Projected reduction in healthcare costs in Belgium after optimization of iodine intake : impact on costs related to thyroid nodular disease

Background: Several surveys in the last 50 years have repeatedly indicated that Belgium is affected by mild iodine deficiency. Within the framework of the national food and health plan in Belgium, a selective, progressive, and monitored strategy was proposed in 2009 to optimize iodine intake. The objective of the present study was to perform a health economic evaluation of the consequences of inadequate iodine intake in Belgium, focusing on undisputed and measurable health outcomes such as thyroid nodular disease and its associated morbidity (hyperthyroidism). Methods: For the estimation of direct, indirect, medical, and nonmedical costs related to thyroid nodular diseases in Belgium, data from the Federal Public Service of Public Health, Food Chain Safety and Environment, the National Institute for Disease and Disability Insurance (RIZIV/INAMI), the Information Network about the prescription of reimbursable medicines (FARMANET), Intercontinental Marketing Services, and expert opinions were used. These costs translate into savings after implementation of the iodization program and are defined as costs due to thyroid nodular disease throughout the article. Costs related to the iodization program are referred to as program costs. Only figures dating from before the start of the intervention were exploited. Only adult and elderly people (>= 18 years) were taken into account in this study because thyroid nodular diseases predominantly affect this age group. Results: The yearly costs due to thyroid nodular diseases caused by mild iodine deficiency in the Belgian adult population are similar to(sic)38 million. It is expected that the iodization program will result in additional costs of similar to(sic)54,000 per year and decrease the prevalence of thyroid nodular diseases by 38% after a 4-5-year period. The net savings after establishment of the program are therefore estimated to be at least (sic)14 million a year. Conclusions: Optimization of iodine intake in Belgium should be quite cost effective, if only considering its impact on nodular thyroid disease. There are likely added benefits relating to more optimal thyroid hormone influenced brain development that are more difficult to estimate but may be even more important

Estructura informativa y Cambio Climático: el caso de ‘El País’

Los medios de comunicación mantienen relaciones económicas con empresas que son ajenas a este sector. El estudio de estas vinculaciones nos acerca a comprender el control que el poder económico tiene sobre los medios. Este trabajo pone el foco en las conexiones entre el Grupo PRISA y entidades con especial impacto sobre el cambio climático, como son las compañías del ámbito de los combustibles fósiles. Para ello, se ha realizado una recogida de datos acerca de estas relaciones y se ha aplicado un enfoque estructural para su interpretación. Para comprobar si el medio puede llegar a emitir mensajes intencionales en consonancia con los que son sus dueños o sus socios, se ha elaborado un estudio de caso sobre la nacionalización de YPF por el Gobierno de Argentina en 2012. En concreto, se ha realizado un análisis del discurso sobre los editoriales que El País publicó durante el proceso de nacionalización de YPF. Como resultado, esta investigación identifica múltiples vinculaciones entre el Grupo PRISA y empresas del ámbito de los combustibles fósiles. Por su parte, el estudio de caso pone de manifiesto cómo la posición del medio puede llegar a alinearse con los intereses de aquellos con los que mantiene relaciones económicas

‘Vacas más verdes’. Encuadres sobre la dieta y el cambio climático en la prensa extremeña

Una de las industrias que más contribuyen a la emisión de gases de efecto invernadero es la agricultura animal, que también conlleva otros problemas ambientales como la gestión de residuos y el consumo de agua, y problemas de índole ética como la explotación animal. La dieta es una herramienta de mitigación del cambio climático que puede resultar controvertida, ya que afecta profundamente a las decisiones individuales. Así, este trabajo se enmarca en la perspectiva de investigación emergente relativa a la comunicación sobre la explotación animal y el calentamiento global, un tema que requiere más presencia en la agenda mediática por la urgencia de la acción climática. Según el informe de Greenpeace Menos es más publicado en 2018, la explotación de animales para alimentación es responsable del 14% de las emisiones de gases de efecto invernadero a nivel mundial. Así, comprender cómo encuadran los medios de comunicación esta problemática resulta de utilidad para contrastar las necesidades que reclama la ciencia del cambio climático y las que trasladan los medios. Esta investigación toma un planteamiento crítico y no antropocéntrico, bajo la perspectiva de los Estudios Críticos sobre Animales y Medios de Comunicación. Dentro de este marco, este trabajo utiliza como herramienta el framing para estudiar los contenidos que vinculan el cambio climático y la explotación animal en los diarios extremeños Hoy y El Periódico de Extremadura desde enero de 2005 a marzo de 2019. Entre los resultados se confirman las siguientes hipótesis: una falta de información acerca del impacto climático de la agricultura animal; una tendencia progresiva al reconocimiento del papel de la explotación de animales en granjas sobre el calentamiento global, aunque con reticencias; un grado de confianza muy relevante en la tecnología para mitigar el calentamiento global; una falta de cuestionamiento acerca de los dilemas éticos implicados, y un tratamiento aislado de otros problemas ambientales asociados

Decrease of vitamin D concentration in patients with HIV infection on a non nucleoside reverse transcriptase inhibitor-containing regimen

<p>Abstract</p> <p>Background</p> <p>Vitamin D is an important determinant of bone health and also plays a major role in the regulation of the immune system. Interestingly, vitamin D status before the start of highly active antiretroviral therapy (HAART) has been recently associated with HIV disease progression and overall mortality in HIV-positive pregnant women. We prospectively studied vitamin D status in HIV individuals on HAART in Belgium.</p> <p>We selected samples from HIV-positive adults starting HAART with a pre-HAART CD4 T-cell count >100 cells/mm³followed up for at least 12 months without a treatment change. We compared 25-hydroxyvitamin D plasma [25-(OH)D] concentration in paired samples before and after 12 months of HAART. 25-(OH)D levels are presented using two different cut-offs: <20 ng/ml and <30 ng/ml.</p> <p>Results</p> <p>Vitamin D deficiency was common before HAART, the frequency of plasma 25-(OH)D concentrations below 20 ng/ml and 30 below ng/ml was 43.7% and 70.1% respectively. After 12 months on HAART, the frequency increased to 47.1% and 81.6%.</p> <p>HAART for 12 months was associated with a significant decrease of plasma 25-(OH)D concentration (p = 0.001). Decreasing plasma 25-(OH)D concentration on HAART was associated in the multivariate model with NNRTI-based regimen (p = 0.001) and lower body weight (p = 0.008). Plasma 25-(OH)D concentrations decreased significantly in both nevirapine and efavirenz-containing regimens but not in PI-treated patients.</p> <p>Conclusions</p> <p>Vitamin D deficiency is frequent in HIV-positive individuals and NNRTI therapy further decreases 25-(OH)D concentrations. Consequently, vitamin D status need to be checked regularly in all HIV-infected patients and vitamin D supplementation should be given when needed.</p

Is vitamin D deficiency involved in the immune reconstitution inflammatory syndrome?

<p>Abstract</p> <p>Background</p> <p>About 20–30% of persons with HIV infection, especially those living in countries with limited resources, experience an immune reconstitution inflammatory syndrome (IRIS) after starting antiretroviral treatment. The active form of vitamin D, 1,25-dihydroxyvitamin D, is a key player in the clearance of pathogens and influences the level of inflammation and macrophage activation.</p> <p>Presentation of the hypothesis</p> <p>We hypothesize that low availability of 1,25-dihydroxyvitamin D, either due to vitamin D deficiency or due to polymorphisms in the vitamin D receptor or in its activating/inactivating enzymes, contributes to the appearance of IRIS. Furthermore, drug interactions with the enzymatic pathways of vitamin D could favour the development of IRIS.</p> <p>Testing the hypothesis</p> <p>Our hypothesis could be explored by a case-control study to assess the prevalence of vitamin D deficiency in HIV-infected patients on antiretroviral treatment who develop and do not develop IRIS.</p> <p>Implications of the hypothesis</p> <p>If the role of vitamin D in IRIS is confirmed, we would be able to screen patients at risk for IRIS by screening for vitamin D deficiency. After confirmation by means of a clinical trial, vitamin D supplementation could be a cheap and safe way to reduce the incidence of IRIS.</p

Ritmos circadianos de sueño y rendimiento académico en estudiantes de medicina

Objective: to evaluate, with a preliminary study, the distribution of circadian rhythms, sleep schedule patterns and their relationship with academic performance on medical students. Methodology: in this descriptive study, a 10 item original questionnaire about sleep rhythms and academic performance was applied to medical students from different semesters. Week (class time) and weekend schedules, preferences, daytime somnolence and academic performance were asked. Three chronotypes (morningness, intermediate and eveningness) were defined among waking-sleeping preference, difficulty to sleep early, exam preparation preference hour and real sleep schedule. The sleep hour deficit per week night was also calculated. Results: Of the 318 medical students that answered the questionnaire, 62.6% corresponded to intermediate chronotypes, 8.8% to evening-type and 28.7% to morning-type. Significant difference was found among the two chronotype tails (p=0.000, Chi-square 31.13). No correlation was found between academic performance and age, sex, chronotype, week sleep deficit and sleep hours in week and weekends. A 71.1% of the students slept 6 or fewer hours during class time and 78% had a sleep deficit (more frequent in the evening chronotype). Conclusions: No relation was found between sleep chronotype and academic performance. Students tend to morningness. Few studies have been made on equatorial zones or without seasonsObjetivo: hacer un estudio preliminar de la distribución de los ritmos circadianos, los patrones horarios de sueño y su relación con el desempeño académico de estudiantes de medicina. Metodología: estudio descriptivo con aplicación de encuesta original de 10 ítems sobre ritmos de sueño y rendimiento académico a estudiantes de medicina de varios semestres. Se indagó sobre las preferencias y horarios de sueño en fines de semana y entre semana, la somnolencia diurna y el rendimiento académico. Según la preferencia para acostarse y levantarse, la dificultad para dormirse temprano, la preferencia horaria para preparar exámenes y el horario real de sueño, se definieron tres cronotipos (madrugador, intermedio y vespertino). También se calculó el déficit de horas de sueño por noche entre semana. Resultados: de los 318 estudiantes de medicina que respondieron la encuesta, el 62.6 % correspondió al cronotipo intermedio, el 8.8 % al vespertino y el 28.7 % al matutino. La diferencia entre los dos extremos fue estadísticamente significativa, ji-cuadrado 31.13, p=0.000. No se encontró correlación entre el rendimiento académico con edad, sexo, cronotipos, déficit de sueño entre semana y número de horas de sueño entre semana y en fines de semana. El 71.1 % de los estudiantes duerme 6 horas o menos entre semana y un 78 % presenta déficit de sueño que es mayor en los vespertinos. Conclusiones: No se encontró relación entre cronotipo de sueño y rendimiento académico. Los estudiantes tienden a una preferencia matutina. Son pocos los estudios realizados en zonas ecuatoriales o sin estaciones

Los problemas y desafíos estructurales de la educación superior en el Chile neoliberal

The objective of this article is to suggest a critical view of the Chilean higher education system through the analysis of aspects that form its structural framework. First, the regulatory landmark and the State role focus on the legislation that regulates the system, since the implementation of the Constitutional Teaching Law (LOCE) in the last dictatorship, and the State role regarding this topic. Second, the Institutionality and management basis refers to the organization of the field and its different types of institutions. Third, Access and retention considers certain aspects of admission to higher education and retention rates, considering the characteristics of the access and the kind of educational institutions where the students enroll. Last, the Funding system reviews how the private resources form the main income to the system, driven by a demand-based funding logic. Finally, some conclusions and projections are outlined.El presente artículo tiene como objetivo realizar una mirada crítica al sistema de educación superior chileno, a través del análisis de lo que, a juicio de los autores, son los pilares estructurales de éste sistema. En primer lugar, el Marco regulatorio y el rol del Estado pone atención en las leyes que regulan el sistema, desde la LOCE implementada en la última dictadura, y el papel que el Estado cumple respecto a este tema. En segundo lugar, el pilar de Institucionalidad y administración se refiere a la organización del sector y sus distintos tipos de instituciones. En tercer lugar, el Acceso y permanencia observa ciertos aspectos del ingreso a la educación superior y tasas de retención, teniendo en cuenta cómo se da éste acceso y a qué tipo de institución. El último es el Financiamiento, que revisa cómo es el aporte privado el principal ingreso de fondos para el sistema, bajo una lógica de financiamiento a la demanda. Finalmente, se trazan algunas conclusiones y proyecciones

Association of Nuclear Factor-Erythroid 2-Related Factor 2, Thioredoxin Interacting Protein, and Heme Oxygenase-1 Gene Polymorphisms with Diabetes and Obesity in Mexican Patients

The nuclear factor-erythroid 2- (NF-E2-) related factor 2 (Nrf2) is abated and its ability to reduce oxidative stress is impaired in type 2 diabetes and obesity. Thus, the aim of this study was to explore if polymorphisms in Nrf2 and target genes are associated with diabetes and obesity in Mexican mestizo subjects. The rs1800566 of NAD(P)H:quinone oxidoreductase 1 (NQO1) gene, rs7211 of thioredoxin interacting protein (TXNIP) gene, rs2071749 of heme oxygenase-1 (HMOX1) gene, and the rs6721961 and the rs2364723 from Nrf2 gene were genotyped in 627 diabetic subjects and 1020 controls. The results showed that the rs7211 polymorphism is a protective factor against obesity in nondiabetic subjects (CC + CT versus TT, OR = 0.40, P=0.005) and in women (CC versus CT + TT, OR = 0.7, P=0.016). TT carriers had lower high-density lipoprotein cholesterol levels and lower body mass index. The rs2071749 was positively associated with obesity (AA versus AG + GG, OR = 1.25, P=0.026). Finally, the rs6721961 was negatively associated with diabetes in men (CC versus CA + AA, OR = 0.62, P=0.003). AA carriers showed lower glucose concentrations. No association was found for rs1800566 and rs2364723 polymorphisms. In conclusion, the presence of Nrf2 and related genes polymorphisms are associated with diabetes and obesity in Mexican patients

Steric, Activation Method and Solvent Effects on the Structure of Paddlewheel Diruthenium Complexes

Conventional heating and solvothermal synthetic methods (with or without microwave activation) have been used to study the reaction of o-, m- and p-methoxybenzoic acid with [Ru2Cl(μ-O2CMe)4]. The tetrasubstituted series [Ru2Cl(µ-O2CC6H4-R)4], with R = o-OMe, m-OMe and p-OMe, has been prepared by the three procedures. Depending on the synthetic method and the experimental conditions, three compounds have been isolated (1a, 1b, 1c) with the o-methoxybenzoate ligand. However, with the m- and p-methoxybenzoate ligands, only the complexes 2 and 3 have been obtained, respectively. Compound 1a, with stoichiometry [Ru2Cl(µ-O2CC6H4-o-OMe)4]n, shows a polymeric structure with the chloride ions bridging the diruthenium units to form linear chains. Compounds 2 and 3, with the same stoichiometry, predictably form zig-zag chains in accordance with their insolubility and their magnetic measurements. Compound 1b, [Ru2Cl(µ-O2CC6H4-o-OMe)4(EtOH)], is a discrete molecular species with a chloride ion and one ethanol molecule occupying the axial positions of the dimetallic unit. Compound 1c is a cation-anion complex, [Ru2(µ-O2CC6H4-o-OMe)4(MeOH)2][Ru2Cl2(µ-O2CC6H4-o-OMe)4]. The cationic complex has two solvent molecules at the axial positions whereas the anionic complex has two chloride ligands at these positions. Complexes have been characterized by elemental analyses, mass spectrometry and IR and UV-vis-NIR spectroscopies. A magnetic study of complexes 1a, 1b, 2 and 3 have also been carried out. The crystal structure of compounds 1b and 1c have been solved by single X-ray crystal methods

Un estado de la cuestión de la formación de Doctores en Comunicación en Latinoamérica

A casi cuatro décadas de haberse implementado los primeros posgrados en Comunicación en Latinoamérica, este artículo propone un estado de la cuestión actualizado, particularmente de la situación de los Doctorados en Comunicación, pensando no sólo en un aporte a la documentación y registro de los esfuerzos que se llevan a cabo desde la región para impulsar la formación doctoral en el área de la Comunicación, sino también en aportar a la construcción de una futura y necesaria reflexión en torno a la posible huella o el impacto, en términos de agendas de investigación, vinculación con el campo, producción académica y científica de estos nuevos cuadros de investigadores.It has been nearly four decades since the first graduate program in Communication in Latin America was born. This article proposes a current state of the art, particularly on the situation of the doctor degree in Communication in Latin American universities, thinking not only on a contribution to the documentation of the efforts carried out from the region to boost doctoral studies in this field, but also the contribution to the future and necessary reflection on the impact in terms of research agendas, liaison to the field, and the academic and scientific production of new research teams.Facultad de Periodismo y Comunicación Socia