arreglos y patrones específicos de relación entre investigadores y tomadores de decisiones, mediante incentivos para la integración.


[RESUMO]. Neste artigo são descritos os principais modelos de integração, as experiências de êxito e os desafios do trabalho conjunto de pesquisadores e responsáveis por tomar decisões que participam da iniciativa Incorporação da Pesquisa para Avançar no Cumprimento dos Objetivos de Desenvolvimento Sustentável (Embedding Research for the Sustainable Development Goals, ER-SDG) e da experiência do Centro de Apoio Técnico (CAT). Em junho de 2018, realizou-se a concessão de financiamento e pré-seleção de 13 projetos de pesquisa provenientes de 11 países de baixa e média renda da América Latina e Caribe (Argentina, Bolívia, Brasil, Colômbia, Equador, Guatemala, Guiana, Haiti, Paraguai, Peru e República Dominicana). Os projetos deveriam enfocar as mudanças necessárias no sistema, políticas ou programas para melhorar a saúde e fundar-se no trabalho conjunto de pesquisadores e responsáveis por tomar decisões visando aproximar a produção de evidências à tomada de decisão nos sistemas e serviços de saúde. O CAT forneceu suporte e orientação à produção de resultados úteis e de qualidade para a tomada de decisão. A experiência confirmou o valor de iniciativas como a ER-SDG para consolidar pontes entre o mundo da pesquisa voltada à implementação de políticas, programas e sistemas de saúde e o mundo dos encarregados de gerir estes programas, serviços e intervenções de saúde. Deve-se enfatizar a necessidade de respeitar e aproveitar cada contexto e os arranjos e padrões próprios da relação entre pesquisadores e responsáveis por tomar decisões criando incentivos à integração.


Asunto(s)
Ciencia de la Implementación , Política Informada por la Evidencia , Investigación sobre Servicios de Salud , América Latina , Región del Caribe , Ciencia de la Implementación , Política Informada por la Evidencia , Investigación sobre Servicios de Salud , América Latina , Región del Caribe , Ciencia de la Implementación , Política Informada por la Evidencia , Investigación sobre Servicios de Salud , Región del Caribe
20.
Artículo en Inglés | PAHO-IRIS | ID: phr-53331

RESUMEN

[ABSTRACT]. Objective. To characterize the design of excise taxes on sugar-sweetened beverages (SSBs) in Latin America and the Caribbean and assess opportunities to increase their impact on SSB consumption and health. Methods. A comprehensive search and review of the legislation in effect as of March 2019, collected through existing Pan American Health Organization and World Health Organization monitoring tools, secondary sources, and surveying ministries of finance. The analysis focused on the type of products taxed, and the structure and base of these excise taxes. Results. Out of the 33 countries analyzed, 21 apply excise taxes on SSBs. Seven countries also apply excise taxes on bottled water and at least four include sugar-sweetened milk drinks. Ten of these excise taxes are ad valorem with some tax bases set early in the value chain, seven are amount-specific, and four have either a combined or mixed structure. Three countries apply excise taxes based on sugar concentration. Conclusions. While the number of countries applying excise taxes on SSBs is promising, there is great heterogeneity in design in terms of structure, tax base, and products taxed. Existing excise taxes could be further leveraged to improve their impact on SSB consumption and health by including all categories of SSBs, excluding bottled water, and relying more on amount-specific taxes regularly adjusted for inflation and possibly based on sugar concentration. All countries would benefit from additional guidance. Future research should aim to address this gap.


[RESUMEN]. Objetivo. Caracterizar el diseño de los impuestos selectivos al consumo de bebidas azucaradas en América Latina y el Caribe, y evaluar las oportunidades de aumentar su impacto en el consumo y la salud. Métodos. Se llevó a cabo una búsqueda y una evaluación exhaustivas de legislaciones vigentes a marzo del 2019, recopilada mediante las herramientas de seguimiento ya existentes de la Organización Panamericana de la Salud y de la Organización Mundial de la Salud, fuentes secundarias, así como mediante una encuesta a ministerios de finanzas. El análisis se centró en el tipo de productos gravados y la estructura y la base de estos impuestos selectivos. Resultados. De los 33 países evaluados, en 21 se aplican impuestos selectivos al consumo de bebidas azucaradas. En siete países también se aplican impuestos selectivos al consumo de agua embotellada y en al menos cuatro, se incluyen las bebidas lácteas azucaradas. Diez de estos impuestos selectivos al consumo son de tipo ad valorem con algunas bases imponibles fijadas al principio de la cadena de valor, siete son de tipo específico y cuatro son de estructura combinada o mixta. En tres países se aplican impuestos selectivos al consumo en función de la concentración de azúcares del producto. Conclusiones. Si bien el número de países en que se aplican impuestos selectivos al consumo de bebidas azucaradas es prometedor, existe una gran heterogeneidad en su diseño en cuanto a la estructura, la base imponible y los productos gravados. Se podrían aprovechar aún más los impuestos selectivos existentes a fin de que tengan un mayor impacto sobre la salud y el consumo si se incluyen todas las categorías de bebidas azucaradas, excluyendo el agua embotellada, y recurriendo más a impuestos de tipo específico ajustados frecuentemente según la inflación y basados posiblemente en la concentración de azúcares del producto. Todos los países se beneficiarían si hubiera mayor orientación. Las próximas investigaciones deberían abordar esta brecha.


[RESUMO]. Objetivo. Caracterizar o modelo dos impostos especiais de consumo sobre bebidas açucaradas na América Latina e no Caribe e avaliar oportunidades para aumentar o impacto desses impostos no consumo de bebidas açucaradas e na saúde. Métodos. Realizou-se uma pesquisa ampla e a análise de legislações vigentes em março de 2019, com informações obtidas por meio de instrumentos de monitoramento da Organização Pan-Americana da Saúde (OPAS) e da Organização Mundial da Saúde (OMS) já existentes, fontes secundárias e levantamento junto aos ministérios da Fazenda. A análise centrou-se no tipo de produtos tributados e na estrutura e base desses impostos especiais de consumo. Resultados. Dos 33 países analisados, 21 aplicam impostos especiais de consumo sobre bebidas açucaradas. Em sete países os impostos especiais de consumo incidem também sobre água engarrafada e, em pelo menos quatro, incluem bebidas lácteas açucaradas. Dez desses tributos especiais são ad valorem com algumas bases tributárias estabelecidas no início da cadeia de valor, sete são de tipo específico e quatro têm uma estrutura combinada ou mista. Em três países os impostos especiais são estabelecidos com base na concentração de açúcares do produto. Conclusões. Apesar do número promissor de países com impostos especiais de consumo sobre bebidas açucaradas, verifica-se grande heterogeneidade nos modelos de tributação em termos de estrutura, base tributária e produtos tributados. Os impostos especiais de consumo vigentes poderiam ser mais bem aproveitados para aumentar o impacto no consumo de bebidas açucaradas e na saúde: incluir todas as categorias de bebidas açucaradas, excluir água engarrafada e recorrer mais a impostos de tipo específico com a correção periódica pela inflação e, possivelmente, com base na concentração de açúcares do produto. Todos os países se beneficiariam em receber mais orientação. Pesquisas futuras devem ter como objetivo abordar essa lacuna.


Asunto(s)
Enfermedades no Transmisibles , Política Nutricional , Economía de la Salud , Obesidad , Legislación como Asunto , Enfermedades no Transmisibles , Política Nutricional , Economía de la Salud , Obesidad , Legislación como Asunto , Enfermedades no Transmisibles , Economía de la Salud , Obesidad , Legislación como Asunto
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