Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 148
Filtrar
1.
Reg Environ Change ; 22(1): 28, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35250377

RESUMEN

The surging demand for commodity crops has led to rapid and severe agricultural frontier expansion globally and has put producing regions increasingly under pressure. However, knowledge about spatial patterns of agricultural frontier dynamics, their leading spatial determinants, and socio-ecological trade-offs is often lacking, hindering contextualized decision making towards more sustainable food systems. Here, we used inventory data to map frontier dynamics of avocado production, a cash crop of increasing importance in global diets, for Michoacán, Mexico, before and after the implementation of the North American Free Trade Agreement (NAFTA). We compiled a set of environmental, accessibility and social variables and identified the leading determinants of avocado frontier expansion and their interactions using extreme gradient boosting. We predicted potential expansion patterns and assessed their impacts on areas important for biodiversity conservation. Avocado frontiers expanded more than tenfold from 12,909 ha (1974) to 152,493 ha (2011), particularly after NAFTA. Annual precipitation, distance to settlements, and land tenure were key factors explaining avocado expansion. Under favorable climatic and accessibility conditions, most avocado expansion occurred on private lands. Contrary, under suboptimal conditions, most avocado expansion occurred on communal lands. Large areas suitable for further avocado expansion overlapped with priority sites for restoration, highlighting an imminent conflict between conservation and economic revenues. This is the first analysis of avocado frontier dynamics and their spatial determinants across a major production region and our results provide entry points to implement government-based strategies to support small-scale farmers, mostly those on communal lands, while trying to minimize the socio-environmental impacts of avocado production. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s10113-022-01883-6.

2.
Artículo en Inglés | MEDLINE | ID: mdl-35169946

RESUMEN

We investigate the validity of the environmental Kuznets curve (EKC) hypothesis for the NAFTA countries. In this investigation, we approach this hypothesis from a different methodology and propose employing the ARMEY curve hypothesis since the mathematical-functional propositions of both hypotheses were constructed on the same inverted U-shaped relationships. Thus, for the first time, it can be interpreted that the EKC hypothesis is empirically tested through a transmission mechanism of the ARMEY curve hypothesis in a single composite model. Therefore, this approach makes our study different from all empirical studies in the relevant literature. We apply the Augmented Mean Group (AMG) estimator to this aim. Empirical findings indicate that the ARMEY curve hypothesis was verified only for the USA. However, this new approach proposed in this study cannot test the EKC hypothesis through the ARMEY curve model for any NAFTA country since this approach requires verification of the ARMEY curve hypothesis and a significant composite model for the same NAFTA country. If our composite model was significant, it might make it possible to numerically determine a maximum real GDP per capita level that would minimize or maximize CO2 emission levels for the USA. Therefore, this study introduces-proposes this new methodology as an alternative way of testing the EKC hypothesis in the relevant literature for future empirical studies.

3.
CienciaUAT ; 15(2): 102-121, ene.-jun. 2021. tab, graf
Artículo en Español | LILACS-Express | LILACS | ID: biblio-1285895

RESUMEN

Resumen La renegociación del Tratado de Libre Comercio de América del Norte entre México, Estados Unidos y Canadá inició en 2017 como medida proteccionista de Estados Unidos. La importancia del acuerdo comercial implicó la participación activa del sector privado mexicano a través del mecanismo "Cuarto de Junto", que funciona como órgano de consulta en negociaciones de acuerdos comerciales. La industria automotriz fue un tema sensible, por el grado de integración de las cadenas de suministro y su impacto para la región de Norteamérica. El objetivo de este trabajo fue analizar la colaboración del sector privado, de la industria automotriz, en los procesos de consulta pública del gobierno mexicano para la definición de su política de apertura comercial, durante la renegociación del Tratado de Libre Comercio de América del Norte. Esta investigación es cualitativa, con alcance descriptivo-exploratorio. Se realizaron 9 entrevistas semiestructuradas a representantes clave del gobierno mexicano, expertos en la disciplina o miembros activos del "Cuarto de Junto". El mecanismo de consulta, a través del "Cuarto de Junto", único en su género, permitió al gobierno mexicano alinear, en gran medida, los intereses del sector privado con los intereses de la política comercial de México. Los acuerdos alcanzados sobre reglas de origen y el incremento en el valor de contenido regional de autopartes si bien exigen mayor participación de la macro región de Norteamérica, otorgan nuevas oportunidades para desarrollar la industria nacional mexicana. La experiencia del sector privado mexicano, las habilidades de negociación e interacción a través del "Cuarto de Junto" y, sobre todo, el intenso cabildeo en Estados Unidos con la cúpula empresarial, legisladores y funcionarios públicos, antes y durante la renegociación, favorecieron al gobierno mexicano para cerrar satisfactoriamente las negociaciones. La transparencia del proceso de consulta pública-privada permitió consolidar alianzas dentro y fuera del país, aunque con retos complejos.


Abstract The renegotiation of the North American Free Trade Agreement between Mexico, the United States and Canada began as a protectionist measure of United States in 2017. The importance of this agreement involved the active participation of the Mexican private sector through the "Side Room" a mechanism that functions as a consulting body for negotiation of international agreements. The automotive industry was a sensitive issue due to the integration level of the supply chains and their impact for the North American region. The objective of this research was to analyze the collaboration of the private sector automotive industry in the public consultation processes of the Mexican government for the definition of Mexico's trade policy during the North American Free Trade Agreement renegotiation period. This is a qualitative research with a descriptive-exploratory scope. Nine semi-structured interviews were carried out with representatives of the Mexican government, experts, or active members of the "Side Room". The "Side Room" consulting mechanism allowed the Mexican Government to align most of the private sector interests to the country's trade policy. Although the agreements reached regarding the rules of origin, and the increment on the regional value content of auto parts may require greater participation from the North American macro region, they allow new opportunities for the development of the domestic industry in Mexico. The experience of the Mexican private sector, the negotiation skills and interaction through the "Side Room" and above all, the intense lobbying in the with the private sector, legislators, and governors before and during renegotiation, had a positive impact for the Mexican government in order to satisfactorily conclude the negotiations. The transparency of the public-private consulting process consolidated alliances inside and outside Mexico, albeit with complex challenges.

4.
Environ Sci Pollut Res Int ; 28(9): 11205-11223, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33111228

RESUMEN

This study examined the predictors of carbon emissions in member countries of the North American Free Trade Agreement (NAFTA). Panel models robust to cross-sectional dependence and slope heterogeneity were used for the study. From the heterogeneity and cross-sectional dependence tests, the studied panel was heterogeneous and cross-sectionally dependent. Also, the unit root and cointegration tests established the series to be first differenced stationary and cointegrated in the long run. Additionally, results of the CCEMG regression estimator in the whole panel affirmed economic growth (GDP) to be a significantly positive predictor of CO2 emissions, while foreign direct investments (FDI) and population growth (POP) were trivial determinants of CO2 emissions. The discoveries were however diverse in the individual countries. Finally, there was no causality between GDP and CO2 emissions and between POP and CO2 emissions. However, there was a one-way causality from CO2 emissions to FDI. Policy recommendations are further discussed.


Asunto(s)
Dióxido de Carbono , Carbono , Dióxido de Carbono/análisis , Estudios Transversales , Desarrollo Económico , América del Norte
5.
Artículo en Inglés | MEDLINE | ID: mdl-32801219

RESUMEN

In October 2019, the Mexican government reformed its General Health Law thus establishing the warning approach to front-of-pack nutrition labeling (FOPNL), and in March 2020, modified its national standard, revamping its ineffective FOPNL, one preemptively developed by industry actors. Implementation is scheduled for later in 2020. However, the new regulation faces fierce opposition from transnational food and beverage companies (TFBCs), including Nestlé, Kellogg, Grupo Bimbo, Coca-Cola, PepsiCo through their trade associations, the National Manufacturers, American Bakers Associations, the Confederation of Industrial Chambers of Mexico and ConMéxico. Mexico, as a regional leader, could tip momentum in favor of FOPNL diffusion across Latin America. But the fate of the Mexican FOPNL and the region currently lies in this government's response to three threats of legal challenges by TFBCs, citing international laws and guidelines including the World Trade Organization (WTO), Codex Alimentarius, and the North American Free Trade Agreement (NAFTA)/US-Mexico-Canada Agreement (USMCA). In this perspective, we argue that these threats should not prevent Mexico or other countries from implementing evidence-informed policies, such as FOPNLs, that pursue legitimate public health objectives.

6.
Environ Sci Technol ; 54(17): 10421-10434, 2020 09 01.
Artículo en Inglés | MEDLINE | ID: mdl-32786598

RESUMEN

Climate change and increasing world population will directly impact the global food supply chain linkages. In the United States, agricultural production requires less irrigated water than before but it still accounts for a third of total water withdrawals. To better understand the evolution of its water use, we perform a structural decomposition analysis of water withdrawals across eight different crops and six livestock categories and differentiate the trends over 1995-2005 vs 2005-2010 to account for the role of the economic crisis in the second period. Based on USGS data, the results show that both periods experienced an overall decline in water withdrawals in the production of all crops except oilseeds. This trend is driven by a decrease in water intensity, reflecting greater efficiency of irrigation systems, and by reduced local per capita income in the second period. However, increased foreign demand for water-intensive sectors like oilseeds from NAFTA and Asian partners mitigated the decline. Results indicate also a decreasing water use in livestock production partially due to a shift from red to white meat consumption in the country. Arguably, recent tariff wars and border closures have greatly reduced the virtual water embodied in American exports.


Asunto(s)
Agricultura , Agua , Animales , Abastecimiento de Alimentos , Industria Manufacturera , Estados Unidos , Abastecimiento de Agua
7.
Rev. peru. biol. (Impr.) ; 27(3): 417-422, jul-sep 2020. tab, graf
Artículo en Español | LILACS-Express | LILACS | ID: biblio-1144974

RESUMEN

Resumen La introducción de cualquier compuesto químico o el cambio de condiciones ambientales impacta en la comunidad bacteriana presente en un suelo. Este trabajo tuvo como objetivo observar los cambios en la comunidad bacteriana de un suelo al que se contaminó con hidrocarburos (gasoil, aceite y mezclas 1:1 gasoil-aceite y 1:1:1 nafta-gasoil-aceite). Se realizaron microcosmos cuya evolución fue estudiada por mineralización, recuento bacteriano, determinación de hidrocarburos totales del petróleo (TPH) y análisis de los principales componentes de la extracción de ácidos de las membranas bacterianas. Se presentaron disturbios en la composición de ácidos grasos de la comunidad bacteriana en todos los tratamientos. El agregado de nutrientes en el sistema de control produce un aumento del recuento bacteriano y el sistema que produjo mejor degradación fue el contenía solo gasoil, la presencia de los hidrocarburos produjo, en el diagrama de PCA, un agrupamiento de las muestras con aceite y de las mezclas.


Abstract Any chemical compound introduction in the soil, impact in bacterial community. This work aimed to observe the changes in the bacterial community of a soil that was contaminated with hydrocarbons (gasoline, diesel, oil and mixtures 1: 1 diesel-oil and 1: 1: 1 gasoline-diesel-oil). Microcosms were considered that were followed by mineralization, bacterial count, determination of TPH and acid extraction to monitor the bacterial community. There were disturbances in the composition of fatty acids of the bacterial community in all treatments. The addition of nutrients in the control system produces an increase in bacterial count and the system that best degraded was the system with diesel alone, the presence of hydrocarbons produced a grouping of samples with oil and mixtures in the PCA diagram.

8.
Global Health ; 16(1): 43, 2020 05 06.
Artículo en Inglés | MEDLINE | ID: mdl-32375823

RESUMEN

The USMCA (NAFTA 2.0), although signed over a year ago, went through several months of renegotiation of certain of its new rules that the Democrat-controlled US Congress wanted altered or strengthened. In December a 'Protocol of Amendment' was agreed upon and signed by the three Parties (the USA, Mexico, and Canada). A number of tough, new measures governing pharmaceuticals were revised or deleted, making it potentially easier for generic competition and lower drug costs in all three countries. Rules on protection of labour rights were also strengthened, lowering the threshold at which a complaint of unfair labour practices could be initiated. Procedures for investigating such a complaint or resolving a formal dispute were also improved. Similar procedural improvements were made on measures affecting environmental protection. These Protocol agreements are more health-positive than health-negative, and in the case of pharmaceuticals are of significant impact. Overall, however, these amendments are simply a political fine-tuning of the agreement. Concerns raised in our earlier health impact assessment of the USMCA, notably how the agreement's regulatory reforms reduce public health policy flexibilities, remain. The agreement continues to subordinate known or potential health costs of many of its measures to dubious claims of aggregate economic gains. Moreover, these gains, if materialized, are likely to accrue to those atop the income/wealth hierarchies in all three nations.


Asunto(s)
Evaluación del Impacto en la Salud , Cooperación Internacional , Canadá , Comercio/economía , Costos y Análisis de Costo , Humanos , México , Salud Pública
9.
Int J Health Serv ; 50(3): 278-291, 2020 07.
Artículo en Inglés | MEDLINE | ID: mdl-32019396

RESUMEN

In 1993, the Canadian federal government ratified the North American Free Trade Agreement (NAFTA). Prior to ratification, compulsory licensing was eliminated from Canada's Patent Act and intellectual property rights (IPRs) were strengthened. Compulsory licensing allows competitors to produce drugs under patent without the consent of the patent holder, challenging drug monopolies and lowering prices, whereas IPRs lengthen patent protections, shielding patent holders from competition and increasing prices. We perform a critical discourse analysis of key provisions in Chapter 17 of NAFTA in light of industry claims that pharmaceutical innovation requires important investments in research and development, justifying high drug prices. We note that since NAFTA, spending in research and development in Canada has decreased and drug prices have increased, becoming a major barrier to equitable access to critically necessary medications. We argue that by modifying the law, the federal government has wronged the Canadian people by discursively appropriating the language of protecting the public good while in practice legitimizing and consolidating private drug development and production, legalizing exorbitant profits, and excluding well-tested publicly financed alternatives. While NAFTA has now been superseded by the Canada-United States-Mexico Agreement, our analysis offers important lessons moving forward.


Asunto(s)
Accesibilidad a los Servicios de Salud , Cooperación Internacional , Canadá , Industria Farmacéutica , Humanos , Propiedad Intelectual , México , Estados Unidos
10.
J Mark Access Health Policy ; 7(1): 1650596, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31489151

RESUMEN

Background: The Trump administration's 'American Patients First' blueprint proposes to reduce drug prices in the USA by increasing drug prices abroad, ex USA. The possibility of the Trump administration to raise drug prices ex USA through legal action via the WTO and bilateral negotiations with foreign trade partners was reviewed. Methods: A literature review was conducted through PUBMED, EMBASE, Media and grey literature to consolidate publications of the Trump administrations' policies and strategies towards foreign countries and drug prices. Results: The Trump administration has withdrawn from and halted major multilateral agreements including the TPP, Paris Agreement, TTIP, UNESCO, NAFTA (now USMCA), and NATO. The Trump administration has been successful in bilateral negotiations for pharmaceuticals' pricing, as seen with Japan, South Korea, Germany, and Mexico and Canada. Conclusion: The objective of raising prices abroad is attainable. Action through the WTO is unlikely, due to its nondiscriminatory principle. Bilateral trade negotiation have proven more promising. In this bilateral framework, financial security and military protection are strong assets for the USA to levy higher drug prices abroad. Although raising drug prices ex USA is possible, further questions as to whether this will directly translate into lower drug prices for American patients are raised.

11.
Global Health ; 15(1): 44, 2019 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-31262313

RESUMEN

Following publication of the original article [1], the authors flagged an error concerning two missing article references, which were unfortunately not provided prior to publication of the article.

12.
Global Health ; 15(1): 35, 2019 05 14.
Artículo en Inglés | MEDLINE | ID: mdl-31088499

RESUMEN

BACKGROUND: In late 2018 the United States, Canada, and Mexico signed a new trade agreement (most commonly referred to by its US-centric acronym, the United States-Mexico-Canada Agreement, or USMCA) to replace the 1994 North American Free Trade Agreement (NAFTA). The new agreement is the first major trade treaty negotiated under the shadow of the Trump Administration's unilateral imposition of tariffs to pressure other countries to accept provisions more favourable to protectionist US economic interests. Although not yet ratified, the agreement is widely seen as indicative of how the US will engage in future international trade negotiations. METHODS: Drawing from methods used in earlier health impact assessments of the Trans-Pacific Partnership agreement, we undertook a detailed analysis of USMCA chapters that have direct or indirect implications for health. We began with an initial reading of the entire agreement, followed by multiple line-by-line readings of key chapters. Secondary sources and inter-rater (comparative) analyses by the four authors were used to ensure rigour in our assessments. RESULTS: The USMCA expands intellectual property rights and regulatory constraints that will lead to increased drug costs, particularly in Canada and Mexico. It opens up markets in both Canada and Mexico for US food exports without reducing the subsidies the US provides to its own producers, and introduces a number of new regulatory reforms that weaken public health oversight of food safety. It reduces regulatory policy space through new provisions on 'technical barriers to trade' and requirements for greater regulatory coherence and harmonization across the three countries. It puts some limitations on contentious investor-state dispute provisions between the US and Mexico, provisions often used to challenge or chill health and environmental measures, and eliminates them completely in disputes between the US and Canada; but it allows for new 'legacy claims' for 3 years after the agreement enters into force. Its labour and environmental chapters contain a few improvements but overall do little to ensure either workers' rights or environmental protection. CONCLUSION: Rather than enhancing public health protection the USMCA places new, extended, and enforceable obligations on public regulators that increase the power (voice) of corporate (investor) interests during the development of new regulations. It is not a health-enhancing template for future trade agreements that governments should emulate.


Asunto(s)
Comercio/legislación & jurisprudencia , Cooperación Internacional/legislación & jurisprudencia , Salud Pública/legislación & jurisprudencia , Canadá , Evaluación del Impacto en la Salud , Humanos , Inversiones en Salud/legislación & jurisprudencia , México , Negociación , Estados Unidos
13.
Healthc Policy ; 14(3): 10-18, 2019 02.
Artículo en Inglés | MEDLINE | ID: mdl-31017862

RESUMEN

Introduction: Biologics are currently protected from competition by eight years of data protection. The renegotiated North American Free Trade Agreement (NAFTA) increases data protection from 8 to 10 years. This study investigates the effect of such an extension on drug spending in Canada. Methods: A list of currently available biologics eligible for data protection along with their 2017 sales was compiled. Two years were added to the current expiration date of data protection to see if it exceeded patent protection, and any theoretical change in spending due to delayed competition was calculated. The number of biologics approved after January 1, 1995, that have competition and the time until competition started was analyzed. Theoretical competition due to increased data protection for biologics where data protection has already expired was examined. Results: Depending on how much of the market is captured by biologic competitors and how strong the patents are, lost savings from data protection extension could range from $0 to $305.8 million. One biologic competitor currently on the market could theoretically have been affected by an increase in data protection. Increased data protection would have had minor effects on products that have already lost data protection. Discussion: The potential impact on drug expenditures of a two-year extension in data protection is highly variable. Possible increases in spending on biologics strengthen the rationale for a national pharmacare plan where monopsony buying power would help to control drug prices overall and offset increased spending on biologics.


Asunto(s)
Productos Biológicos/economía , Seguridad Computacional/legislación & jurisprudencia , Costos de los Medicamentos/estadística & datos numéricos , Canadá , Humanos , Cooperación Internacional/legislación & jurisprudencia
14.
Sci Total Environ ; 667: 234-247, 2019 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-30831363

RESUMEN

Inequality in access to ecosystem services is inextricably linked with environmental justice in socially heterogeneous urban settings. Historically, San Antonio has been the gateway to Mexico and is strategically located along the North American Free Trade Agreement (NAFTA) corridor. It is also characterized by some of the most distinct residential segregation among U.S. cities. However, little is understood about the ways in which historically institutionalized residential segregation initiated by the Home Owners' Loan Corporation (HOLC) and NAFTA have affected socio-ecological outcomes. Here, this paper presents a novel empirical study of racial residential segregation. The study utilizes quantitative and spatially explicit estimates of regulating ecosystem services and biodiversity, and links the supply of ecosystem services to the distribution of human well-being within a heterogeneous social-ecological system. Specifically, the paper employed 1930s HOLC redlining maps and applied the ceteris paribus approach for racial concentrations to reflect a historical legacy and path dependence by institutional inertia. The results point to the social-ecological divide in that Hispanic and African American minorities derive fewer ecosystem benefits and face greater health risks and socio-economic disadvantages (p < 0.01). Notably, NAFTA corridor-related health risks are the most significant for the Hispanic population (p < 0.01). These patterns are likely to persist and may be amplified by 2050 (adjusted R2 = 0.646). The findings highlight that institutional transformations are essential for the greater social-ecological equity in the San Antonio region under NAFTA and, potentially, new United States-Mexico-Canada Agreement. Additionally, by assessing the EJ implications of spatially heterogeneous distribution of ecosystem services supply, the paper provides methodology that enhances science-based planning and better environmental decision-making to avoid or mitigate social-ecological divides in rapidly urbanizing regions both in the U.S. and around the world.

15.
Heliyon ; 4(8): e00717, 2018 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-30094384

RESUMEN

We quantify the relationship between trade with the U.S. and electric loads in Mexico. Exports to the U.S. are highly statistically significant in explaining energy loads and significant in explaining peak loads, both in the presence and the absence of a deterministic trend in loads. These results support the hypothesis that trade impacts industrial load disproportionately. We conclude that a failure to renegotiate NAFTA is an important regulatory risk for buyers and sellers of electricity in Mexico. We offer an approach to adjusting forecasts accordingly.

16.
Sci Total Environ ; 619-620: 1259-1271, 2018 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-29734604

RESUMEN

A fundamental premise of the Millennium Ecosystem Assessment is that biodiversity and ecosystem services are key determinants of long-term sustainability of social-ecological systems. With a continuing decline in local and global biodiversity and ecosystem services, it is crucial to understand how biodiversity and various ecosystem services interact and how land change may modify these interactions over time. However, few studies have been conducted to quantify these relationships. In this study, we present the first empirical comparative results to analyze how spatial associations between biodiversity and ecosystem services (BES) changed at multiple scales between 1984 and 2010 in the rapidly urbanizing San Antonio River Basin (SARB), Texas, USA. We found statistically significant positive spatial associations among biodiversity, carbon storage, and sediment retention both in the entire SARB and the urban watersheds in Bexar County. Overall, biodiversity and carbon storage declined across the SARB, while sediment retention remained relatively stable. Moreover, the rates of biodiversity loss and carbon storage degradation were negatively related to the urban expansion and have accelerated since the inception of the North American Free Trade Agreement (NAFTA) in 1994. During the pre- and post-NAFTA periods (1984-1995 and 1995-2010, respectively) the rates of biodiversity loss increased from 0.7% to 0.9%, and the rates of carbon-storage loss increased from 0.1% to 1.4% per annum in the urban watersheds. Our hotspot analyses indicate that the upstream watersheds in the Basin, which supply water to the critically important Edwards Aquifer, should be targeted for priority conservation to mitigate the adverse impacts of land change on BES. Our results suggest the strong need for green infrastructure policies that integrate biodiversity conservation and sustainable use of multiple ecosystem services to address the environmentally deleterious impacts of the extensive land change under the NAFTA and to ensure the long-term social-ecological sustainability of the rapidly urbanizing SARB.

17.
Am J Surg ; 216(2): 326-330, 2018 08.
Artículo en Inglés | MEDLINE | ID: mdl-29502856

RESUMEN

BACKGROUND: We compared characteristics and outcomes of palpable versus nonpalpable, hormone-sensitive, early-stage breast cancers. METHODS: Patients from the North American Fareston vs. Tamoxifen Adjuvant (NAFTA) trial were divided into palpable (n = 513) and nonpalpable (n = 1063) tumor groups. Differences in pathological features, loco-regional therapy, disease-free survival (DFS) and overall survival (OS) were analyzed. RESULTS: Patients with palpable tumors were older, had larger tumors, and higher rates of lymph-node involvement. The tumors were more likely to be poorly differentiated, of high nuclear grade, and display lymphovascular invasion. After mean followup of 59 months, DFS and OS were significantly lower for palpable than nonpalpable tumors (DFS 93.5% vs. 98.4%, p < 0.001, OS 88.5% vs. 95.6%, p < 0.001). Controlling for age, size and nodal status, palpability was an independent factor for DFS (OR = 2.56; 95%CI, 1.37-4.79, p = 0.003) and OS (OR = 2.12; 95%CI, 1.38-3.28, p < 0.001). CONCLUSIONS: In a group of hormone-sensitive, mostly postmenopausal early-stage breast cancer patients, palpable tumors were more likely to have more aggressive features and metastatic potential, which translated in to a higher incidence of breast cancer-related events and worse overall survival.


Asunto(s)
Neoplasias de la Mama/diagnóstico , Detección Precoz del Cáncer/métodos , Palpación/métodos , Receptores de Estrógenos/metabolismo , Tamoxifeno/administración & dosificación , Toremifeno/administración & dosificación , Anciano , Antineoplásicos Hormonales/administración & dosificación , Neoplasias de la Mama/tratamiento farmacológico , Neoplasias de la Mama/metabolismo , Supervivencia sin Enfermedad , Relación Dosis-Respuesta a Droga , Femenino , Estudios de Seguimiento , Humanos , Estudios Prospectivos , Tasa de Supervivencia/tendencias , Estados Unidos/epidemiología
18.
Healthc Pap ; 16(4): 4-7, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-28901911

RESUMEN

Health professions regulation today faces a myriad of challenges, due to both the perceived performance of regulatory colleges, how health systems have evolved, and even larger political and economic shifts such as the renegotiation of NAFTA. In this issue of Healthcare Papers, Wilkie and Tzountzouris (2017) describe the work of the College of Medical Laboratory Technologists of Ontario (CMLTO) to redefine professionalism in the context of these challenges. Their paper, and the comments of the responding authors in this issue highlight that there, is an overarching perception that health regulatory structures - across a range of professions - are not working as effectively as they should. Across this issue of Healthcare Papers, attention is drawn to the fact that more can be done to improve both the function and perception of professional regulatory bodies. However, each paper presents a different approach to how improvements in function and perception are possible.


Asunto(s)
Atención a la Salud/organización & administración , Empleos en Salud/normas , Rol Profesional , Control Social Formal , Competencia Clínica , Atención a la Salud/normas , Personal de Salud , Humanos , Relaciones Interprofesionales , Ontario , Calidad de la Atención de Salud
19.
CMAJ ; 189(26): E881-E887, 2017 Jul 04.
Artículo en Inglés | MEDLINE | ID: mdl-28676578

RESUMEN

BACKGROUND: Critics of free trade agreements have argued that they threaten public health, as they eliminate barriers to trade in potentially harmful products, such as sugar. Here we analyze the North American Free Trade Agreement (NAFTA), testing the hypothesis that lowering tariffs on food and beverage syrups that contain high-fructose corn syrup (HFCS) increased its use in foods consumed in Canada. METHODS: We used supply data from the Food and Agriculture Organization of the United Nations to assess changes in supply of caloric sweeteners including HFCS after NAFTA. We estimate the impact of NAFTA on supply of HFCS in Canada using an innovative, quasi-experimental methodology - synthetic control methods - that creates a control group with which to compare Canada's outcomes. Additional robustness tests were performed for sample, control groups and model specification. RESULTS: Tariff reductions in NAFTA coincided with a 41.6 (95% confidence interval 25.1 to 58.2) kilocalorie per capita daily increase in the supply of caloric sweeteners including HFCS. This change was not observed in the control groups, including Australia and the United Kingdom, as well as a composite control of 16 countries. Results were robust to placebo tests and additional sensitivity analyses. INTERPRETATION: NAFTA was strongly associated with a marked rise in HFCS supply and likely consumption in Canada. Our study provides evidence that even a seemingly modest change to product tariffs in free trade agreements can substantially alter population-wide dietary behaviour and exposure to risk factors.


Asunto(s)
Bebidas/análisis , Comercio/legislación & jurisprudencia , Ingestión de Energía , Jarabe de Maíz Alto en Fructosa/provisión & distribución , Canadá , Análisis de los Alimentos , Jarabe de Maíz Alto en Fructosa/economía , Humanos , Almacenamiento y Recuperación de la Información , Obesidad/epidemiología , Salud Pública , Naciones Unidas , Estados Unidos
20.
Nat Prod Res ; 31(10): 1209-1213, 2017 May.
Artículo en Inglés | MEDLINE | ID: mdl-27618365

RESUMEN

The aim of this work was to evaluate some secondary metabolites, antioxidant activity of methanolic leaf extracts of five Ziziphus spina-christi provenances (INRGREF, Tozeur, Degueche, Nafta and Kebelli) and their allelopathic effects on Trigonella foenum-graecum and Lens culinaris. Leaves were collected during 2013 and 2014. Total phenols, flavonoids, tannins and antioxidant activity were evaluated using the Folin ciocalteux, Aluminum trichloride, vanillin and scavenging activity on 22-diphenyl-1-picrylhydrazyl (DPPH) radical methods, respectively. Total phenols, tannins and flavonoids were present, at levels of 57.41 mg GAE/g DW, 31.98 mg RE/g DW and 14.68 µg CE/g DW, respectively. The high antioxidant activity (0.086 µg/mL) was noted in kebelli provenance (2013). The highest germination, plumule and radicle lengths of tested species were observed in INRGREF provenance. Z. spina-christi leaf extracts may be suggested in foods and pharmaceutical industries. Leaf extracts could also provide a natural herbicide with a positive impact on the environment.


Asunto(s)
Alelopatía , Antioxidantes/farmacología , Lens (Planta)/efectos de los fármacos , Fenoles/análisis , Trigonella/efectos de los fármacos , Ziziphus/química , Flavonoides/análisis , Germinación/efectos de los fármacos , Extractos Vegetales/análisis , Extractos Vegetales/farmacología , Hojas de la Planta/química , Semillas/química , Taninos/análisis
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA
...