Elecciones municipales de 2015 en Paraguay : cambios simbólicos y continuidades sustanciales

Artículo originalEste artículo describe los resultados electorales de los comicios municipales de 2015 en Paraguay. Se examinan las principales tendencias y se ponen en perspectiva comparada histórica, destacando, en particular, los cambios respecto a las elecciones anteriores de 2010. El trabajo argumenta que en términos de resultados agregados se mantuvo la predominancia de los partidos tradicionales y la debilidad de los terceros partidos. El proceso electoral evidenció un retroceso de la Asociación Nacional Republicana (ANR) en varias de las grandes ciudades del país, el fortalecimiento del Partido Liberal Radical Auténtico en el departamento Central, el más poblado del país, y un creciente uso de alianzas electorales como estrategia para enfrentar a la ANR. Asimismo, los votantes parecen ser cada vez más críticos, tener mayor capacidad de evaluar a los incumbentes y castigar el mal desempeño de los gobernantes locales

Efectos electorales de las transferencias monetarias condicionadas : evidencia del programa Tekoporã en Paraguay

Tesis de DoctoradoLa presente tesis busca corroborar la existencia de efectos electorales vinculados a la expansión territorial de un programa de transferencias monetarias condicionadas, así como el mecanismo causal que hace posible tales efectos. La falta de consenso en la literatura acerca del mencionado vínculo causal configura un vacío explicativo que este trabajo propone completar, mediante el análisis de evidencia original vinculada al programa Tekoporã de Paraguay. La primera hipótesis que guía esta investigación plantea que un aumento en el número de beneficiarios a nivel distrital puede generar efectos electorales positivos para el partido de gobierno en tanto éste posea capacidad atribuirse la responsabilidad de dicho incremento. La segunda hipótesis sugiere que los efectos electorales favorables se llegan a producir mediante la acción de actores partidarios locales que trabajan activamente para atribuir la responsabilidad del programa al partido de gobierno, acción potenciada por la situación de vulnerabilidad socioeconómica de la población local y su cercanía con la misma. La verificación de ambas hipótesis es lograda mediante una “tríada inferencial”, que combina estrategias de inferencia causal basada en estudios observacionales con rastreo de procesos: tras la validación de los supuestos que preceden a la inferencia causal atendiendo al contexto del programa seleccionado, se procede a corroborar la existencia de efectos electorales sistemáticos vinculados a la expansión territorial de este programa durante distintos gobiernos, para luego verificar la presencia del mecanismo de atribución de responsabilidad a en base a casos distritales representativos. Los análisis que estructuran la tesis corroboran ambas hipótesis y permiten observar la manera en que la acción local de actores partidarios generan atribución de responsabilidad por la política pública de implementación nacional en clave particularista y, en consecuencia, consiguen generar réditos electorales favorables al partido de gobierno agregados al nivel subnacional.Fil: Duarte Recalde, Liliana Rocío. Universidad Nacional de San Martín. Escuela de Política y Gobierno; Argentin

Elecciones municipales en Paraguay 2021: confirmación de la hegemonía colorada en contexto de pandemia

The municipal elections held in Paraguay in 2021 were the first elections in which the preferential voting system and ballot printing machines were used in this country. Although the campaign period was carried out in the context of a pandemic, the candidates’ campaign strategies tended to be the same as in other contexts. The electoral results reaffirm the territorial control exercised by the Republican National Association, despite the public discontent expressed against this party and the image of corruption associated with their candidacies. The results also reveal the growing presence of electoral alliances at the district level throughout the country.Las elecciones municipales realizadas en Paraguay en 2021 fueron las primeras en que se utilizó el sistema de voto preferente y las máquinas para la impresión de votos en este país. Si bien el periodo de campaña se realizó en un contexto de pandemia, las estrategias de promoción de las candidaturas tendieron a ser las mismas que en otros contextos. Los resultados electorales reafirman el control territorial ejercido por la Asociación Nacional Republicana, a pesar del descontento ciudadano manifestado contra este partido y la imagen de corrupción asociada a candidaturas de este. Los resultados revelan también la presencia creciente de alianzas electorales en los distintos distritos del país

Body mass index and waist circumference in relation to the risk of 26 types of cancer : a prospective cohort study of 3.5 million adults in Spain

A high body mass index (BMI) has been associated with increased risk of several cancers; however, whether BMI is related to a larger number of cancers than currently recognized is unclear. Moreover, whether waist circumference (WC) is more strongly associated with specific cancers than BMI is not well established. We aimed to investigate the associations between BMI and 26 cancers accounting for non-linearity and residual confounding by smoking status as well as to compare cancer risk estimates between BMI and WC. Prospective cohort study with population-based electronic health records from Catalonia, Spain. We included 3,658,417 adults aged ≥ 18 years and free of cancer at baseline between 2006 and 2017. Our main outcome measures were cause-specific hazard ratios (HRs) with 99% confidence intervals (CIs) for incident cancer at 26 anatomical sites. After a median follow-up time of 8.3 years, 202,837 participants were diagnosed with cancer. A higher BMI was positively associated with risk of nine cancers (corpus uteri, kidney, gallbladder, thyroid, colorectal, breast post-menopausal, multiple myeloma, leukemia, non-Hodgkin lymphoma) and was positively associated with three additional cancers among never smokers (head and neck, brain and central nervous system, Hodgkin lymphoma). The respective HRs (per 5 kg/m 2 increment) ranged from 1.04 (99%CI 1.01 to 1.08) for non-Hodgkin lymphoma to 1.49 (1.45 to 1.53) for corpus uteri cancer. While BMI was negatively associated to five cancer types in the linear analyses of the overall population, accounting for non-linearity revealed that BMI was associated to prostate cancer in a U-shaped manner and to head and neck, esophagus, larynx, and trachea, bronchus and lung cancers in an L-shaped fashion, suggesting that low BMIs are an approximation of heavy smoking. Of the 291,305 participants with a WC measurement, 27,837 were diagnosed with cancer. The 99%CIs of the BMI and WC point estimates (per 1 standard deviation increment) overlapped for all cancers. In this large Southern European study, a higher BMI was associated with increased risk of twelve cancers, including four hematological and head and neck (only among never smokers) cancers. Furthermore, BMI and WC showed comparable estimates of cancer risk associated with adiposity. Supplementary information accompanies this paper at 10.1186/s12916-020-01877-3

Association between metabolic syndrome and 13 types of cancer in Catalonia : A matched case-control study

Metabolic syndrome (MS) is the simultaneous occurrence of a cluster of predefined cardiovascular risk factors. Although individual MS components are associated with increased risk of cancer, it is still unclear whether the association between MS and cancer differs from the association between individual MS components and cancer. The aim of this matched case-control study was to estimate the association of 13 types of cancer with (1) MS and (2) the diagnosis of 0, 1 or 2 individual MS components. Cases included 183,248 patients ≥40 years from the SIDIAP database with incident cancer diagnosed between January 2008-December 2017. Each case was matched to four controls by inclusion date, sex and age. Adjusted conditional logistic regression models were used to evaluate the association between MS and cancer risk, comparing the effect of global MS versus having one or two individual components of MS. MS was associated with an increased risk of the following cancers: colorectal (OR: 1.28, 95%CI: 1.23-1.32), liver (OR: 1.93, 95%CI: 1.74-2.14), pancreas (OR: 1.79, 95%CI: 1.63-1.98), post-menopausal breast (OR: 1.10, 95%CI: 1.06-1.15), pre-menopausal endometrial (OR: 2.14, 95%CI: 1.74-2.65), post-menopausal endometrial (OR: 2.46, 95%CI: 2.20-2.74), bladder (OR: 1.41, 95%CI: 1.34-1.48), kidney (OR: 1.84, 95%CI: 1.69-2.00), non-Hodgkin lymphoma (OR: 1.23, 95%CI: 1.10-1.38), leukaemia (OR: 1.42, 95%CI: 1.31-1.54), lung (OR: 1.11, 95%CI: 1.05-1.16) and thyroid (OR: 1.71, 95%CI: 1.50-1.95). Except for prostate, pre-menopause breast cancer and Hodgkin and non-Hodgkin lymphoma, MS is associated with a higher risk of cancer than 1 or 2 individual MS components. Estimates were significantly higher in men than in women for colorectal and lung cancer, and in smokers than in non-smokers for lung cancer. MS is associated with a higher risk of developing 11 types of common cancer, with a positive correlation between number of MS components and risk of cancer

The natural history of symptomatic COVID-19 during the first wave in Catalonia

The natural history of coronavirus disease 2019 (COVID-19) has yet to be fully described. Here, we use patient-level data from the Information System for Research in Primary Care (SIDIAP) to summarise COVID-19 outcomes in Catalonia, Spain. We included 5,586,521 individuals from the general population. Of these, 102,002 had an outpatient diagnosis of COVID-19, 16,901 were hospitalised with COVID-19, and 5273 died after either being diagnosed or hospitalised with COVID-19 between 1st March and 6th May 2020. Older age, being male, and having comorbidities were all generally associated with worse outcomes. These findings demonstrate the continued need to protect those at high risk of poor outcomes, particularly older people, from COVID-19 and provide appropriate care for those who develop symptomatic disease. While risks of hospitalisation and death were lower for younger populations, there is a need to limit their role in community transmission

Characteristics and outcomes of 627 044 COVID-19 patients living with and without obesity in the United States, Spain, and the United Kingdom

Altres ajuts: This research received partial support from the National Institute for Health Research (NIHR) Oxford Biomedical Research Center (BRC), US National Institutes of Health, US Department of Veterans Affairs, Janssen Research & Development, and IQVIA. The University of Oxford received funding related to this work from the Bill & Melinda Gates Foundation (Investment ID INV016201 and INV-019257). APU has received funding from the Medical Research Council (MRC) [MR/K501256/1, MR/N013468/1] and Fundación Alfonso Martín Escudero (FAME) (APU). VINCI [VA HSR RES 13-457] (SLD, MEM, KEL). JCEL has received funding from the Medical Research Council (MR/K501256/1) and Versus Arthritis (21605). MR is funded by Wereld Kanker Onderzoek Fonds (WKOF), as part of the World Cancer Research Fund International grant program [grant number: 2017/1630]A detailed characterization of patients with COVID-19 living with obesity has not yet been undertaken. We aimed to describe and compare the demographics, medical conditions, and outcomes of COVID-19 patients living with obesity (PLWO) to those of patients living without obesity. We conducted a cohort study based on outpatient/inpatient care and claims data from January to June 2020 from Spain, the UK, and the US. We used six databases standardized to the OMOP common data model. We defined two non-mutually exclusive cohorts of patients diagnosed and/or hospitalized with COVID-19; patients were followed from index date to 30 days or death. We report the frequency of demographics, prior medical conditions, and 30-days outcomes (hospitalization, events, and death) by obesity status. We included 627 044 (Spain: 122 058, UK: 2336, and US: 502 650) diagnosed and 160 013 (Spain: 18 197, US: 141 816) hospitalized patients with COVID-19. The prevalence of obesity was higher among patients hospitalized (39.9%, 95%CI: 39.8−40.0) than among those diagnosed with COVID-19 (33.1%; 95%CI: 33.0−33.2). In both cohorts, PLWO were more often female. Hospitalized PLWO were younger than patients without obesity. Overall, COVID-19 PLWO were more likely to have prior medical conditions, present with cardiovascular and respiratory events during hospitalization, or require intensive services compared to COVID-19 patients without obesity. We show that PLWO differ from patients without obesity in a wide range of medical conditions and present with more severe forms of COVID-19, with higher hospitalization rates and intensive services requirements. These findings can help guiding preventive strategies of COVID-19 infection and complications and generating hypotheses for causal inference studies

Characteristics and outcomes of over 300,000 patients with COVID-19 and history of cancer in the United States and Spain

Background: We described the demographics, cancer subtypes, comorbidities, and outcomes of patients with a history of cancer and coronavirus disease 2019 (COVID-19). Second, we compared patients hospitalized with COVID-19 to patients diagnosed with COVID-19 and patients hospitalized with influenza. Methods: We conducted a cohort study using eight routinely collected health care databases from Spain and the United States, standardized to the Observational Medical Outcome Partnership common data model. Three cohorts of patients with a history of cancer were included: (i) diagnosed with COVID-19, (ii) hospitalized with COVID-19, and (iii) hospitalized with influenza in 2017 to 2018. Patients were followed from index date to 30 days or death. We reported demographics, cancer subtypes, comorbidities, and 30-day outcomes. Results: We included 366,050 and 119,597 patients diagnosed and hospitalized with COVID-19, respectively. Prostate and breast cancers were the most frequent cancers (range: 5%–18% and 1%–14% in the diagnosed cohort, respectively). Hematologic malignancies were also frequent, with non-Hodgkin’s lymphoma being among the five most common cancer subtypes in the diagnosed cohort. Overall, patients were aged above 65 years and had multiple comorbidities. Occurrence of death ranged from 2% to 14% and from 6% to 26% in the diagnosed and hospitalized COVID-19 cohorts, respectively. Patients hospitalized with influenza (n ¼ 67,743) had a similar distribution of cancer subtypes, sex, age, and comorbidities but lower occurrence of adverse events. Conclusions: Patients with a history of cancer and COVID-19 had multiple comorbidities and a high occurrence of COVID-19-related events. Hematologic malignancies were frequent. Impact: This study provides epidemiologic characteristics that can inform clinical care and etiologic studies.</p