992 research outputs found
ORIENTATION BY BULK MESSENGER SENSORS IN AQUATIC VERTEBRATES
Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/72353/1/j.1749-6632.1969.tb13050.x.pd
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Barriers to Pediatric Sickle Cell Disease Guideline Recommendations.
National guidelines recommend that providers counsel all patients with sickle cell anemia about hydroxyurea (HU) therapy and screen children with sickle cell anemia annually for the risk of stroke with transcranial Doppler (TCD). We surveyed a national convenience sample of sickle cell disease clinicians to assess factors associated with low adherence. Adherence was 46% for TCD screening. Low adherence was associated with a lack of outcome expectancy (eg, a belief that there would be poor patient follow-up to TCD testing; P < .05). Adherence was 72% for HU counseling. Practice barriers (eg, lack of support staff or time) and a lack of agreement with HU recommendations were associated with low adherence (P < .05). This study demonstrates that different types of strategies are needed to improve TCD screening (to address follow-up and access to testing) versus HU counseling (to address physician agreement and practice barriers)
PRM10 Calibration of a Cost-Effectiveness Model to Evaluate the Incorporation of a Quadrivalent HPV Types 6, 11, 16, 18 Vaccine in Argentina: Disease Burden Component
Alcohol-attributable burden of cancer in Argentina
Introduction: Alcohol consumption is a risk factor for several types of cancer. Alcohol consumption levels in Argentina are among the highest in the world, and malignant neoplasms are the second cause of death in the country. Public health strategies aimed at reducing alcohol consumption could possibly lead to a decrease in cancer burden. Alcohol-attributable burden has been estimated before in neighboring countries Chile and Brazil. We now aimed to quantify the burden for Argentina. Methods: We obtained data on alcohol consumption levels from a national representative health survey and etiologic effect sizes for the association between alcohol and cancer from the most recent comprehensive meta-analysis. We estimated the number of alcohol-attributable cancer-related deaths and disability-adjusted life years (DALYs), stratified by consumption level (light (0.1â12.5Â g/day), moderate (12.6â50Â g/day), or heavy (> 50Â g/day) drinking). We additionally explored which hypothetical scenario would achieve the highest reduction in alcohol-attributable cancer burden: 1) heavy drinkers shifting to moderate drinking or 2) moderate drinkers shifting to light drinking. Results: In 2018, 53% of the Argentinean population consumed alcohol. In men 3.7% of all cancer deaths and DALYs were attributable to alcohol consumption, in women this was 0.8% of all cancer deaths and DALYs. When moderate drinkers would shift to light drinking, 46% of alcohol-attributable cancer deaths and DALYs would be prevented, opposed to only 24% when heavy drinkers would shift to moderate drinking. Conclusion: Most cancer deaths and DALYs were attributable to moderate alcohol consumption (50%). This calls for implementation of population-wide strategiesâinstead of targeting heavy drinking onlyâto effectively reduce harmful use of alcohol and its impact on disease burden.Fil: Van de Luitgaarden, I. A. T.. Utrecht University; PaĂses BajosFil: Bardach, Ariel Esteban. Consejo Nacional de Investigaciones CientĂficas y TĂ©cnicas. Oficina de CoordinaciĂłn Administrativa Parque Centenario. Centro de Investigaciones en EpidemiologĂa y Salud PĂșblica. Instituto de Efectividad ClĂnica y Sanitaria. Centro de Investigaciones en EpidemiologĂa y Salud PĂșblica; ArgentinaFil: Espinola, N.. Instituto de Efectividad ClĂnica y Sanitaria; ArgentinaFil: Schrieks, I.C.. No especifĂca;Fil: Grobbee, D. E.. Utrecht University; PaĂses BajosFil: Beulens, J. W. J.. Utrecht University; PaĂses Bajo
Cutaneous Larva Migrans among Devotees of the Nallur Temple in Jaffna, Sri Lanka
Background: Many cases of Cutaneous Larva Migrans (CLM) have been observed among devotees, during and immediately after the annual festival at the Nallur Hindu temple in Jaffna. Objective: To ascertain the risk factors associated with infestation and devotees â knowledge and practices regarding the condition. Methodology/Principal Findings: A cross-sectional study using an interviewer-administered questionnaire and observation was conducted in August 2010. Out of 200 selected devotees 194(97%) responded. Soil and dog faecal samples were collected from the temple premises and examined for the presence of nematode larva and egg respectively. Among 194 male respondents, 58.2%(95 % CI: 51.2%â65.0%) had lesions of CLM. One hundred and thirty (67%) respondents performed the ritual everyday; whereas 33 % did so on special days. One hundred and twelve (57.7%) participants performed the ritual before 5.00am and remaining 42.3 % performed after 5.00am. Among the participants, 77(36.7%) had the similar condition in previous years. One hundred and fifty seven (80.9%) were aware about this disease and 52(27%) devotees adopted some kind of precautionary measures. Bivariate analysis showed significant association between occurrence of CLM lesions and frequency of performing the ritual (p,0.001, OR-15.1; 95 % CI:7.2-32.0), the timing of ritual performance (p = 0.022, OR-1.96; 95 % CI:1.10â3.52), similar condition in previous year (p,0.001, OR-6.83; 95 % CI: 3.39â13.76) and previous awareness of th
COVID-19 and pregnancy: An umbrella review of clinical presentation, vertical transmission, and maternal and perinatal outcomes
Background We conducted an overview of systematic reviews (SRs) summarizing the best evidence regarding the effect of COVID-19 on maternal and child health following Cochrane methods and PRISMA statement for reporting (PROSPERO-CRD42020208783). Methods We searched literature databases and COVID-19 research websites from January to October 2020. We selected relevant SRs reporting adequate search strategy, data synthesis, risk of bias assessment, and/or individual description of included studies describing COVID-19 and pregnancy outcomes. Pair of reviewers independently selected studies through COVIDENCE web-software, performed the data extraction, and assessed its quality through the AMSTAR-2 tool. Discrepancies were resolved by consensus. Each SRâs results were synthesized and for the most recent, relevant, comprehensive, and with the highest quality, by predefined criteria, we presented GRADE evidence tables. Results We included 66 SRs of observational studies out of 608 references retrieved and most (61/66) had "critically low" overall quality. We found a relatively low degree of primary study overlap across SRs. The most frequent COVID-19 clinical findings during pregnancy were fever (28â100%), mild respiratory symptoms (20â79%), raised C-reactive protein (28â96%), lymphopenia (34â80%), and pneumonia signs in diagnostic imaging (7â99%). The most frequent maternal outcomes were C-section (23â96%) and preterm delivery (14â64%). Most of their babies were asymptomatic (16â93%) or presented fever (0â50%), low birth weight (5â43%) or preterm delivery (2â69%). The odds ratio (OR) of receiving invasive ventilation for COVID-19 versus non-COVID-19 pregnant women was 1.88 (95% Confidence Interval [CI] 1.36â2.60) and the OR that their babies were admitted to neonatal intensive care unit was 3.13 (95%CI 2.05â4.78). The risk of congenital transmission or via breast milk was estimated to be low, but close contacts may carry risks. Conclusion This comprehensive overview supports that pregnant women with COVID-19 may be at increased risk of adverse pregnancy and birth outcomes and low risk of congenital transmission.Fil: Ciapponi, AgustĂn. Consejo Nacional de Investigaciones CientĂficas y TĂ©cnicas. Oficina de CoordinaciĂłn Administrativa Parque Centenario. Centro de Investigaciones en EpidemiologĂa y Salud PĂșblica. Instituto de Efectividad ClĂnica y Sanitaria. Centro de Investigaciones en EpidemiologĂa y Salud PĂșblica; Argentina. Instituto de Efectividad ClĂnica y Sanitaria; ArgentinaFil: Bardach, Ariel Esteban. Instituto de Efectividad ClĂnica y Sanitaria; Argentina. Consejo Nacional de Investigaciones CientĂficas y TĂ©cnicas. Oficina de CoordinaciĂłn Administrativa Parque Centenario. Centro de Investigaciones en EpidemiologĂa y Salud PĂșblica. Instituto de Efectividad ClĂnica y Sanitaria. Centro de Investigaciones en EpidemiologĂa y Salud PĂșblica; ArgentinaFil: ComandĂ©, Daniel. Instituto de Efectividad ClĂnica y Sanitaria; ArgentinaFil: Berrueta, Mabel. Instituto de Efectividad ClĂnica y Sanitaria; ArgentinaFil: Argento, Fernando J.. Instituto de Efectividad ClĂnica y Sanitaria; ArgentinaFil: Rodriguez Cairoli, Federico. Instituto de Efectividad ClĂnica y Sanitaria; ArgentinaFil: Zamora, Natalia. Instituto de Efectividad ClĂnica y Sanitaria; ArgentinaFil: Santa MarĂa, Victoria. Instituto de Efectividad ClĂnica y Sanitaria; ArgentinaFil: Xiong, Xu. University of Tulane; Estados UnidosFil: Zaraa, Sabra. University of Washington; Estados UnidosFil: Mazzoni, Agustina. Instituto de Efectividad ClĂnica y Sanitaria; ArgentinaFil: Buekens, Pierre. University of Tulane; Estados Unido
Power, norms and institutional change in the European Union: the protection of the free movement of goods
How do institutions of the European Union change? Using an institutionalist approach, this article highlights the interplay between power, cognitive limits, and the normative order that underpins institutional settings and assesses their impact upon the process of institutional change. Empirical evidence from recent attempts to reinforce the protection of the free movement of goods in the EU suggests that, under conditions of uncertainty, actors with ambiguous preferences assess attempts at institutional change on the basis of the historically defined normative order which holds a given institutional structure together. Hence, path dependent and incremental change occurs even when more ambitious and functionally superior proposals are on offer
Integrating modes of policy analysis and strategic management practice : requisite elements and dilemmas
There is a need to bring methods to bear on public problems that are inclusive, analytic, and quick. This paper describes the efforts of three pairs of academics working from three different though complementary theoretical foundations and intervention backgrounds (i.e., ways of working) who set out together to meet this challenge. Each of the three pairs had conducted dozens of interventions that had been regarded as successful or very successful by the client groups in dealing with complex policy and strategic problems. One approach focused on leadership issues and stakeholders, another on negotiating competitive strategic intent with attention to stakeholder responses, and the third on analysis of feedback ramifications in developing policies. This paper describes the 10 year longitudinal research project designed to address the above challenge. The important outcomes are reported: the requisite elements of a general integrated approach and the enduring puzzles and tensions that arose from seeking to design a wide-ranging multi-method approach
An Integrated Epidemiological and Economic Model of COVID-19 NPIs in Argentina
We added a multi-sectoral economic framework to a SVEIR epidemiological model, combining the economic rationale of the DAEDALUS model with a detailed treatment of lockdown fatigue and declining compliance with Public Health and Social Measures reported in recent empirical work, to quantify the epidemic and economic benefits and costs of alternative lockdown and PHSM policies, both in terms of intensity and length. Our calibration replicates key features of the case and death-curves and economic cost for Argentina in 2021. The model allows us to quantify the short-term policy trade-off between lives and livelihoods and show that it can be significantly improved with targeted pharmaceutical policies such as vaccine rollout to reduce mainly severe disease and the death toll from COVID-19, as has been highlighted by previous studies.Fil: Rubinstein, Adolfo Luis. Consejo Nacional de Investigaciones CientĂficas y TĂ©cnicas. Oficina de CoordinaciĂłn Administrativa Parque Centenario. Centro de Investigaciones en EpidemiologĂa y Salud PĂșblica. Instituto de Efectividad ClĂnica y Sanitaria. Centro de Investigaciones en EpidemiologĂa y Salud PĂșblica; ArgentinaFil: Levy Yeyati, Eduardo Luis. Consejo Nacional de Investigaciones CientĂficas y TĂ©cnicas; Argentina. Universidad Torcuato Di Tella; ArgentinaFil: LĂłpez Osornio, Alejandro. Instituto de Efectividad ClĂnica y Sanitaria; ArgentinaFil: Filippini, Federico. Universidad Torcuato Di Tella; ArgentinaFil: Santoro, AdriĂĄn. Instituto de Efectividad ClĂnica y Sanitaria; ArgentinaFil: Cejas, Cintia. Instituto de Efectividad ClĂnica y Sanitaria; ArgentinaFil: Bardach, Ariel Esteban. Consejo Nacional de Investigaciones CientĂficas y TĂ©cnicas. Oficina de CoordinaciĂłn Administrativa Parque Centenario. Centro de Investigaciones en EpidemiologĂa y Salud PĂșblica. Instituto de Efectividad ClĂnica y Sanitaria. Centro de Investigaciones en EpidemiologĂa y Salud PĂșblica; ArgentinaFil: Palacios, Alfredo. Instituto de Efectividad ClĂnica y Sanitaria; ArgentinaFil: Argento, Fernando J.. Instituto de Efectividad ClĂnica y Sanitaria; ArgentinaFil: Balivian, Jamile. Instituto de Efectividad ClĂnica y Sanitaria; ArgentinaFil: Augustovski, Federico Ariel. Consejo Nacional de Investigaciones CientĂficas y TĂ©cnicas. Oficina de CoordinaciĂłn Administrativa Parque Centenario. Centro de Investigaciones en EpidemiologĂa y Salud PĂșblica. Instituto de Efectividad ClĂnica y Sanitaria. Centro de Investigaciones en EpidemiologĂa y Salud PĂșblica; ArgentinaFil: PichĂłn-riviere, Andres. Consejo Nacional de Investigaciones CientĂficas y TĂ©cnicas. Oficina de CoordinaciĂłn Administrativa Parque Centenario. Centro de Investigaciones en EpidemiologĂa y Salud PĂșblica. Instituto de Efectividad ClĂnica y Sanitaria. Centro de Investigaciones en EpidemiologĂa y Salud PĂșblica; Argentin
An Integrated Epidemiological and Economic Model of COVID-19 NPIs in Argentina
We added a multi-sectoral economic framework to a SVEIR epidemiological model, combining the economic rationale of the DAEDALUS model with a detailed treatment of lockdown fatigue and declining compliance with Public Health and Social Measures reported in recent empirical work, to quantify the epidemic and economic benefits and costs of alternative lockdown and PHSM policies, both in terms of intensity and length. Our calibration replicates key features of the case and death-curves and economic cost for Argentina in 2021. The model allows us to quantify the short-term policy trade-off between lives and livelihoods and show that it can be significantly improved with targeted pharmaceutical policies such as vaccine rollout to reduce mainly severe disease and the death toll from COVID-19, as has been highlighted by previous studies.Fil: Rubinstein, Adolfo Luis. Consejo Nacional de Investigaciones CientĂficas y TĂ©cnicas. Oficina de CoordinaciĂłn Administrativa Parque Centenario. Centro de Investigaciones en EpidemiologĂa y Salud PĂșblica. Instituto de Efectividad ClĂnica y Sanitaria. Centro de Investigaciones en EpidemiologĂa y Salud PĂșblica; ArgentinaFil: Levy Yeyati, Eduardo Luis. Consejo Nacional de Investigaciones CientĂficas y TĂ©cnicas; Argentina. Universidad Torcuato Di Tella; ArgentinaFil: LĂłpez Osornio, Alejandro. Instituto de Efectividad ClĂnica y Sanitaria; ArgentinaFil: Filippini, Federico. Universidad Torcuato Di Tella; ArgentinaFil: Santoro, AdriĂĄn. Instituto de Efectividad ClĂnica y Sanitaria; ArgentinaFil: Cejas, Cintia. Instituto de Efectividad ClĂnica y Sanitaria; ArgentinaFil: Bardach, Ariel Esteban. Consejo Nacional de Investigaciones CientĂficas y TĂ©cnicas. Oficina de CoordinaciĂłn Administrativa Parque Centenario. Centro de Investigaciones en EpidemiologĂa y Salud PĂșblica. Instituto de Efectividad ClĂnica y Sanitaria. Centro de Investigaciones en EpidemiologĂa y Salud PĂșblica; ArgentinaFil: Palacios, Alfredo. Instituto de Efectividad ClĂnica y Sanitaria; ArgentinaFil: Argento, Fernando J.. Instituto de Efectividad ClĂnica y Sanitaria; ArgentinaFil: Balivian, Jamile. Instituto de Efectividad ClĂnica y Sanitaria; ArgentinaFil: Augustovski, Federico Ariel. Consejo Nacional de Investigaciones CientĂficas y TĂ©cnicas. Oficina de CoordinaciĂłn Administrativa Parque Centenario. Centro de Investigaciones en EpidemiologĂa y Salud PĂșblica. Instituto de Efectividad ClĂnica y Sanitaria. Centro de Investigaciones en EpidemiologĂa y Salud PĂșblica; ArgentinaFil: PichĂłn-riviere, Andres. Consejo Nacional de Investigaciones CientĂficas y TĂ©cnicas. Oficina de CoordinaciĂłn Administrativa Parque Centenario. Centro de Investigaciones en EpidemiologĂa y Salud PĂșblica. Instituto de Efectividad ClĂnica y Sanitaria. Centro de Investigaciones en EpidemiologĂa y Salud PĂșblica; Argentin
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