Migration and cancer mortality among Colombian migrants in the USA: a death certification study

Este estudo teve como objetivo comparar padrões de mortalidade por câncer entre os imigrantes colombianos nos EUA e colombianos em sua terra natal. Dados de 2008 a 2012 foram coletados, e foram calculadas taxas de mortalidade por câncer de colombianos residindo em seu país natal e colombianos residindo em Califórnia, Flórida e Nova York, bem como taxas específicas de mortalidade por idade e sexo por cada 100.000 pessoas. Para comparar as duas populações, tanto antes como após a correção pela escolaridade, as razões de taxas de mortalidade (MRR) foram estimadas por modelo de regressão binomial negativa. Foi descoberto que colombianos em sua terra natal apresentam taxas de mortalidade por câncer mais altas quando comparados aos que residem nos EUA (MRR masculino 1,4 (IC 95%: 1,2-1,5), MRR feminino 1,5 (IC 95%: 1,3-1,7)). Essas diferenças persistem para a maioria dos tipos de câncer, mesmo após correção pela escolaridade. Os colombianos em sua terra natal apresentaram taxa de mortalidade por câncer gástrico (MRR masculino 2,6; feminino 2,8) e cervical (MRR 5,0) significativamente mais alta em comparação com os que residem nos EUA. As desigualdades educacionais na mortalidade por câncer foram mais acentuadas para aqueles que moram em sua terra natal. A menor taxa de mortalidade por câncer observada entre os colombianos nos EUA, porém, não pode ser atribuída às diferenças de escolaridade, um indicador de status socioeconômico. Em vez disso, provavelmente ocorre devido à maior acessibilidade aos serviços de saúde preventivos e curativos nos EUA.We aim to compare cancer mortality rates of USA Colombian migrants (USA Colombians) to Colombians in their country of origin (CO Colombians). Using Colombian national mortality data and data on cancer deaths among Colombians residing in the states of California, Florida, and New York (USA Colombians) for the period 2008-2012, we estimated sex-specific and age-standardized mortality rates (ASMR), expressed per 100,000 persons. For comparisons between the two populations before and after adjustment for educational level, negative binomial regression models were used to compute Mortality Rate Ratios (MRR). CO Colombians had higher cancer mortality rates compared with USA Colombians (male MRR 1.4 [95%CI: 1.2-1.5], female MRR 1.5 [95%CI: 1.3-1.7]). These differences persisted for most cancers even after adjustment for education. CO Colombians had significantly higher mortality from gastric (MRR 2.6 in males and 2.8 in females) and cervical cancer (MRR 5.0) compared with US Colombians. Educational inequalities in cancer mortality were more pronounced among CO Colombians than among USA Colombians. Lower cancer mortality observed among USA Colombians cannot be attributed to differences in education, an indicator of socio-economic status. Rather, it is likely due to better access to preventive and curative healthcare in the USA

Time trends in educational inequalities in cancer mortality in Colombia, 1998-2012

Objectives: To evaluate trends in premature cancer mortality in Colombia by educational level in three periods: 1998-2002 with low healthcare insurance coverage, 2003-2007 with rapidly increasing coverage and finally 2008-2012 with almost universal coverage (2008-2012). Setting: Colombian population-based, national secondary mortality data. Participants: We included all (n=188 091) cancer deaths occurring in the age group 20-64 years between 1998 and 2012, excluding only cases with low levels of quality of registration (n=2902, 1.5%). Primary and secondary outcome measures: In this descriptive study, we linked mortality data of ages 20-64 years to census data to obtain age-standardised cancer mortality rates by educational level. Using Poisson regression, we modelled premature mortality by educational level estimating rate ratios (RR), relative index of inequality (RII) and the Slope Index of Inequality (SII). Results: Relative measures showed increased risks of dying among the lower educated compared to the highest educated; this tendency was stronger in women (RRprimary1.49; RRsecondary1.22, both p<0.0001) than in men (RRprimary 1.35; RRsecondary 1.11, both p<0.0001). In absolute terms (SII), cancer caused a difference per 100 000 deaths between the highest and lowest educated of 20.5 in males and 28.5 in females. RII was significantly higher among women and the younger age categories. RII decreased between the first and second periods; afterwards (2008-2012), it increased significantly back to their previous levels. Among women, no significant increases or declines in cancer mortality over time were observed in recent periods in the lowest educated group, whereas strong recent declines were observed in those with secondary education or higher. Conclusions: Educational inequalities in cancer mortality in Colombia are increasing in absolute and relative terms, and are concentrated in young age categories. This trend was not curbed by increases in healthcare insurance coverage. Policymakers should focus on improving equal access to prevention, early detection, diagnostic and treatment facilities

Análisis de desempeño de un vehículo eléctrico transformado

Colombia, like other developing countries has been incorporating different electrical vehicles to the automotive national market. While the acquisition of a brand new electric vehicle is still expensive, transformation from used traditional vehicles (combustion) to electrical vehicles has become an interesting economical option. This work presents a performance evaluation of a transformed vehicle from its combustion version. The theoretical and experimental analysis (in rugged geographical reliefs such as Colombia) are necessary to consolidate the validity of this type of proposals at technical, economic and environmental impact levels. The procedure of an electric conversion presented herein showed significant mitigation of greenhouse gases owing to the renunciation of 6,54 L per 100 km and hence avoiding CO emissions: 1,808 g/km and THC + NOx: 0,652 g/km. The procedure included selection of both suitable car (low weight) and electric conversion kit, as well as assembly design, disassembly of combustion system, implementation of electric components. Additionally, experimental tests were performed to determine the behavior with respect to power under some load demands validating the proposed traction model.Colombia, como otros países en desarrollo, ha venido incorporando diferentes vehículos eléctricos en el mercado nacional automotriz. Mientras, la adquisición de un nuevo vehículo eléctrico sigue siendo costosa, la transformación de vehículos tradicionales usados ​​(combustión) a vehículos eléctricos se ha vuelto una opción económica e interesante. Este trabajo presenta una evaluación de rendimiento de un vehículo transformado a partir de su versión de combustión. Los análisis teóricos y experimentales en relieves geográficos accidentados como Colombia son necesarios para consolidar la validez de este tipo de propuestas a niveles de impacto técnico, económico y ambiental. El procedimiento de una conversión eléctrica presentada aquí mostró una significativa mitigación de gases de efecto invernadero debido a la renuncia al uso de 6,54 L por 100 km, y de ahí se evita emisiones de CO: 1,808 g/km de CO y 0,652 g/km de THC + NOx.&nbsp; El procedimiento incluyó la selección tanto del carro apropiado (bajo peso) como del kit de conversión eléctrica, y también el diseño del ensamblaje, el desmontaje del sistema de combustión y la implementación de componentes eléctricos. Adicionalmente, se realizaron pruebas experimentales para determinar el comportamiento con respecto a la potencia en algunas solicitudes de carga que validan el modelo de tracción plantada

Análisis de desempeño de un vehículo eléctrico transformado

Colombia, like other developing countries has been incorporating different electrical vehicles to the automotive national market. While the acquisition of a brand new electric vehicle is still expensive, transformation from used traditional vehicles (combustion) to electrical vehicles has become an interesting economical option. This work presents a performance evaluation of a transformed vehicle from its combustion version. The theoretical and experimental analysis (in rugged geographical reliefs such as Colombia) are necessary to consolidate the validity of this type of proposals at technical, economic and environmental impact levels. The procedure of an electric conversion presented herein showed significant mitigation of greenhouse gases owing to the renunciation of 6,54 L per 100 km and hence avoiding CO emissions: 1,808 g/km and THC + NOx: 0,652 g/km. The procedure included selection of both suitable car (low weight) and electric conversion kit, as well as assembly design, disassembly of combustion system, implementation of electric components. Additionally, experimental tests were performed to determine the behavior with respect to power under some load demands validating the proposed traction model.Colombia, como otros países en desarrollo, ha venido incorporando diferentes vehículos eléctricos en el mercado nacional automotriz. Mientras, la adquisición de un nuevo vehículo eléctrico sigue siendo costosa, la transformación de vehículos tradicionales usados ​​(combustión) a vehículos eléctricos se ha vuelto una opción económica e interesante. Este trabajo presenta una evaluación de rendimiento de un vehículo transformado a partir de su versión de combustión. Los análisis teóricos y experimentales en relieves geográficos accidentados como Colombia son necesarios para consolidar la validez de este tipo de propuestas a niveles de impacto técnico, económico y ambiental. El procedimiento de una conversión eléctrica presentada aquí mostró una significativa mitigación de gases de efecto invernadero debido a la renuncia al uso de 6,54 L por 100 km, y de ahí se evita emisiones de CO: 1,808 g/km de CO y 0,652 g/km de THC + NOx.&nbsp; El procedimiento incluyó la selección tanto del carro apropiado (bajo peso) como del kit de conversión eléctrica, y también el diseño del ensamblaje, el desmontaje del sistema de combustión y la implementación de componentes eléctricos. Adicionalmente, se realizaron pruebas experimentales para determinar el comportamiento con respecto a la potencia en algunas solicitudes de carga que validan el modelo de tracción plantada

Social inequalities in male cancer in a metropolis in the Southeast region of Brazil

OBJETIVO: Analisar as desigualdades segundo a vulnerabilidade social na incidência, mortalidade e estimativa de sobrevida de neoplasias no sexo masculino. MÉTODOS: Foram analisados os casos e as mortes do total de neoplasias e das cinco mais incidentes em homens com 30 anos ou mais no município de Campinas (SP), entre 2010 e 2014, utilizando dados do Registro de Câncer de Base Populacional (RCBP) e do Sistema de Informação sobre Mortalidade (SIM). As áreas de residência foram agrupadas em cinco estratos de vulnerabilidade social (EVS) utilizando o Índice Paulista de Vulnerabilidade Social. Para cada EVS, foram calculadas as taxas de incidência e de mortalidade padronizadas por idade. Um proxy de sobrevida em cinco anos foi calculado pelo complemento da razão da taxa de mortalidade pela taxa de incidência. As desigualdades entre os estratos foram mensuradas pelas razões entre taxas, pelo índice relativo de desigualdade (IRD) e pelo índice angular de desigualdade. RESULTADOS: O IRD revelou que a incidência do total de neoplasias (0,66, IC95% 0,62–0,69) e dos cânceres colorretal e de pulmão foram menores entre os socialmente mais vulneráveis, que apresentaram maior incidência dos cânceres de estômago e da cavidade oral. As taxas de mortalidade por câncer de estômago, cavidade oral, próstata e por todas as neoplasias foram superiores nos segmentos mais vulneráveis, sem diferenças na mortalidade por câncer colorretal e de pulmão. A sobrevida foi menor no estrato de maior vulnerabilidade social para todos os cânceres estudados. O índice angular de desigualdade (IAD) mostrou o excesso de casos nos menos vulneráveis e de óbitos nos mais vulneráveis. As desigualdades sociais revelaram-se distintas conforme a localização do tumor e o indicador analisado. CONCLUSÃO: Constata-se uma tendência de inversão das desigualdades entre incidência e mortalidade e sobrevida, sendo esta última desfavorável ao segmento de maior vulnerabilidade social para os tipos de câncer, apontando a existência de inequidade no acesso ao diagnóstico precoce e ao tratamento efetivo e oportuno.OBJECTIVE: To analyze inequalities in incidence, mortality, and estimated survival for neoplasms in men according to social vulnerability. METHODS: Analysis of cases and deaths of all neoplasms and the five most common in men aged 30 years or older in the city of Campinas (SP), between 2010 and 2014, using data from the Population-Based Cancer Registry (RCBP) and the Mortality Information System (SIM). The areas of residence were grouped into five social vulnerability strata (SVS) using São Paulo Social Vulnerability Index. For each SVS, age-standardized incidence and mortality rates were calculated. A five-year survival proxy was calculated by complementing the ratio of the mortality rate to the incidence rate. Inequalities between strata were measured by the ratios between rates, the relative inequality index (RII) and the angular inequality index (AII). RESULTS: RII revealed that the incidence of all neoplasms (0.66, 95%CI 0.62–0.69) and colorectal and lung cancers were lower among the most socially vulnerable, who presented a higher incidence of stomach and oral cavity cancer. Mortality rates for stomach, oral cavity, prostate and all types of cancer were higher in the most vulnerable segments, with no differences in mortality for colorectal and lung cancer. Survival was lower in the most social vulnerable stratum for all types of cancer studied. AII showed excess cases in the least vulnerable and deaths in the most vulnerable. Social inequalities were different depending on the tumor location and the indicator analyzed. CONCLUSION: There is a trend of reversal of inequalities between incidence-mortality and incidence-survival, and the most social vulnerable segment presents lower survival rates for the types of cancer, pointing to the existence of inequality in access to early diagnosis and effective and timely treatment

Trends in inequalities in premature cancer mortality by educational level in Colombia, 1998-2007

Background There is a paucity of studies on socioeconomic inequalities in cancer mortality in developing countries. We examined trends in inequalities in cancer mortality by educational attainment in Colombia during a period of epidemiological transition and rapid expansion of health insurance coverage. Methods Population mortality data (1998–2007) were linked to census data to obtain age-standardised cancer mortality rates by educational attainment at ages 25–64 years for stomach, cervical, prostate, lung, colorectal, breast and other cancers. We used Poisson regression to model mortality by educational attainment and estimated the contribution of specific cancers to the slope index of inequality in cancer mortality. Results We observed large educational inequalities in cancer mortality, particularly for cancer of the cervix (rate ratio (RR) primary vs tertiary groups=5.75, contributing 51% of cancer inequalities), stomach (RR=2.56 for males, contributing 49% of total cancer inequalities and RR=1.98 for females, contributing 14% to total cancer inequalities) and lung (RR=1.64 for males contributing 17% of total cancer inequalities and 1.32 for females contributing 5% to total cancer inequalities). Total cancer mortality rates declined faster among those with higher education, with the exception of mortality from cervical cancer, which declined more rapidly in the lower educational groups. Conclusions There are large socioeconomic inequalities in preventable cancer mortality in Colombia, which underscore the need for intensifying prevention efforts. Reduction of cervical cancer can be achieved through reducing human papilloma virus infection, early detection and improved access to treatment of preneoplastic lesions. Reinforcing antitobacco measures may be particularly important to curb inequalities in cancer mortality

Eco-Sustainable housing development for vulnerable population

El trabajo consiste en el montaje de un módulo habitacional ecosostenible para sectores vulnerables (en el caso de este proyecto: Fundación “Kyrios”, centro de restauración), fabricado en plástico y tetrapack reciclado, proveniente de residuos en procesos de empaque de diferentes empresas; con instalación de sistemas ecoeficientes (panel fotovoltaico, y colector solar) para suplir demandas energéticas eléctrica y térmica respectivamente. Se realizan pruebas de resistencia mecánica, conductividad térmica, acústica y permeabilidad del material de construcción que garantizan las condiciones de habitabilidad adecuadas. Abstract The project consists of the installation of an environmentally sustainable housing module (In this project, for the “Kyrios” Foundation, Rehabilitation Center): the module was built with waste plastic materials discarded from industrial packaging processes. Different sustainable systems were installed (photovoltaic system, solar collector) to satisfy electricity and thermal energy demands. In order to satisfy the conditions of housing, different tests were performed on the construction material such as mechanical resistance, thermal and acoustic conductivity and permeability

Education and pneumonia mortality: a trend analysis of its inequalities in Colombian adults

Objective To explore the existence and trends of social inequalities related to pneumonia mortality in Colombian adults using educational level as a proxy of socioeconomic status. Methods We obtained individual and anonymised registries from death certificates due to pneumonia for 1998–2015. Educational level data were gathered from microdata of the Colombian Demography Health Surveys. Rate ratios (RR) were estimated by using Poisson regression models, comparing mortality of educational groups with mortality in the highest education group. Relative index of inequality (RII) was measured to assess changes in disparities, regressing mortality on the midpoint of the cumulative distribution of education, thereby considering the size of each educational group. Results For adults 25+ years, the risk of dying was significantly higher among lower educated. The RRs depict increased risks of dying comparing lower and highest education level, and this tendency was stronger in woman than in men (RR for primary education=2.34 (95% CI 2.32 to 2.36), RR for secondary education=1.77 (95% CI 1.75 to 1.78) versus RR for primary education=1.83 (95% CI 1.81 to 1.85), RR for secondary education=1.51 (95% CI 1.50 to 1.53)). According to age groups, young adults (25–44 years) showed the largest inequality in terms of educational level; RRs for pneumonia mortality regarding the tertiary educated groups show increased mortality in the lower and secondary educated, and these differences decreased with ages. RII in pneumonia mortality among adult men was 2.01 (95% CI 2.00 to 2.03) and in women 2.46 (95% CI 2.43 to 2.48). The RII was greatest at young ages, for both sexes. Time trends showed steadily significant increases for RII in both men and women (estimated annual percentage change (EAPC)men=3.8; EAPCwomen=2.6). Conclusion A significant increase on the educational inequalities in mortality due to pneumonia during all period was found among men and women. Efforts to reduce pneumonia mortality in adults improving population health by raising education levels should be strengthened with policies that assure widespread access to economic and social opportunitie