1,279 results
Search Results
2. [Detection of IgM against the dengue++ virus in whole blood absorbed on filter paper].
- Author
-
Vázquez S, Sáenz E, Huelva G, González A, Kourí G, and Guzmán M
- Subjects
- Humans, Sensitivity and Specificity, Dengue Virus immunology, Filtration instrumentation, Immunoglobulin M blood, Paper
- Abstract
This paper presents a standardized procedure for the detection of IgM antibodies to dengue virus in blood samples taken from filter paper. The samples were obtained from 118 patients, of whom 91 had been clinically diagnosed with dengue and 27 with a viral infection unrelated to that disease. The first group of patients came from Costa Rica and Nicaragua and the second group from Cuba. All the samples were tested for IgM antibody against dengue virus by means of a capture enzyme immunoassay (EIA). Analysis of the results for patients from all three countries together yielded a sensitivity of 98.1% and a specificity of 98.5% for the test done on whole blood on filter paper stored at 4 degrees C; agreement between the results of that test and those of the EIA using serum samples was 96%. In a comparison of the results obtained with three samples from the same patient--whole blood on filter paper stored at room temperature, the same type of sample stored at 4 degrees C, and serum--the agreement was 86%. This study demonstrates the high diagnostic sensitivity and specificity achieved when whole blood absorbed on filter paper is processed in the manner described in detail in the article. The authors recommend the use of this method in the dengue surveillance programs in the Region.
- Published
- 1998
- Full Text
- View/download PDF
3. [Global funding for papers of excellence on smoking, 2010-2014].
- Author
-
Granda-Orive JI, Alonso-Arroyo A, García-Río F, López-Padilla DE, Solano-Reina S, Jiménez-Ruiz CA, and Aleixandre-Benavent R
- Subjects
- Humans, Smoking
- Abstract
Objective: The objective of this study was to investigate the funding received by papers of excellence on smoking at the global level between 2010 and 2014 through the Web of Science, and to find out if funding is associated with greater impact., Method: We searched the Science Citation Index Expanded (SCIE) and the Social Sciences Citation Index (SSCI) through the Web of Science platform on 20 May 2015 (typology consisting of originals and reviews for the period from 2010 to 2014). The search strategy was "smok*" OR "tobac*." To select the papers of excellence, we picked those that had an h index (i.e., number of articles having at least that many citations) from among the papers in the overall sample generated by the strategy., Results: Of the 193 papers of excellence on smoking that were identified, 158 had received funding from 279 different financing institutions that intervened 522 times. The funding came primarily from government agencies, private foundations, and the pharmaceutical industry. Public funding declined and private funding increased over the years included in the analysis. Receipt of funding was not associated with greater impact at a later date., Conclusions: Most of the papers of excellence on smoking received external funding primarily from government agencies, private foundations, and the pharmaceutical industry. Public funding has decreased, while private funding has increased. Receipt of funding was not associated with greater impact at a later date.
- Published
- 2015
4. Detección de IgM contra el virus del dengue en sangre entera absorbida en papel de filtro Detection of IgM antibodies to dengue virus in whole blood absorbed on filter paper
- Author
-
Susana Vázquez, Elisabeth Sáenz, Gustavo Huelva, Alcides González, Gustavo Kourí, and María Guzmán
- Subjects
lcsh:Arctic medicine. Tropical medicine ,lcsh:RC955-962 ,lcsh:Public aspects of medicine ,lcsh:R ,lcsh:Medicine ,lcsh:RA1-1270 - Abstract
En este trabajo se presenta la normalización del procedimiento de detección de anticuerpos IgM contra el virus del dengue en muestras de sangre tomadas en papel de filtro. Las muestras se obtuvieron de 118 pacientes, de los cuales 91 tenían un diagnóstico clínico de dengue y 27 un diagnóstico de una infección viral que no guardaba relación con esa enfermedad, siendo los primeros originarios de Costa Rica y Nicaragua y de Cuba los segundos. En todas las muestras se determinó la presencia de anticuerpos IgM contra el virus del dengue mediante un inmunoensayo enzimático (ELISA) de captura. Al analizarse en su conjunto los resultados de los pacientes de los tres países se determinaron una sensibilidad y especificidad de 98,1% y 98,5%, respectivamente, para la prueba efectuada con sangre entera en papel de filtro conservada a 4 °C, y una concordancia de 96% entre los resultados de esa prueba y los del ELISA. Cuando se compararon los resultados obtenidos con las tres muestras de un mismo paciente --las de sangre en papel de filtro conservadas a la temperatura ambiental y a 4 °C, y la del suero correspondiente-- también se obtuvo una concordancia de 86%. Este estudio demuestra la elevada sensibilidad y especificidad diagnósticas logradas con el procesamiento de sangre entera absorbida en papel de filtro en las condiciones detalladas en el artículo. Los autores recomiendan utilizar este método en los programas de vigilancia de dengue en la Región.This paper presents a standardized procedure for the detection of IgM antibodies to dengue virus in blood samples taken from filter paper. The samples were obtained from 118 patients, of whom 91 had been clinically diagnosed with dengue and 27 with a viral infection unrelated to that disease. The first group of patients came from Costa Rica and Nicaragua and the second group from Cuba. All the samples were tested for IgM antibody against dengue virus by means of a capture enzyme immunoassay (EIA). Analysis of the results for patients from all three countries together yielded a sensitivity of 98.1% and a specificity of 98.5% for the test done on whole blood on filter paper stored at 4 °C; agreement between the results of that test and those of the EIA using serum samples was 96%. In a comparison of the results obtained with three samples from the same patient--whole blood on filter paper stored at room temperature, the same type of sample stored a 4 °C, and serum--the agreement was 86%. This study demonstrates the high diagnostic sensitivity and specificity achieved when whole blood absorbed on filter paper is processed in the manner described in detail in the article. The authors recommend the use of this method in the dengue surveillance programs in the Region.
- Published
- 1998
5. [Detection of antibodies against Trypanosoma cruzi in Somoto, Nicaragua, using indirect ELISA and IFI on blood samples on filter paper].
- Author
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Palacios X, Belli A, and Espino AM
- Subjects
- Adolescent, Adult, Age Distribution, Animals, Antibodies, Protozoan blood, Chagas Disease blood, Chagas Disease epidemiology, Child, Child, Preschool, Female, Filtration instrumentation, Fluorescent Antibody Technique, Indirect, Humans, Infant, Infant, Newborn, Leishmaniasis, Cutaneous immunology, Leishmaniasis, Visceral immunology, Male, Middle Aged, Nicaragua epidemiology, Seroepidemiologic Studies, Sex Distribution, Antibodies, Protozoan analysis, Chagas Disease immunology, Enzyme-Linked Immunosorbent Assay methods, Trypanosoma cruzi immunology
- Abstract
We standardized a solid-phase enzyme-linked immunosorbent assay (ELISA) in order to study the presence of Trypanosoma cruzi antibodies in asymptomatic persons who live in an area of Nicaragua endemic for Chagas' disease. The test was standardized to analyze filter-paper blood samples, which are easy to transport. In the first phase of our investigation, ELISA was used to study 18 samples of total serum and 18 eluates of blood from patients with chronic Chagas' disease; 30 samples of serum and 30 eluates of blood from healthy people, used as negative controls; and 14 samples of serum and 14 eluates of blood from patients with cutaneous or visceral leishmaniasis, which were used to study cross-reactions. Both with the total-serum and the blood-eluate samples, the ELISA test provided 100% sensitivity and 90% specificity. Cross-reactions in the patient samples were observed only with visceral leishmaniasis. The second phase of our investigation was a population study that included eight rural communities in the area of Somoto, Nicaragua. Through random sampling, filter-paper blood samples were collected from 2,434 people (1,335 men and 1,099 women) from the communities of Aguas Calientes, El Brocal, La Manzana, Las Playas, Los Canales, Santa Isabel, Santa Rosa, and Santa Teresa. Studied by ELISA and by indirect immunofluorescence (IIF), the samples included 260 found seropositive by ELISA (10.7%), of which 207 were positive according to IIF (8.5%). With both techniques, the majority of seropositives were among women, but the difference between men and women was not statistically significant. There was a high level of agreement between the results obtained with the two techniques. There was an upward trend with age, with 5.4% of those found seropositive by ELISA being persons 10 years of age or younger and 42.7% of those found seropositive being older than 50. The vast majority of the individuals analyzed were asymptomatic.
- Published
- 2000
- Full Text
- View/download PDF
6. Utilization of blood samples taken on filter paper for detection of IgM antibodies to dengue virus.
- Subjects
- Blood Specimen Collection methods, Dengue diagnosis, Dengue immunology, Filtration, Humans, Population Surveillance methods, Antibodies, Viral immunology, Dengue Virus immunology, Immunoglobulin M immunology
- Published
- 1996
7. [Changes in the medical profession and their influence on medical education. Position paper on Latin America presented at the World Conference on Medical Education, Edinburgh, Scotland, August 1993].
- Subjects
- Developing Countries, Health Services economics, Health Services Administration, Information Services, Latin America, Technology trends, Universities, Education, Medical organization & administration, Education, Medical trends, Professional Practice trends
- Published
- 1994
8. Anatomía de la financiación mundial de artículos de excelencia en tabaquismo, 2010-2014.
- Author
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de Granda-Orive, José Ignacio, Alonso-Arroyo, Adolfo, García-Río, Francisco, López-Padilla, Daniel E., Solano-Reina, Segismundo, Jiménez-Ruiz, Carlos A., and Aleixandre-Benavent, Rafael
- Subjects
- *
SERIAL publications , *GOVERNMENT agencies , *ENDOWMENT of research , *PHARMACEUTICAL industry , *SMOKING , *PRIVATE sector , *ECONOMICS - Abstract
Objective. The objective of this study was to investigate the funding received by papers of excellence on smoking at the global level between 2010 and 2014 through the Web of Science, and to find out if funding is associated with greater impact. Method. We searched the Science Citation Index Expanded (SCIE) and the Social Sciences Citation Index (SSCI) through the Web of Science platform on 20 May 2015 (typology consisting of originals and reviews for the period from 2010 to 2014). The search strategy was “smok*” OR “tobac*.” To select the papers of excellence, we picked those that had an h index (i.e., number of articles having at least that many citations) from among the papers in the overall sample generated by the strategy. Results. Of the 193 papers of excellence on smoking that were identified, 158 had received funding from 279 different financing institutions that intervened 522 times. The funding came primarily from government agencies, private foundations, and the pharmaceutical industry. Public funding declined and private funding increased over the years included in the analysis. Receipt of funding was not associated with greater impact at a later date. Conclusions. Most of the papers of excellence on smoking received external funding primarily from government agencies, private foundations, and the pharmaceutical industry. Public funding has decreased, while private funding has increased. Receipt of funding was not associated with greater impact at a later date. [ABSTRACT FROM AUTHOR]
- Published
- 2015
9. Calidad de vida del personal de salud durante la pandemia de COVID-19: revisión exploratoria.
- Author
-
Wauters, Mariana, Zamboni Berra, Thaís, de Almeida Crispim, Juliane, Arcêncio, Ricardo Alexandre, and Cartagena-Ramos, Denisse
- Subjects
- *
WORK environment , *RESEARCH , *ONLINE information services , *CINAHL database , *DATABASES , *WELL-being , *SOCIAL support , *ATTITUDES of medical personnel , *SYSTEMATIC reviews , *JOB stress , *MEDICAL personnel , *SOCIAL stigma , *QUALITY of life , *PSYCHOSOCIAL factors , *LITERATURE reviews , *MEDLINE , *THEMATIC analysis , *ANXIETY , *FATIGUE (Physiology) , *INDUSTRIAL hygiene , *COVID-19 pandemic , *PSYCHOLOGICAL stress , *CORPORATE culture - Abstract
Objective. Describe the quality of life of health personnel, the work environment, and interactions between employees and their work environment during the pandemic. Methods. A scoping review was conducted. The electronic databases PubMed, Cumulative Index of Nursing and Allied Literature Complete, and Google Scholar were used, as well as the repositories of the World Health Organization and the Centers for Disease Control and Prevention. Primary, secondary, and grey literature studies published between December 2019 and March 2021 in Spanish, English, and Portuguese were included. Methodological quality was assessed using the Authority, Accuracy, Coverage, Objectivity, Date and Importance (AACODS) checklist; a tool for the measurement of multiple systematic reviews (AMSTAR); and the Critical Appraisal Checklist for Text and Opinion Papers. A thematic analysis was carried out based on the quality-of-life and well-being model. Results. Of a total of 208 articles, 11 were included. The quality of life of health personnel during the COVID-19 pandemic was affected by the characteristics of health personnel, the work environment, and interactions between employees and their work environment. Problems related to psychosocial and occupational factors were observed. Discussion. The quality of life of health personnel was characterized by stigmatization, stress, anxiety, and fatigue. Organizational management and the implementation of psychological interventions appear to affect interactions between employees and their work environment, and improve their quality of life. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
10. Detección de IgM contra el virus del dengue en sangre entera absorbida en papel de filtro
- Author
-
Gustavo Huelva, Gustavo Kourí, María G. Guzmán, Susana Vázquez, Elisabeth Sáenz, and Alcides González
- Subjects
lcsh:Arctic medicine. Tropical medicine ,Filter paper ,biology ,medicine.diagnostic_test ,business.industry ,lcsh:RC955-962 ,lcsh:Public aspects of medicine ,lcsh:R ,Public Health, Environmental and Occupational Health ,lcsh:Medicine ,lcsh:RA1-1270 ,Venous blood ,Dengue virus ,medicine.disease_cause ,medicine.disease ,Virology ,Dengue fever ,Degree Celsius ,Immunoassay ,biology.protein ,medicine ,Antibody ,business ,Whole blood - Abstract
En este trabajo se presenta la normalización del procedimiento de detección de anticuerpos IgM contra el virus del dengue en muestras de sangre tomadas en papel de filtro. Las muestras se obtuvieron de 118 pacientes, de los cuales 91 tenían un diagnóstico clínico de dengue y 27 un diagnóstico de una infección viral que no guardaba relación con esa enfermedad, siendo los primeros originarios de Costa Rica y Nicaragua y de Cuba los segundos. En todas las muestras se determinó la presencia de anticuerpos IgM contra el virus del dengue mediante un inmunoensayo enzimático (ELISA) de captura. Al analizarse en su conjunto los resultados de los pacientes de los tres países se determinaron una sensibilidad y especificidad de 98,1% y 98,5%, respectivamente, para la prueba efectuada con sangre entera en papel de filtro conservada a 4 °C, y una concordancia de 96% entre los resultados de esa prueba y los del ELISA. Cuando se compararon los resultados obtenidos con las tres muestras de un mismo paciente --las de sangre en papel de filtro conservadas a la temperatura ambiental y a 4 °C, y la del suero correspondiente-- también se obtuvo una concordancia de 86%. Este estudio demuestra la elevada sensibilidad y especificidad diagnósticas logradas con el procesamiento de sangre entera absorbida en papel de filtro en las condiciones detalladas en el artículo. Los autores recomiendan utilizar este método en los programas de vigilancia de dengue en la Región.
- Published
- 1998
11. Improving household nutrition security and public health in the CARICOM, 2018-2022.
- Author
-
Jones, Waneisha, Murphy, Madhuvanti M., Henry, Fitzroy, Dunn, Leith, and Samuels, T. Alafia
- Subjects
- *
NON-communicable diseases , *OBESITY , *EVALUATION of human services programs , *NUTRITION , *FOOD security , *PUBLIC health , *CULTURAL pluralism , *HUMAN services programs - Abstract
The Caribbean is experiencing a worsening epidemic of obesity and noncommunicable diseases (NCDs) and it has the worst rates of premature mortality from cardiovascular diseases in the region of the Americas. Creating enabling environments to improve dietary diversity would help reduce obesity and diet-related NCDs. The Improving Household Nutrition Security and Public Health in the CARICOM project aimed to increase dietary diversity in the Caribbean, and to determine and implement effective, gender-sensitive interventions to improve food sovereignty, household food security, and nutrition in CARICOM states. Primary quantitative and qualitative research, scoping reviews, stakeholder engagement, implementation of interventions and dissemination activities were undertaken. This paper describes the overall project design and implementation, discusses challenges and limitations, and presents core achievements to inform further work in Small Island Developing States throughout CARICOM to advance the nutrition agenda in the Caribbean. The results of the project's research activities are presented in other papers published in this special issue on nutrition security in CARICOM states. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
12. La aplicación HEARTS: una herramienta clínica para el manejo del riesgo cardiovascular y la hipertensión en la atención primaria de salud.
- Author
-
Ordunez, Pedro, Tajer, Carlos, Gaziano, Thomas, Rodríguez, Yenny A., Rosende, Andrés, and Jaffe, Marc G.
- Subjects
- *
CARDIOVASCULAR diseases risk factors , *HYPERTENSION , *MEDICAL quality control , *MOBILE apps , *PUBLIC health , *PRIMARY health care , *RISK assessment , *HUMAN services programs , *QUALITY assurance - Abstract
HEARTS in the Americas is the regional adaptation of the World Health Organization's Global Hearts Initiative, which will be the model for risk management for cardiovascular disease (CVD) in primary health care in the Region of the Americas by 2025. It has already been implemented in 21 countries and 1045 primary health care centers throughout Latin America and the Caribbean. It takes a public health and health systems approach to systematically introduce simplified interventions at the primary health care level and focuses on hypertension as a clinical entry point. This paper introduces a new, improved application (app), the main component of which is the calculator for CVD risk and hypertension management. The paper summarizes the risk assessment approach and the methodology used by the World Health Organization to update its cardiovascular risk charts in 2019; describes the app, its use, functionality and validation process; and provides a set of practical recommendations for optimizing CVD risk and hypertension management by using the app in clinical practice. The HEARTS app is a powerful tool to improve the quality of care provided in primary health settings. The creation and dissemination of the HEARTS app is an essential step in the journey towards eliminating preventable CVD in the Americas. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
13. The HEARTS app: a clinical tool for cardiovascular risk and hypertension management in primary health care.
- Author
-
Ordunez, Pedro, Tajer, Carlos, Gaziano, Thomas, Rodriguez, Yenny A., Rosende, Andres, and Jaffe, Marc G.
- Subjects
- *
CARDIOVASCULAR diseases risk factors , *HYPERTENSION , *MEDICAL quality control , *MOBILE apps , *CARDIOVASCULAR diseases , *PRIMARY health care , *RISK assessment , *MEDICAL informatics - Abstract
HEARTS in the Americas is the regional adaptation of the World Health Organization's Global Hearts Initiative, which will be the model for risk management for cardiovascular disease (CVD) in primary health care in the Region of the Americas by 2025. It has already been implemented in 21 countries and 1045 primary health care centers throughout Latin America and the Caribbean. It takes a public health and health systems approach to systematically introduce simplified interventions at the primary health care level and focuses on hypertension as a clinical entry point. This paper introduces a new, improved application (app), the main component of which is the calculator for CVD risk and hypertension management. The paper summarizes the risk assessment approach and the methodology used by the World Health Organization to update its cardiovascular risk charts in 2019; describes the app, its use, functionality and validation process; and provides a set of practical recommendations for optimizing CVD risk and hypertension management by using the app in clinical practice. The HEARTS app is a powerful tool to improve the quality of care provided in primary health settings. The creation and dissemination of the HEARTS app is an essential step in the journey towards eliminating preventable CVD in the Americas. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
14. Improving household nutrition security and public health in the CARICOM, 2018–2022
- Author
-
Waneisha Jones, Madhuvanti M. Murphy, Fitzroy Henry, Leith Dunn, and T. Alafia Samuels
- Subjects
noncommunicable diseases ,food and nutrition security ,public health ,caribbean region ,Medicine ,Arctic medicine. Tropical medicine ,RC955-962 ,Public aspects of medicine ,RA1-1270 - Abstract
The Caribbean is experiencing a worsening epidemic of obesity and noncommunicable diseases (NCDs) and it has the worst rates of premature mortality from cardiovascular diseases in the region of the Americas. Creating enabling environments to improve dietary diversity would help reduce obesity and diet-related NCDs. The Improving Household Nutrition Security and Public Health in the CARICOM project aimed to increase dietary diversity in the Caribbean, and to determine and implement effective, gender-sensitive interventions to improve food sovereignty, household food security, and nutrition in CARICOM states. Primary quantitative and qualitative research, scoping reviews, stakeholder engagement, implementation of interventions and dissemination activities were undertaken. This paper describes the overall project design and implementation, discusses challenges and limitations, and presents core achievements to inform further work in Small Island Developing States throughout CARICOM to advance the nutrition agenda in the Caribbean. The results of the project’s research activities are presented in other papers published in this special issue on nutrition security in CARICOM states.
- Published
- 2022
- Full Text
- View/download PDF
15. Evaluación ética de las violaciones de la intimidad en las investigaciones epidemiológicas y la divulgación de información en la era de Internet: salvaguardar la información de identidad de los pacientes infecciosos
- Author
-
Zhang, Zhen and Zang, Zheng
- Published
- 2024
16. La aplicación de la bioética como fundamento jurídico en las sentencias judiciales relativas al derecho a la salud en Brasil
- Author
-
Sbalcheiro Mariot, Evandro Antonio, Barbas, Stela, and Nunes, Rui
- Published
- 2024
17. The HEARTS app: a clinical tool for cardiovascular risk and hypertension management in primary health care
- Author
-
Pedro Ordunez, Carlos Tajer, Thomas Gaziano, Yenny A. Rodriguez, Andres Rosende, and Marc G. Jaffe
- Subjects
heart disease risk factors ,hypertension ,medical informatics applications ,Medicine ,Arctic medicine. Tropical medicine ,RC955-962 ,Public aspects of medicine ,RA1-1270 - Abstract
HEARTS in the Americas is the regional adaptation of the World Health Organizations Global Hearts Initiative, which will be the model for risk management for cardiovascular disease (CVD) in primary health care in the Region of the Americas by 2025. It has already been implemented in 21 countries and 1045 primary health care centers throughout Latin America and the Caribbean. It takes a public health and health systems approach to systematically introduce simplified interventions at the primary health care level and focuses on hypertension as a clinical entry point. This paper introduces a new, improved application (app), the main component of which is the calculator for CVD risk and hypertension management. The paper summarizes the risk assessment approach and the methodology used by the World Health Organization to update its cardiovascular risk charts in 2019; describes the app, its use, functionality and validation process; and provides a set of practical recommendations for optimizing CVD risk and hypertension management by using the app in clinical practice. The HEARTS app is a powerful tool to improve the quality of care provided in primary health settings. The creation and dissemination of the HEARTS app is an essential step in the journey towards eliminating preventable CVD in the Americas.
- Published
- 2022
- Full Text
- View/download PDF
18. The scope and sustainability of, and data about, utilization of embedded research: qualitative evidence from Latin America and the Caribbean
- Author
-
Victor Becerril-Montekio, Pilar Torres-Pereda, Luis Alberto García-Bello, and Jacqueline Alcalde-Rabanal
- Subjects
implementation science ,health services research ,latin america ,caribbean region ,Medicine ,Arctic medicine. Tropical medicine ,RC955-962 ,Public aspects of medicine ,RA1-1270 - Abstract
Objectives. This paper describes and analyzes embedded implementation research and the empirical processes of planning for utilization, strategies to promote utilization and the sustainability of utilization of results from research led by decision-makers in Latin America and the Caribbean. Methods. This qualitative, descriptive and interpretive study is based on the findings from semistructured interviews with members of teams working under the Embedding Research for the Sustainable Development Goals initiative (2018–2019) as well as their responses to a self-assessment follow-up questionnaire 1 year after the project was completed. Results. Altogether 13 teams from 11 countries participated in the Initiative. Nine teams had a core team composed of a decision-maker as the principal investigator assisted by a researcher as co-principal investigator. Four teams included more than one co-principal investigator; and in five teams, the originally assigned principal investigator was replaced. There was an interesting relationship between the expected utilization of research results, the utilization strategies, the sustainability of research uptake and the teams’ collaboration modalities. When decision-makers and co-principal investigators were active participants, the intention to use the results and strategies for utilization were clearly oriented to improve implementation. In teams with basically a formal collaboration between the two principals, plans for utilization were unclear or focused on producing academic knowledge. The participation of implementers below the rank of principal investigator decision-maker may be relevant. Conclusions. Embedded implementation research is an innovative tool that may foster the utilization of research and strengthen health programs and services. Considering the internal dynamics of such research teams will enhance planning and strategies for research utilization as well as the sustainability of practical and actionable findings.
- Published
- 2024
- Full Text
- View/download PDF
19. Advancing environmental public health in Latin America and the Caribbean
- Author
-
Marcelo Korc and Fred Hauchman
- Subjects
climate change ,environmental health ,environment and public health ,health equity ,health policy ,sustainable development ,americas ,Medicine ,Arctic medicine. Tropical medicine ,RC955-962 ,Public aspects of medicine ,RA1-1270 - Abstract
This paper highlights the important leadership role of the public health sector, working with other governmental sectors and nongovernmental entities, to advance environmental public health in Latin America and the Caribbean toward the achievement of 2030 Sustainable Development Goal 3: Health and Well-Being. The most pressing current and future environmental public health threats are discussed, followed by a brief review of major historical and current international and regional efforts to address these concerns. The paper concludes with a discussion of three major components of a regional environmental public health agenda that responsible parties can undertake to make significant progress toward ensuring the health and well-being of all people throughout Latin America and the Caribbean.
- Published
- 2021
- Full Text
- View/download PDF
20. Need for open data on COVID-19 vaccine uptake among pregnant people in the Caribbean: a call to action.
- Author
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Pinkney, Jodian A., Carroll, Kamali N., Rich, Katherine M., Hurtado, Rocio M., Ciaranello, Andrea L., Bogart, Laura M., Ojikutu, Bisola O., and Hyle, Emily P.
- Subjects
- *
IMMUNIZATION , *DATABASE management , *INTERPROFESSIONAL relations , *COVID-19 vaccines , *PREGNANT women , *DATA analytics , *ACCESS to information ,DEVELOPED countries - Abstract
Pregnant people with coronavirus disease 2019 (COVID-19) have a higher risk of adverse maternal and fetal outcomes compared with pregnant people without COVID-19. In 2021, large increases in maternal mortality were reported in Jamaica, almost half of which were attributable to COVID-19. COVID-19 vaccination has been shown to reduce these risks, but low- and middle-income countries lack free, publicly available data, known as open data, on COVID-19 vaccine uptake for their pregnant populations. The objectives of this paper were to: review how high-income countries use open data to detect trends in COVID-19 vaccine uptake among pregnant people and develop vaccination distribution strategies; outline barriers to making open data available for maternal COVID-19 vaccination in the Caribbean; and propose a multipronged strategy that would increase the availability of open data on maternal COVID-19 vaccination in the Caribbean. A multipronged strategy to fill the data void would involve: (i) utilizing existing Caribbean maternal immunization data collection entities; (ii) adapting digital software tools to establish maternal electronic immunization registries; and (iii) collaborating with local partners skilled in data analytics. Making open data available for COVID-19 vaccine uptake among pregnant people in the Caribbean could offer substantial benefits, including the development of measurable maternal COVID-19 vaccination goals and the facilitation of vaccine decision-making discussions between providers and pregnant people. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
21. Clusters of rare disorders and congenital anomalies in South America.
- Author
-
Cardoso-dos-Santos, Augusto César, Reales, Guillermo, and Schuler-Faccini, Lavinia
- Subjects
- *
HUMAN abnormalities , *RARE diseases , *SOUTH Americans , *POPULATION geography , *DESCRIPTIVE statistics , *SYSTEMATIC reviews , *MEDLINE , *GENETIC disorders , *ONLINE information services , *PUBLIC health - Abstract
Objective. To map geographic clusters of rare disorders and congenital anomalies reported in South America. Methods. Qualitative systematic review conducted in Medline/PubMed, Lilacs, and Scielo electronic databases to identify studies meeting eligibility criteria. The strategy resulted in 1 672 unique articles, from which 164 were selected for full reading by a pair of reviewers. Results. Fifty-five articles reported at least one cluster of genetic disorders or congenital anomalies in South American territory. From these papers, 122 clusters were identified, of which half (61) were related to autosomal recessive disorders. Sixty-five (53.3%) of the clusters were located in Brazil. Conclusions. The results of the review reinforce that rare diseases and congenital anomalies can occur in a non-random way in space, which is discussed in the perspective of the complex history of formation, social organization, and genetic structure of the South American population. Mapping clusters in population medical genetics can be an important public health tool, given that such places concentrate cases of rare diseases that frequently require multiprofessional, specialized care. Therefore, these results can support important agendas in public health related to rare diseases and congenital anomalies, such as health promotion and surveillance. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
22. Plataforma de monitoreo y evaluación para HEARTS en las Américas: hacia la mejora de los programas de control de la hipertensión a nivel poblacional en la atención primaria de salud.
- Author
-
Prado, Patric, Gamarra, Ángelo, Rodríguez, Libardo, Brettler, Jeffrey, Farrell, Margaret, Girola, María E., Malcolm, Taraleen, Martínez, Ramón, Molina, Virginia, Moran, Andrew E., Neupane, Dinesh, Rosende, Andrés, Valdés González, Yamilé, Mukhtar, Qaiser, and Ordunez, Pedro
- Subjects
- *
CARDIOVASCULAR disease prevention , *HUMAN services programs , *MEDICAL quality control , *HYPERTENSION , *PRIMARY health care , *EVALUATION of human services programs , *BENCHMARKING (Management) , *HEALTH policy , *DECISION making , *PATIENT monitoring , *QUALITY assurance , *SOFTWARE architecture - Abstract
HEARTS in the Americas is the Pan American Health Organization flagship program to accelerate the reduction of the cardiovascular disease (CVD) burden by improving hypertension control and CVD secondary prevention in primary health care. A monitoring and evaluation (M&E) platform is needed for program implementation, benchmarking, and informing policy-makers. This paper describes the conceptual bases of the HEARTS M&E platform including software design principles, contextualization of data collection modules, data structure, reporting, and visualization. The District Health Information Software 2 (DHIS2) web-based platform was chosen to implement aggregate data entry of CVD outcome, process, and structural risk factor indicators. In addition, PowerBI was chosen for data visualization and dashboarding for the analysis of performance and trends above the health care facility level. The development of this new information platform was focused on primary health care facility data entry, timely data reporting, visualizations, and ultimately active use of data to drive decision-making for equitable program implementation and improved quality of care. Additionally, lessons learnt and programmatic considerations were assessed through the experience of the M&E software development. Building political will and support is essential to developing and deploying a flexible platform in multiple countries which is contextually specific to the needs of various stakeholders and levels of the health care system. The HEARTS M&E platform supports program implementation and reveals structural and managerial limitations and care gaps. The HEARTS M&E platform will be central to monitoring and driving further population-level improvements in CVD and other noncommunicable disease-related health. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
23. Revising primary and secondary school curricula in the Caribbean to enhance education on the risks for noncommunicable diseases.
- Author
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Jones, Waneisha, Sobers, Natasha, Brown-Perry, Alsian, Bristol, Laurette, and Samuels, T. Alafia
- Subjects
- *
HIGH schools , *CURRICULUM , *INTERPROFESSIONAL relations , *PHYSICAL education , *NON-communicable diseases , *CARIBBEAN people , *FOOD habits , *NUTRITIONAL status , *CHILDHOOD obesity , *HEALTH promotion , *MEALS , *HEALTH education , *NUTRITION education , *DISEASE risk factors , *CHILDREN - Abstract
In the English-speaking Caribbean, an estimated 46% of men and 61% of women are currently overweight or obese, and 8% of children younger than 5 years are also overweight. To combat this worsening epidemic, driven by unhealthy dietary patterns, the Heads of Government of the Caribbean Community (CARICOM) issued the 2007 Port-of-Spain Declaration, which included mandates on the provision of healthy school meals, promotion of healthy dietary patterns, and reintroduction of physical education in schools. These mandates are aligned with evidence-based approaches used in childhood obesity prevention programs. School-based interventions, including curriculum revisions, are part of a multipronged approach to improve nutrition in children and are designed to complement and reinforce other interventions in schools. However, formal evaluation of the Port-of-Spain Declaration showed that most CARICOM member countries had difficulty implementing the mandates related to schools and diet. The Improving Household Nutrition Security and Public Health in the CARICOM project, in collaboration with regional institutions, the CARICOM Secretariat, and the Caribbean Examinations Council, sought to enhance nutrition education through revision of region-wide primary and secondary school curricula to increase the focus on prevention of noncommunicable diseases. This paper describes the process of revising the Caribbean Examinations Council's Human and Social Biology syllabus for secondary schools and the CARICOM Health and Family Life Education Regional Curriculum Framework for primary schools, which was achieved through multisectoral collaboration. We used the Framework for Reporting Adaptations and Modifications-Enhanced model to describe the process through which the modifications were made. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
24. An initiative to improve mental health practice in primary care in Caribbean countries.
- Author
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Lauria-Horner, Bianca, Knaak, Stephanie, Cayetano, Claudina, Vernon, Andrew, and Pietrus, Michael
- Subjects
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MENTAL health services , *MEDICAL quality control , *RESEARCH funding , *PRIMARY health care , *EVALUATION of human services programs , *MEDICAL care , *SCIENTIFIC observation , *CONFIDENCE , *DESCRIPTIVE statistics , *LONGITUDINAL method , *SURVEYS , *THEMATIC analysis , *QUALITY assurance , *HEALTH outcome assessment , *CONFIDENCE intervals , *SOCIAL stigma , *COGNITION - Abstract
Objectives. The aim of this initiative was to assess whether a novel training program - Understanding Stigma and Strengthening Cognitive Behavioral Interpersonal Skills - could improve primary health care providers' confidence in the quality of mental health care they provide in the Caribbean setting by using the Plan-Do-Study-Act rapid cycle for learning improvement. Methods. We conducted a prospective observational study of the impact of this training program. The training was refined during three cycles: first, the relevance of the program for practice improvement in the Caribbean was assessed. Second, pilot training of 15 local providers was conducted to adapt the program to the culture and context. Third, the course was launched in fall 2021 with 96 primary care providers. Pre- and post-program outcomes were assessed by surveys, including providers' confidence in the quality of the mental health care they provided, changes in stigma among the providers and their use of and comfort with the tools. This paper describes an evaluation of the results of cycle 3, the official launch. Results. A total of 81 participants completed the program. The program improved primary care providers' confidence in the quality of mental health care that they provided to people with lived experience of mental health disorders, and it reduced providers' stigmatization of people with mental health disorders. Conclusions. The program's quality improvement model achieved its goals in enhancing health care providers' confidence in the quality of the mental health care they provided in the Caribbean context; the program provides effective tools to support the work and it helped to empower and engage clients. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
25. Lessons learned from the implementation of integrated serosurveillance of communicable diseases in the Americas.
- Author
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Saboyá-Díaz, Martha-Idalí, Castellanos, Luis Gerardo, Morice, Ana, Ade, Maria Paz, Rey-Benito, Gloria, Cooley, Gretchen M., Scobie, Heather M., Wiegand, Ryan E., Coughlin, Melissa M., and Martin, Diana L.
- Subjects
- *
COMMUNICABLE diseases , *PUBLIC health surveillance , *SUPERVISION of employees , *HUMAN services programs , *RESEARCH funding , *SOCIOECONOMIC factors , *DECISION making , *SEROLOGY , *BIOLOGICAL assay , *HEALTH care teams - Abstract
Objective. Systematize the experience and identify challenges and lessons learned in the implementation of an initiative for integrated serosurveillance of communicable diseases using a multiplex bead assay in countries of the Americas. Methods. Documents produced in the initiative were compiled and reviewed. These included concept notes, internal working papers, regional meetings reports, and survey protocols from the three participating countries (Mexico, Paraguay, and Brazil) and two additional countries (Guyana and Guatemala) where serology for several communicable diseases was included in neglected tropical diseases surveys. Information was extracted and summarized to describe the experience and the most relevant challenges and lessons learned. Results. Implementing integrated serosurveys requires interprogrammatic and interdisciplinary work teams for the design of survey protocols to respond to key programmatic questions aligned to the needs of the countries. Valid laboratory results are critical and rely on the standardized installment and roll-out of laboratory techniques. Field teams require adequate training and supervision to properly implement survey procedures. The analysis and interpretation of serosurveys results should be antigen-specific, contextualizing the responses for each disease, and triangulated with programmatic and epidemiological data for making decisions tailored to specific population socioeconomic and ecologic contexts. Conclusions. Integrated serosurveillance as a complementary tool for functional epidemiological surveillance systems is feasible to use and key components should be considered: political engagement, technical engagement, and integrated planning. Aspects such as designing the protocol, selecting target populations and diseases, laboratory capacities, anticipating the capacities to analyze and interpret complex data, and how to use it are key. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
26. The scope and sustainability of, and data about, utilization of embedded research: qualitative evidence from Latin America and the Caribbean/ Alcance, sostenibilidad y datos sobre la utilizacion de la investigacion incorporada: evidencia cualitativa procedente de America Latina y el Caribe/ Escopo, sustentabilidade e dados da utilizacao de pesquisa com implementacao incorporada: evidencias qualitativas da America Latina e do Caribe
- Author
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Becerril-Montekio, Victor, Torres-Pereda, Pilar, Garcia-Bello, Luis Alberto, and Alcalde-Rabanal, Jacqueline
- Published
- 2024
- Full Text
- View/download PDF
27. FROM INTENTION TO BEHAVIOR: ANALYTICAL MODEL OF DOCTOR'S MORAL HAZARD BEHAVIOR-BASED ON PLANNED BEHAVIOR THEORY
- Author
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Wang, Yaohui, He, Lina, Liu, Quanlong, and Li, Xinchun
- Published
- 2020
28. ETHICS AND PUBLIC HEALTH: DEFINITION OF PRIORITIES IN THE MEXICAN HEALTH REFORM/Etica y salud publica: definicion de prioridades en la Reforma Sanitaria mexicana/Etica e saude publica: definicao de prioridades na Reforma Sanitaria mexicana
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Gómez-Dantés, Octavio and Frenk, Julio
- Published
- 2020
29. LA NATURALEZA EN LA CONSTITUCION: VISIONES INDIGENAS Y PROPUESTAS ANTE LA CRISIS/Nature and the Constitution: Indigenous Perspectives and Proposals for the Crisis/A natureza na Constituicao: visoes indigenas e propostas diante da crise
- Author
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Galdámez Zelada, Liliana and Millaleo Hernández, Salvador
- Published
- 2020
30. FACE, FACIAL RECOGNITION TECHNOLOGY AND PERSONAL PRIVACY /Rostro, tecnologia de reconocimiento facial y privacidad personal /Face, tecnologia de reconhecimento facial e privacidade pessoal
- Author
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Li, Wei, Hua, Menglian, Sun, Ying, Li, Husheng, and Lin, Yanhu
- Published
- 2023
- Full Text
- View/download PDF
31. CHALLENGES AND OPPORTUNITIES IN CLINICAL ETHICS WITH THE IMPLEMENTATION OF KOREA'S END-OF-LIFE ACT/Desafíos y oportunidades en ética clínica con la implementación de la Ley de fin de vida de Corea/Desafios e oportunidades em etica clinica com a implementacao do Ato de Fim-da-Vida na Coreia
- Author
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Kim, Claire Junga
- Published
- 2019
32. Maintaining the Region of the Americas free of polio: best practices for incident management support teams
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Carlos A. Emanuele, Anne E. Jean Baptiste, Ana E. Chévez, Mirta Magarinos, Maite V. Antelo, Sonia Arza, Emilia Cain, Gloria Rey-Benito, Martha Velandia-Gonzalez, and Daniel Salas
- Subjects
poliomyelitis ,vaccination coverage ,surveillance ,pan american health organization ,americas ,Medicine ,Arctic medicine. Tropical medicine ,RC955-962 ,Public aspects of medicine ,RA1-1270 - Abstract
The Pan American Health Organization (PAHO) and its Member States have been leading the efforts to eradicate wild poliovirus in the Region of Americas since smallpox's successful elimination in 1971. The region became the first to be certified free of wild poliovirus in 1994. However, in July 2022, an unvaccinated patient with no recent travel history was diagnosed with poliomyelitis in the United States of America. In response to the emergence of a circulating vaccine-derived poliovirus in the United States, PAHO established the Polio Incident Management Support Team. This team has been coordinating response efforts, focusing on: coordination, planning, and monitoring; risk communication and community engagement; surveillance and case investigation; vaccination; and rapid response. In this paper, we identified and documented best practices observed following establishment of the Incident Management Support Team (September 2022–2023) through a comprehensive review and analysis of various data sources and country-specific data from the polio surveillance dashboard. The aim was to share these best practices, highlighting technical support and implementation of polio measures by Member States. Despite several challenges, the Americas region remains polio-free. Polio risk is declining, with a July 2023 assessment showing fewer countries at medium, high, and very high risk. This progress reflects improved immunization coverage, surveillance, containment, health determinants, and outbreak preparedness and response. The PAHO Polio Incident Management Support Team has played a key role in supporting these efforts.
- Published
- 2024
- Full Text
- View/download PDF
33. Institutional care in four Latin American countries: the importance of fostering public information and evaluation strategies
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Patrick Alexander Wachholz, Patricia Morsch, Pablo Villalobos Dintrans, Isabel Barrientos-Calvo, Jorge Browne, Omar Yaxmehen Bello-Chavolla, and Enrique Vega
- Subjects
long-term care ,aging ,latin america ,Medicine ,Arctic medicine. Tropical medicine ,RC955-962 ,Public aspects of medicine ,RA1-1270 - Abstract
More than 8 million older people in Latin America depend on long-term care (LTC), accounting for 12% of people aged ≥ 60 years and almost 27% of those aged ≥ 80. It is crucial to develop sustainable strategies for providing LTC in the area, including institutional care. This special report aims to characterize institutional LTC in four countries (Brazil, Chile, Costa Rica and Mexico), using available information systems, and to identify the strategies adopted to support institutional care in these countries. This narrative review used nationwide, open-access, public data sources to gather demographic estimates and information about institutional LTC coverage and the availability of open-access data for the proportion of people with LTC needs, the number of LTC facilities and the number of residents living in them. These countries have a larger share of older people than the average in Latin America but fewer LTC facilities than required by the demand. National surveys lack standardization in defining disability, LTC and dependency on care. Information about institutional care is mainly fragmented and does not regularly include LTC facilities, their residents and workers. Data are crucial to inform evidence-based decisions to favor prioritization and to support advances in promoting policies around institutional LTC in Latin America. Although information about institutional care in the region is fragmented and insufficient, this paper profiles the four selected countries. It highlights the need for a better structure for datadriven LTC information systems. The lack of information emphasizes the urgency of the need to focus on and encourage research into this topic.
- Published
- 2024
- Full Text
- View/download PDF
34. Integrating economics into the rationale for multisectoral action on obesity.
- Author
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Ellis, Vivian L. and Milliken, Olga V.
- Subjects
- *
ECONOMICS , *OBESITY , *PUBLIC health , *PRIVATE sector , *PUBLIC sector - Abstract
Obesity is a compelling example of the challenges of championing and mobilizing a response that involves the whole of government and all of society. This paper discusses the need for economic rationales to strengthen the case for government intervention on obesity, with a view to better engaging the expertise and resources of nonhealth sectors. The paper also briefly reviews economic theory and evidence that could support an integrated multisectoral rationale for action, noting opportunities to expand the integration of economic evidence in the Americas. [ABSTRACT FROM AUTHOR]
- Published
- 2018
- Full Text
- View/download PDF
35. La renovación de la atención primaria de salud en las Américas.
- Author
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Macinko, James, Montenegro, Hernán, Adell, Carme Nebot, and Etienne, Carissa
- Subjects
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HEALTH care reform -- Congresses , *PRIMARY health care , *HEALTH policy , *HEALTH services administration -- Law & legislation , *RIGHT to health , *CONFERENCES & conventions - Abstract
At the 2003 meeting of the Directing Council of the Pan American Health Organization (PAHO), the PAHO Member States issued a mandate to strengthen primary health care (Resolution CD44.R6). The mandate led in 2005 to the document "Renewing Primary Health Care in the Americas. A Position Paper of the Pan American Health Organization/WHO [World Health Organization]," and it culminated in the Declaration of Montevideo, an agreement among the governments of the Region of the Americas to renew their commitment to primary health care (PHC). Scientific data have shown that PHC, regarded as the basis of all the health systems in the Region, is a key component of effective health systems and can be adapted to the range of diverse social, cultural, and economic conditions that exist. The new, global health paradigm has given rise to changes in the population's health care needs. Health services and systems must adapt to address these changes. Building on the legacy of the International Conference on Primary Health Care, held in 1978 in Alma-Ata (Kazakhstan, Union of Soviet Socialist Republics), PAHO proposes a group of strategies critical to adopting PHC-based health care systems based on the principles of equity, solidarity, and the right to the highest possible standard of health. The main objective of the strategies is to develop and/or strengthen PHC-based health systems in the entire Region of the Americas. A substantial effort will be required on the part of health professionals, citizens, governments, associations, and agencies. This document explains the strategies that must be employed at the national, subregional, regional, and global levels. [ABSTRACT FROM AUTHOR]
- Published
- 2007
- Full Text
- View/download PDF
36. Monitoring and evaluation platform for HEARTS in the Americas: improving population-based hypertension control programs in primary health care.
- Author
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Prado, Patric, Gamarra, Angelo, Rodriguez, Libardo, Brettler, Jeffrey, Farrell, Margaret, Girola, Maria E., Malcolm, Taraleen, Martinez, Ramon, Molina, Virginia, Moran, Andrew E., Neupane, Dinesh, Rosende, Andres, Valdés González, Yamilé, Mukhtar, Qaiser, and Ordunez, Pedro
- Subjects
- *
CARDIOVASCULAR disease prevention , *HYPERTENSION , *CARDIOVASCULAR diseases risk factors , *MEDICAL quality control , *NON-communicable diseases , *PATIENT monitoring , *PRIMARY health care , *SOFTWARE architecture , *COMMUNITY-based social services , *DECISION making , *POLICY sciences - Abstract
HEARTS in the Americas is the Pan American Health Organization flagship program to accelerate the reduction of the cardiovascular disease (CVD) burden by improving hypertension control and CVD secondary prevention in primary health care. A monitoring and evaluation (M&E) platform is needed for program implementation, benchmarking, and informing policy-makers. This paper describes the conceptual bases of the HEARTS M&E platform including software design principles, contextualization of data collection modules, data structure, reporting, and visualization. The District Health Information Software 2 (DHIS2) web-based platform was chosen to implement aggregate data entry of CVD outcome, process, and structural risk factor indicators. In addition, PowerBI was chosen for data visualization and dashboarding for the analysis of performance and trends above the health care facility level. The development of this new information platform was focused on primary health care facility data entry, timely data reporting, visualizations, and ultimately active use of data to drive decision-making for equitable program implementation and improved quality of care. Additionally, lessons learnt and programmatic considerations were assessed through the experience of the M&E software development. Building political will and support is essential to developing and deploying a flexible platform in multiple countries which is contextually specific to the needs of various stakeholders and levels of the health care system. The HEARTS M&E platform supports program implementation and reveals structural and managerial limitations and care gaps. The HEARTS M&E platform will be central to monitoring and driving further population-level improvements in CVD and other noncommunicable disease-related health. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
37. Progress, challenges and the need to set concrete goals in the global tobacco endgame.
- Author
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Bostic, Chris, Bianco, Eduardo, and Hefler, Marita
- Subjects
- *
SMOKING prevention , *HEALTH policy , *ELECTRONIC cigarettes , *HUMAN rights , *MANUFACTURING industries , *WORLD health , *PUBLIC health , *LEGAL status of sales personnel , *GOVERNMENT policy , *TOBACCO products , *SMOKING , *TOBACCO , *GOAL (Psychology) - Abstract
The tobacco endgame is rapidly moving from aspirational and theoretical toward a concrete and achievable goal and, in some cases, enacted policy. Endgame policies differ from traditional tobacco control measures by explicitly aiming to permanently end, rather than simply minimize, tobacco use. The purpose of this paper is to outline recent progress made in the tobacco endgame, its relationship to existing tobacco control policies, the challenges and how endgame planning can be adapted to different tobacco control contexts. Examples of implemented policies in three cities in the United States and national policies in the Netherlands and New Zealand are outlined, as well as recent endgame planning developments in Europe. Justifications for integrating endgame targets into tobacco control policy and the need to set concrete time frames are discussed, including planning for ending the sale of tobacco products. Tobacco endgame planning must consider the jurisdiction-specific tobacco control context, including the current prevalence of tobacco use, existing policies, implementation of the World Health Organization's Framework Convention on Tobacco Control, and public support. However, the current tobacco control context should not determine whether endgame planning should happen, but rather how and when different endgame approaches can occur. Potential challenges include legal challenges, the contested role of e-cigarettes and the tobacco industry's attempt to co-opt the rhetoric of smoke-free policies. While acknowledging the different views regarding e-cigarettes and other products, we argue for a contractionary approach to the tobacco product market. The tobacco control community should capitalize on the growing theoretical and empirical evidence, political will and public support for the tobacco endgame, and set concrete goals for finally ending the tobacco epidemic. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
38. Mathematical and statistical models for the control of mosquito-borne diseases: the experience of Costa Rica.
- Author
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Vásquez, Paola, Sanchez, Fabio, Barboza, Luis A., García, Yury E., Calvo, Juan G., Shu-Wei Chou-Chen, and Mery, Gustavo
- Subjects
- *
RELATIVE medical risk , *MOSQUITO vectors , *DENGUE , *CHIKUNGUNYA , *MACHINE learning , *MOSQUITO-borne diseases , *RISK assessment , *DECISION making , *STATISTICAL models , *ZIKA virus infections , *PROBABILITY theory , *ALGORITHMS , *DISEASE risk factors , *INFECTIOUS disease transmission - Abstract
Objective. To summarize the results of research conducted in Costa Rica in which mathematical and statistical methods were implemented to study the transmission dynamics of mosquito-borne diseases. Methods. Three articles with mathematical and statistical analysis on vector-borne diseases in Costa Rica were selected and reviewed. These papers show the value and relevance of using different quantitative methods to understand disease dynamics and support decision-making. Results. The results of these investigations: 1) show the impact on dengue case reports when a second pathogen emerges, such as chikungunya; 2) recover key parameters in Zika dynamics using Bayesian inference; and 3) show the use of machine learning algorithms and climatic variables to forecast the dengue relative risk in five different locations. Conclusions. Mathematical and statistical modeling enables the description of mosquito-borne disease transmission dynamics, providing quantitative information to support prevention/control methods and resource allocation planning. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
39. Diretrizes de 2021 da Organização Mundial da Saúde sobre o tratamento medicamentoso da hipertensão arterial: repercussões para as políticas na Região das Américas.
- Author
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Campbell, Norm R. C., Paccot Burnens, Melanie, Whelton, Paul K., Angell, Sonia Y., Jaffe, Marc G., Cohn, Jennifer, Espinosa Brito, Alfredo, Irazola, Vilma, Brettler, Jeffrey W., Roccella, Edward J., Maldonado Figueredo, Javier Isaac, Rosende, Andres, and Ordunez, Pedro
- Subjects
- *
HYPERTENSION , *HEALTH policy , *WELL-being , *STRATEGIC planning , *PUBLIC health , *MEDICAL protocols , *HEALTH equity , *ADULTS ,CARDIOVASCULAR disease related mortality - Abstract
Cardiovascular disease (CVD) is the leading cause of death in the Americas and raised blood pressure accounts for over 50% of CVD. In the Americas over a quarter of adult women and four in ten adult men have hypertension and the diagnosis, treatment and control are suboptimal. In 2021, the World Health Organization (WHO) released an updated guideline for the pharmacological treatment of hypertension in adults. This policy paper highlights the facilitating role of the WHO Global HEARTS initiative and the HEARTS in the Americas initiative to catalyze the implementation of this guideline, provides specific policy advice for implementation, and emphasizes that an overarching strategic approach for hypertension control is needed. The authors urge health advocates and policymakers to prioritize the prevention and control of hypertension to improve the health and wellbeing of their populations and to reduce CVD health disparities within and between populations of the Americas. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
40. Pilares y líneas de acción para los sistemas de salud integrados y centrados en las personas y las comunidades.
- Author
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Pérez-Hernández, Galileo, Ehrenberg, Nieves, Gómez-Duarte, Ingrid, Cruz, Dionne, Leyns, Christine, López-Vázquez, Julieta, Perman, Gastón, Ríos, Víctor, Robles, William, Rojas-Araya, Karol, Sáenz-Madrigal, Rocío, and Solís-Calvo, Luis
- Subjects
- *
HEALTH policy , *LEADERSHIP , *PATIENT-centered care , *DIGITAL health , *CONCEPTUAL structures , *HEALTH care reform , *PRIMARY health care , *INTEGRATED health care delivery , *POLICY sciences , *HEALTH planning - Abstract
This paper presents the position of the Latin American working group of the International Foundation for Integrated Care (IFIC). The working group brings together various Latin American actors and organizations in support of actions that facilitate the transformation of health systems in the region towards integrated systems that focus on people not as isolated individuals but as subjects of law in the complex social and environmental contexts where they live and interact. The working group proposes nine pillars of integrated care to be used as a conceptual framework for policy development and changes in practices: 1) shared vision and values; 2) population health; 3) people and communities as partners; 4) resilient communities; 5) capacities of human resources for health; 6) governance and leadership; 7) digital solutions; 8) aligned payment systems; and 9) public transparency. Based on these pillars, lines of work are proposed to strengthen alliances and networks, advocacy, research, and capacity-building, in order to help develop health and social systems that are effectively integrated and focused not only on people but also on communities in Latin America. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
41. Directrices de la Organización Mundial de la Salud del 2021 sobre el tratamiento farmacológico de la hipertensión: implicaciones de política para la Región de las Américas.
- Author
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Campbell, Norm R. C., Paccot Burnens, Melanie, Whelton, Paul K., Angell, Sonia Y., Jaffe, Marc G., Cohn, Jennifer, Espinosa Brito, Alfredo, Irazola, Vilma, Brettler, Jeffrey W., Roccella, Edward J., Maldonado Figueredo, Javier Isaac, Rosendeb, Andres, and Ordunez, Pedro
- Subjects
- *
CARDIOVASCULAR disease prevention , *HYPERTENSION , *HEALTH policy , *MEDICAL protocols , *HUMAN services programs , *POLICY sciences , *HEALTH equity , *HEALTH promotion ,CARDIOVASCULAR disease related mortality - Abstract
Cardiovascular disease (CVD) is the leading cause of death in the Americas and raised blood pressure accounts for over 50% of CVD. In the Americas over a quarter of adult women and four in ten adult men have hypertension and the diagnosis, treatment and control are suboptimal. In 2021, the World Health Organization (WHO) released an updated guideline for the pharmacological treatment of hypertension in adults. This policy paper highlights the facilitating role of the WHO Global HEARTS initiative and the HEARTS in the Americas initiative to catalyze the implementation of this guideline, provides specific policy advice for implementation, and emphasizes that an over-arching strategic approach for hypertension control is needed. The authors urge health advocates and policymakers to prioritize the prevention and control of hypertension to improve the health and wellbeing of their populations and to reduce CVD health disparities within and between populations of the Americas. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
42. Enfermedades crónicas degenerativas como factor de riesgo de letalidad por COVID-19 en México.
- Author
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Ángeles Correa, María Guadalupe, Villarreal Ríos, Enrique, Galicia Rodríguez, Liliana, Vargas Daza, Emma Rosa, Frontana Vázquez, Gabriel, Monrroy Amaro, Sergio Javier, Ruiz Pinal, Viridiana, Dávalos Álvarez, Javier, and Santibáñez Beltrán, Shaid
- Subjects
- *
REVERSE transcriptase polymerase chain reaction , *RELATIVE medical risk , *COVID-19 , *CHRONIC diseases , *RISK assessment , *COMPARATIVE studies , *DESCRIPTIVE statistics , *STATISTICAL sampling , *LONGITUDINAL method - Abstract
Objective. To determine the relative risk of a lethal outcome associated with chronic degenerative conditions in patients with COVID-19. Methods. A cohort study was conducted using electronic medical records belonging to patients who tested positive for COVID-19 on RT-PCR while receiving care as outpatients or inpatients in a social security system facility between March 2020 and March 2021. Two study groups were formed. The exposed group was divided into four subgroups, each of which was diagnosed with one and only one chronic condition (diabetes, hypertension, obesity, or chronic kidney disease); the unexposed group was obtained from the medical records of patients without comorbidities. A total of 1 114 medical records were examined using simple random sampling. Once the minimum sample size was reached, the relative risk was calculated for each chronic condition. Combinations of two, three, and four conditions were created, and each of them was included in the analysis. Results. In the absence of a chronic degenerative condition, the prevalence of a lethal outcome from COVID-19 is 3.8%; in the presence of type 2 diabetes mellitus, 15.8%; in the presence of arterial hypertension, 15.6%; and in the presence of obesity, 15.0%. For diabetes and hypertension combined, the prevalence of a lethal outcome is 54.1%; for diabetes and obesity combined, 36.8%, and for obesity and hypertension combined, 28.1%. Conclusion. In patients with COVID-19, the relative risk of a lethal outcome is 4.17 for those with diabetes, 4.13 for those with hypertension, and 3.96 for those with obesity. For two chronic conditions combined, the relative risk doubles or triples. The relative risk of a lethal outcome is 14.27 for diabetes plus hypertension; 9.73 for diabetes plus obesity, and 7.43 for obesity plus hypertension. Chronic conditions do not present alone; they generally occur together, hence the significance of the relative risks for lethal outcomes presented in this paper. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
43. Scientific publication speed and retractions of COVID-19 pandemic original articles.
- Author
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Schonhaut, Luisa, Costa-Roldan, Italo, Oppenheimer, Ilan, Pizarro, Vicente, Han, Dareen, and Díaz, Franco
- Subjects
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PUBLISHING , *RESEARCH methodology , *FRAUD in science , *DESCRIPTIVE statistics , *COVID-19 pandemic - Abstract
Objective. To describe the editorial processing time of published COVID-19 research articles and compare this with a similar topic, human influenza, and analyze the number of publications, withdrawals, and retractions. Methods. A descriptive-analytical study using PubMed on research articles with the MeSH terms human influenza and COVID-19. Time to acceptance (from submission to acceptance) and time to publication (from acceptance to publication) were compared. Retractions and withdrawals were reviewed both qualitatively and quantitatively. Results. There were 31 319 research articles on COVID-19 and 4 287 on human influenza published during 2020. The median time to acceptance for COVID-19 was lower than that for human influenza (8 vs. 92 days). The median time to publication for COVID-19 articles was shorter than those on human influenza (12 vs. 16 days); 47.0% of COVID-19 research articles were accepted within the first week of submission, and 19.5% within one day. There were 82 retractions and withdrawals for COVID-19 articles, 1 for human influenza, and 5 for articles that contain both terms; these were mainly related to ethical misconduct, and 27 (31.0%) were published by the same group of authors in one highest-quartile journal. Conclusions. The conundrum between fast publishing and adequate standards is shown in this analysis of COVID-19 research articles. The speed of acceptance for COVID-19 manuscripts was 11.5 times faster than for human influenza. The high number of acceptances within a day or week of submission and the number of retractions and withdrawals of COVID-19 papers might be a warning sign about the possible lack of a quality control process in scientific publishing and the peer review process. [ABSTRACT FROM AUTHOR]
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- 2022
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44. Cox model and decision trees: an application to breast cancer data.
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Cardoso Pereira, Lucas, Silva, Sóstenes Jerônimo da, Romualdo Fidelis, Cleanderson, de Lima Brito, Alisson, Alves Xavier Júnior, Silvio Fernando, dos Santos Andrade, Lorena Sofia, Casé de Oliveira, Milena Edite, and Almeida de Oliveira, Tiago
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BREAST cancer prognosis , *BREAST tumor treatment , *DECISION trees , *MATHEMATICAL statistics , *PARAMETERS (Statistics) , *SPECIALTY hospitals , *HORMONE therapy , *TIME , *RETROSPECTIVE studies , *ACQUISITION of data , *REGRESSION analysis , *MOLECULAR pathology , *CANCER patients , *TREATMENT effectiveness , *CANCER treatment , *COMPARATIVE studies , *RISK assessment , *MEDICAL records , *KAPLAN-Meier estimator , *DESCRIPTIVE statistics , *RESEARCH funding , *STATISTICAL models , *BREAST tumors , *PROPORTIONAL hazards models , *LONGITUDINAL method , *HORMONE receptor positive breast cancer , *IMMUNOTHERAPY ,MORTALITY risk factors - Abstract
Objective. To evaluate, using semiparametric methodologies of survival analysis, the relationship between covariates and time to death of patients with breast cancer, as well as the determination discriminatory power in the conditional inference tree of patients who had cancer. Methods. A retrospective cohort study was conducted using data collected from medical records of women who had breast cancer and underwent treatment between 2005 and 2015 at the Hospital da Fundação de Assistencial da Paraíba in Campina Grande, State of Paraiba, Brazil. Survival curves were estimated using the Kaplan-Meier method, Cox regression, and conditional decision tree. Results. Women with triple-negative molecular subtypes had a shorter survival time compared to women with positive hormone receptors. The addition of hormone therapy reduced the risk of a patient dying by 5.5%, and the risk of a HER2-positive patient dying was 34.5% lower compared to those who were negative for this gene. Patients undergoing hormone therapy had a median survival time of 4 753 days. Conclusions. This paper shows a favorable scenario for the use of immunotherapy for patients with HER2 overexpression. Further studies could assess the effectiveness of immunotherapy in patients with other conditions, to favor the prognosis and better quality of life for the patient. [ABSTRACT FROM AUTHOR]
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- 2022
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45. Estimating national excess mortality from subnational data: application to Argentina.
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Karlinsky, Ariel
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DISEASE clusters , *COVID-19 , *INTERNATIONAL relations , *MORTALITY , *PUBLIC health , *COVID-19 pandemic - Abstract
This paper presents a method to estimate excess mortality where national data are missing for some or all of the coronavirus disease 2019 (COVID-19) pandemic period, but subnational data exist, such as in Argentina. By making use of the stability of the regional distribution of deaths, data on deaths in Córdoba province were used to project excess deaths in Argentina from March 2020 up to the end of 2021. The number of excess deaths was estimated at 134 504, which is 14.8% higher than the reported number of COVID-19 deaths in Argentina for the same time period. [ABSTRACT FROM AUTHOR]
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- 2022
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46. An updated systematic review and meta-analysis on the social determinants of diabetes and related risk factors in the Caribbean
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Leonor Guariguata, Catherine Brown, Natasha Sobers, Ian Hambleton, T. Alafia Samuels, and Nigel Unwin
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Diabetes mellitus ,noncommunicable diseases ,gender and health ,obesity ,risk factors ,Caribbean region ,Medicine ,Arctic medicine. Tropical medicine ,RC955-962 ,Public aspects of medicine ,RA1-1270 - Abstract
Objectives. To conduct an analysis of the most recent data on diabetes and its risk factors by gender and other social determinants of health to understand why its prevalence is higher among women than men in the Caribbean; to inform policy agenda-setting for diabetes prevention and control in the Caribbean; and to identify gaps in the evidence that require further research. Methods. A previous systematic review of the literature describing studies conducted in the Caribbean that presented the distribution of diabetes, its outcomes, and risk factors, by one or more social determinants, was updated to include sources from 1 January 2007 – 31 December 2016. Surveys by the World Health Organization (WHO) were also included. Where data were sufficient, meta-analyses were undertaken. Results. A total of 8 326 manuscripts were identified. Of those, 282 were selected for full text review, and 114, for abstraction. In all, 36 papers, including WHO-related surveys, had sufficient information for meta-analysis. More women compared to men were obese (OR: 2.1; 95%CI = 1.65 – 2.69), physically inactive (OR: 2.18; 95%CI = 1.75 – 2.72), and had diabetes (OR: 1.48; 95%CI = 1.25 – 1.76). More men smoked (OR: 4.27; 95%CI = 3.18 – 5.74) and had inadequate fruit and vegetable intake (OR: 1.37; 95%CI = 1.21 – 1.57) Conclusion. Thirty-six papers were added to the previously conducted systematic review; of those, 13 were added to the meta-analysis. Diabetes and its risk factors (primarily obesity and physical inactivity) continue to disproportionately affect women in the Caribbean. Smoking interventions should be targeted at men in this geographic area.
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- 2018
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47. Communication strategy to disseminate the results of the evaluation of the Port-of-Spain Declaration (POSDEVAL) across multiple audiences in the Caribbean
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Natalie S. Greaves, Joan Tull, Trevor Hassell, and T. Alafia Samuels
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Health communication ,noncommunicable diseases ,health policy ,Caribbean region ,Medicine ,Arctic medicine. Tropical medicine ,RC955-962 ,Public aspects of medicine ,RA1-1270 - Abstract
Like many nations in the Americas, the countries of the Caribbean are facing increasing morbidity and mortality associated with noncommunicable diseases (NCDs). In 2007, based on advocacy by Sir George Alleyne and others, the Caribbean Community (CARICOM) convened the first in the world Heads of Government NCDs Summit. This summit issued the Port of Spain Declaration that served not only as a rallying point to accelerate the regional NCDs response, but also as a catalyst for the first United Nations high-level meeting on NCDs in September 2011. In 2014, seven years after the CARICOM NCDs Summit, a formal evaluation of the Port of Spain Declaration (POSDEVAL) was conducted to investigate its impact and learn lessons to support and further accelerate its implementation. One mechanism was to review successes and challenges in the NCDs response and effectively communicate findings to stakeholders and the public. The results of the evaluation and the implementation of the Port of Spain Declaration are presented by other papers in this supplement. The present paper describes the communication and social information process used for sharing POSDEVAL findings across multiple layers of social influence in the Caribbean, primarily in 2016 – 2017. The main steps of the communication process are shared as a possible strategy for disseminating NCDs research information and accelerating control and policy adoption in other Small Island Developing States and middle-income countries.
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- 2018
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48. Need for open data on COVID-19 vaccine uptake among pregnant people in the Caribbean: a call to action
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Jodian A. Pinkney, Kamali N. Carroll, Katherine M. Rich, Rocio M. Hurtado, Andrea L. Ciaranello, Laura M. Bogart, Bisola O. Ojikutu, and Emily P. Hyle
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covid-19 ,vaccination ,pregnancy ,caribbean region ,Medicine ,Arctic medicine. Tropical medicine ,RC955-962 ,Public aspects of medicine ,RA1-1270 - Abstract
Pregnant people with coronavirus disease 2019 (COVID-19) have a higher risk of adverse maternal and fetal outcomes compared with pregnant people without COVID-19. In 2021, large increases in maternal mortality were reported in Jamaica, almost half of which were attributable to COVID-19. COVID-19 vaccination has been shown to reduce these risks, but low- and middle-income countries lack free, publicly available data, known as open data, on COVID-19 vaccine uptake for their pregnant populations. The objectives of this paper were to: review how high-income countries use open data to detect trends in COVID-19 vaccine uptake among pregnant people and develop vaccination distribution strategies; outline barriers to making open data available for maternal COVID-19 vaccination in the Caribbean; and propose a multipronged strategy that would increase the availability of open data on maternal COVID-19 vaccination in the Caribbean. A multipronged strategy to fill the data void would involve: (i) utilizing existing Caribbean maternal immunization data collection entities; (ii) adapting digital software tools to establish maternal electronic immunization registries; and (iii) collaborating with local partners skilled in data analytics. Making open data available for COVID-19 vaccine uptake among pregnant people in the Caribbean could offer substantial benefits, including the development of measurable maternal COVID-19 vaccination goals and the facilitation of vaccine decision-making discussions between providers and pregnant people.
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- 2023
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49. Integrating economics into the rationale for multisectoral action on obesity
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Vivian L. Ellis and Olga V. Milliken
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Obesity ,models, economic ,health behavior ,health economics ,public health ,Medicine ,Arctic medicine. Tropical medicine ,RC955-962 ,Public aspects of medicine ,RA1-1270 - Abstract
Obesity is a compelling example of the challenges of championing and mobilizing a response that involves the whole of government and all of society. This paper discusses the need for economic rationales to strengthen the case for government intervention on obesity, with a view to better engaging the expertise and resources of nonhealth sectors. The paper also briefly reviews economic theory and evidence that could support an integrated multisectoral rationale for action, noting opportunities to expand the integration of economic evidence in the Americas.
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- 2018
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50. Evaluación de la campaña antitabaco en Uruguay: balance de diez años y desafíos.
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Triunfo, Patricia, Harris, Jeffrey, and Balsa, Ana
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In 2005, shortly after ratifying the Framework Convention on Tobacco Control (FCTC), Uruguay began an ambitious tobacco control campaign that brought the country to the global forefront in the fight against smoking. The wide range of measures implemented in a relatively short period and the rigorousness with which policies were implemented and enforced have few precedents, even in the most developed countries. This paper presents a synthesis and update of several papers by the authors that evaluate different aspects of the campaign ten years following ratification of the FCTC. In particular, these research studies highlight the campaign's aggregate impact on the drop in prevalence of current tobacco consumption in adult and youth populations, and on decisions by pregnant women to quit smoking (1, 2), as well as the relative impact of tax policies in relation to non-price tobacco control measures. The analyses are based on observational studies (at the population or individual level) that use external (Argentina and Chile) and internal (nonsmokers) control groups. Pending challenges in the design of antismoking policies are also discussed. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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