434,924 research outputs found

    Política de tratamiento protección de datos personales

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    En la política puede encontrar para qué se usan los datos, qué tipo de datos recolectamos, bajo qué canales los recolectamos y cuánto tiempo los tenemos. Puede identificar si tiene el derecho de comunicarlos o no, dependiendo de los tipos. Y lo más importante, puede saber cómo proceder si tiene una queja o reclamo. Encuentre también la Autorización para el Tratamiento de Datos Personales

    Eliminating artificial trans fatty acids in Argentina: estimated effects on the burden of coronary heart disease and costs

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    Objective: To estimate the impact of Argentine policies to reduce trans fatty acids (TFA) on coronary heart disease (CHD), disability-adjusted life years (DALYs) and associated health-care costs. Methods: We estimated the baseline intake of TFA before 2004 to be 1.5% of total energy intake. We built a policy model including baseline intake of TFA, the oils and fats used to replace artificial TFAs, the clinical effect of reducing artificial TFAs and the costs and DALYs saved due to averted CHD events. To calculate the percentage of reduction of CHD, we calculated CHD risks on a population-based sample before and after implementation. The effect of the policies was modelled in three ways, based on projected changes: (i) in plasma lipid profiles; (ii) in lipid and inflammatory biomarkers; and (iii) the results of prospective cohort studies. We also estimated the present economic value of DALYs and associated health-care costs of coronary heart disease averted. Findings: We estimated that projected changes in lipid profile would avert 301 deaths, 1066 acute CHD events, 5237 DALYs and 17 million United States dollars (US)inhealthcarecostsannually.BasedontheadverseeffectsofTFAintakereportedinprospectivecohortstudies,1517deaths,5373acuteCHDevents,26394DALYsandUS) in health-care costs annually. Based on the adverse effects of TFA intake reported in prospective cohort studies, 1517 deaths, 5373 acute CHD events, 26 394 DALYs and US 87 million would be averted annually. Conclusion: Even under the most conservative scenario, reduction of TFA intake had a substantial effect on public health. These findings will help inform decision-makers in Argentina and other countries on the potential public health and economic impact of this policy.Fil: Rubinstein, Adolfo Luis. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Elorriaga, Natalia. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Garay, Ulises. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Poggio, Rosana. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Caporale, Joaquin. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Matta, Maria Gabriela. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Augustovski, Federico Ariel. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Pichón-Riviere, Andrés. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Mozaffarian, Dariush. Tufts University; Estados Unido

    Occupational Physical Activity and Cardiovascular Risk Factors Profile in the Adult Population of the Southern Cone of Latin America: Results From the CESCAS I Study

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    OBJECTIVE: We explore the association between occupational physical activity (OPA) and cardiovascular risk factors in four cities of the Southern Cone. METHODS: Robust multivariable linear regression models were used to examine the associations. RESULTS: The working population was constituted by 1868 men and 1672 women. Men performing high levels of OPA showed higher levels of high-density lipoprotein (HDL; mean adj. diff. = 2.24 mg/dL; P = 0.004), lower levels of triglycerides (-24.59 mg/dL; P = 0.006), and total cholesterol (TC)/HDL ratio values (-0.21; P = 0.015) than reference. Women in the highest category of OPA had higher levels of HDL (2.85 mg/dL; P = 0.006), lower TC/HDL (0.27; P = 0.001), and low-density lipoprotein/HDL ratios (-0.18; P = 0.003) than sedentary activities. CONCLUSION: Individuals who performed high levels of OPA did not exhibit a worse cardiovascular risk profile and an improvement on selected biomarkers was observed when compared with those performing sedentary activities.Fil: Poggio, Rosana. Instituto de Efectividad Clínica y Sanitaria; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Melendi, Santiago Ezequiel. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Gutierrez, Laura. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Elorriaga, Natalia. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Irazola, Vilma. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; Argentin

    Cost-Effectiveness of a Comprehensive Approach for Hypertension Control in Low-Income Settings in Argentina: Trial-Based Analysis of the Hypertension Control Program in Argentina

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    Background: A recent cluster randomized trial evaluating a multicomponent intervention showed significant reductions in blood pressure in low-income hypertensive subjects in Argentina. Objectives: To assess the cost-effectiveness of this intervention. Methods: A total of 1432 hypertensive participants were recruited from 18 primary health care centers. The intervention included home visits led by community health workers, physician education, and text messaging. Resource use and quality of life data using the three-level EuroQol five-dimensional questionnaire were prospectively collected. The study perspective was that of the public health care system, and the time horizon was 18 months. Intention-to-treat analysis was used to analyze cost and health outcomes (systolic blood pressure [SBP] change and quality-adjusted life-years [QALYs]). A 1 time gross domestic product per capita per QALY was used as the cost-effectiveness threshold (US 14,062).Results:Baselinecharacteristicsweresimilarinthetwoarms.QALYssignificantlyincreasedby0.06(9514,062). Results: Baseline characteristics were similar in the two arms. QALYs significantly increased by 0.06 (95% confidence interval [CI] 0.04–0.09) in the intervention group, and SBP net difference favored the intervention group: 5.3 mm Hg (95% CI 0.27–10.34). Mean total costs per participant were higher in the intervention arm: US 304 in the intervention group and US 154inthecontrolgroup(adjusteddifferenceofUS154 in the control group (adjusted difference of US 140.18; 95% CI US 75.41US75.41–US 204.94). The incremental cost-effectiveness ratio was 3299perQALY(953299 per QALY (95% credible interval 1635–6099) and US 26 per mm Hg of SBP (95% credible interval 13–46). Subgroup analysis showed that the intervention was cost-effective in all prespecified subgroups (age, sex, cardiovascular risk, and body mass index). Conclusions: The multicomponent intervention was cost-effective for blood pressure control among low-income hypertensive patients.Fil: Augustovski, Federico Ariel. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Chaparro, Martin. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Palacios, Alfredo. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Shi, Lizheng. University of Tulane; Estados UnidosFil: Beratarrechea, Andrea Gabriela. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Irazola, Vilma. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Rubinstein, Adolfo Luis. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Mills, Katherine. University of Tulane; Estados UnidosFil: He, Jiang. University of Tulane; Estados UnidosFil: Pichón-Riviere, Andrés. Instituto de Efectividad Clínica y Sanitaria; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentin

    Obstetric violence: a Latin American legal response to mistreatment during childbirth

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    Over the last several years, a new legal construct has emerged in Latin America that encompasses elements of quality of obstetric care and mistreatment of women during childbirth - both issues of global maternal health import. Termed "obstetric violence," this legal construct refers to disrespectful and abusive treatment that women may experience from health care providers during pregnancy, childbirth, and the postpartum period, as well as other elements of poor quality care, such as failure to adhere to evidence-based best practices. This new legal term emerged out of concerted efforts by women's groups and networks, feminists, professional organizations, international and regional bodies, and public health agents and researchers to improve the quality of care that women receive across the region.Fil: Williams, Caitlin R.. University of North Carolina; Estados UnidosFil: Jerez, Celeste. Universidad de Buenos Aires. Facultad de Filosofía y Letras. Instituto Interdisciplinario de Estudios de Género; ArgentinaFil: Klein, Karen. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Correa, Malena. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Belizan, Jose. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Cormick, Gabriela. Instituto de Efectividad Clínica y Sanitaria; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. University of Cape Town; Sudáfric

    Stillbirth rates in 20 countries of Latin America: an ecological study

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    Objective: To describe country-level stillbirth rates and their change over time in Latin America, and to measure the association of stillbirth rates with socio-economic and health coverage indicators in the region. Design: Ecological study. Setting: 20 countries of Latin America. Population or Sample: Aggregated data from pregnant women with countries as units of analysis. Methods: We used stillbirth estimates, and socio-economic and healthcare coverage indicators reported from 2006 to 2016 from UNICEF, United Nations Development Programme and World Bank datasets. We calculated Spearman's correlation coefficients between stillbirths rates and socioeconomic and health coverage indicators. Main outcome measures: National estimates of stillbirth rates in each country. Results: The estimated stillbirth rate for Latin America for 2015 was 8.1 per 1000 births (range 3.1–24.9). Seven Latin America countries had rates higher than 10 stillbirths per 1000 births. The average annual reduction rate for the region was 2% (range 0.1–3.8%), with the majority of Latin America countries ranging between 1.5 and 2.5%. National stillbirth rates were correlated to: women's schooling (rS = −0.7910), gross domestic product per capita (rS = −0.8226), fertility rate (rS = 0.6055), urban population (rS = −0.6316), and deliveries at health facilities (rS = −0.6454). Conclusions: Country-level estimated stillbirth rates in Latin America varied widely in 2015. The trend and magnitude of reduction in stillbirth rates between 2000 and 2015 was similar to the world average. Socio-economic and health coverage indicators were correlated to stillbirth rates in Latin America. Tweetable abstract: Stillbirth rates decreased in Latin America but remain relatively high, with wide variations among countries.Fil: Pingray, María Verónica. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Althabe, Fernando. Instituto de Efectividad Clínica y Sanitaria; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Vazquez, Paula. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Correa, Malena. Instituto de Efectividad Clínica y Sanitaria; Argentina. University of Tulane; Estados UnidosFil: Pajuelo, Mónica. University Johns Hopkins; Estados UnidosFil: Belizan, Jose. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; Argentin

    Smoking Patterns and Receipt of Cessation Services Among Pregnant Women in Argentina and Uruguay

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    Introduction: The 5A’s (Ask, Advise, Assess, Assist, and Arrange) strategy, a best-practice approach for cessation counseling, has been widely implemented in high-income countries for pregnant women; however, no studies have evaluated implementation in middle-income countries. The study objectives were to assess smoking patterns and receipt of 5A’s among pregnant women in Buenos Aires, Argentina and Montevideo, Uruguay. Methods: Data were collected through administered questionnaires to women at delivery hospitalizations during October 2011–May 2012. Eligible women attended one of 12 maternity hospitals or 21 associated prenatal care clinics. The questionnaire included demographic data, tobacco use/cessation behaviors, and receipt of the 5A’s. Self-reported cessation was verified with saliva cotinine. Results: Overall, of 3400 pregnant women, 32.8% smoked at the beginning of pregnancy; 11.9% quit upon learning they were pregnant or later during pregnancy, and 20.9% smoked throughout pregnancy. Smoking prevalence varied by country with 16.1% and 26.7% who smoked throughout pregnancy in Argentina and Uruguay, respectively. Among pregnant smokers in Argentina, 23.8% reported that a provider asked them about smoking at more than one prenatal care visit; 18.5% were advised to quit; 5.3% were assessed for readiness to quit, 4.7% were provided assistance, and 0.7% reported follow-up was arranged. In Uruguay, those percentages were 36.3%, 27.9%, 5.4%, 5.6%, and 0.2%, respectively. Conclusions: Approximately, one in six pregnant women smoked throughout pregnancy in Buenos Aires and one in four in Montevideo. However, a low percentage of smokers received any cessation assistance in both countries. Healthcare providers are not fully implementing the recommended 5A’s intervention to help pregnant women quit smoking.Fil: Berrueta, Amanda Mabel. Instituto de Efectividad Clínica y Sanitaria; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Morello, Paola. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Alemán, Alicia. Unidad de Investigación Clínica y Epidemiológica Montevideo; UruguayFil: Tong, Van T.. Centers for Disease Control and Prevention; Estados UnidosFil: Johnson, Carolyn. Tulane School of Public Health and Tropical Medicine; Estados UnidosFil: Dietz, Patricia M.. Centers for Disease Control and Prevention; Estados UnidosFil: Farr, Sherry L.. Centers for Disease Control and Prevention; Estados UnidosFil: Mazzoni, Agustina. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Colomar, Mercedes. Unidad de Investigación Clínica y Epidemiológica Montevideo; UruguayFil: Ciganda, Alvaro. Unidad de Investigación Clínica y Epidemiológica Montevideo; UruguayFil: Llambi, Laura. Unidad de Investigación Clínica y Epidemiológica Montevideo; UruguayFil: Becú, Ana. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Gibbons, Luz. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Smith, Ruben A.. Centers for Disease Control and Prevention; Estados UnidosFil: Buekens, Pierre. Tulane School of Public Health and Tropical Medicine; Estados UnidosFil: Belizan, Jose. Instituto de Efectividad Clínica y Sanitaria; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Althabe, Fernando. Instituto de Efectividad Clínica y Sanitaria; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentin

    How can we improve the use of essential evidence-based interventions?

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    Between 250,000-280,000 women die worldwide during pregnancy and childbirth each year and children in low- and middle-income countries are 56 times more likely to die before the age of 5 than children in high-income countries. This Editorial discusses the publishing of a supplement within Reproductive Health titled Essential interventions for maternal, newborn and child health which aims to provide a scientific basis to the recommended interventions along with implementation strategies and proposed packages of care.Fil: Belizan, Jose. Instituto de Efectividad Clínica y Sanitaria; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Salaria, Natasha. BioMed Central; Reino UnidoFil: Valanzasca, Pilar. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Mbizvo, Michael. University of Zimbabwe; Zimbabu
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