Health goals in Uruguay: results of “Good Feeding Practices”

Marisa Buglioli: Departamento de Medicina Preventiva, Facultad de Medicina, Universidad de la República, Uruguay.-- Cecilia Severi: Departamento de Medicina Preventiva, Facultad de Medicina, Universidad de la República, Uruguay.-- Ima León: Departamento de Medicina Preventiva, Facultad de Medicina, Universidad de la República, Uruguay.-- Cecilia Cárpena: Ministerio de Salud Pública, Uruguay.-- Noemí Katzkowicz: Ministerio de Salud Pública, Uruguay.-- Javier Lasida: Universidad Católica del Uruguay. Contacto: Cecilia Severi. Dirección: Instituto de Higiene, Alfredo Navarro 3851. Tel./fax. 598 2 4801867. E-mail: [email protected] reforma de la salud, incluye pagar por el cumplimiento de metas asistenciales. En 1996 se implementó un programa de mejora de la calidad, la acreditación de servicios de salud en Buenas Prácticas de Alimentación (BPA), que en 2009 el Ministerio de Salud Pública lo incorporó como meta. El objetivo de este trabajo fue estudiar los resultados de las BPA. Se realizó un análisis secundario de los datos de encuestas aplicadas por Unicef sobre una muestra representativa de la población. Se procesaron las tasas de lactancia exclusiva al sexto mes sobre las bases de los años 1996, 1999, 2003, 2007 y 2011. Se calculó la evolución de las tasas por acreditación de los prestadores de salud, tipo de prestador y región. Posteriormente se aplicó un modelo binario probit, para medir los factores asociados al resultado de lactancia. Los resultados muestran un incremento en la lactancia en los servicios que aplican BPA en todo el período (37% a 67%). La regresión probit muestra a la acreditación en BPA como la variable que mayormente incrementa la probabilidad de lactancia exclusiva al 6 mes, llegando a un 17% con un desvío estándar de alrededor 2% (p<0.05). La diferencia de lactancia materna entre 2007 y 2011, es de 10 puntos (57 Y 67% respectivamente). Los resultados de las BPA han sido satisfactorios y la acreditación parece ser una herramienta que mejora la lactancia.The health reform included a payment for assistance goals. In 1996, began a quality improvement program, Accreditation of health providers in Good feeding Practices (BPA), which in 2009 was included as a heath goal by the Ministry of Health. The objective of this study was to study results of BPA .A secondary analysis of surveys data applied by Unicef was done over a representative sample of the population adjusted by age, type of health provider and region. It were processed exclusive breast feeding rates at 6 month over 1996, 1999, 2003, 2007 and 2011 data bases. It was calculated the evolution of these rates by accreditation of health providers, type of provider (public/private) and geographic region. Later, a binary probit model was applied to measure the variables associated to the results of breastfeeding. Exclusive breast feeding increased in health providers which applied BPA all over the period (37% to 67%). Probit regression showed that accreditation in BPA was the variable which most increased the probability of exclusive breast feeding (17%, SD 2% and p<0.05). Breast feeding rate in 2007 (inclusion of BPA as health goal) differs 10 points with that of 2011 (57% and 67% respectively). Results of BPA were good and the strategy of accreditation seems to be an effective tool to improve exclusive breast feeding at 6 months old. The inclusion of BPA as a health goal had capitalized and enhanced a previous experience

Salud, nutrición y desarrollo en la primera infancia en Uruguay : primeros resultados de la ENDIS

Estudio de los resultados de la Primera Encuesta Nacional de Salud, Nutrición y Desarrollo Infantil, primera de esta índole que se realiza en Uruguay.Resumen ejecutivo -- Prólogo, por Marina Arismendi y Cristina Lustemberg -- I. INTRODUCCIÓN -- II. DETERMINANTES DE LOS DESEMPEÑOS EN LA PRIMERA INFANCIA -- II.1. Crecimiento y nutrición -- II.2. Salud -- II.3. Desarrollo infantil -- III. FUENTES DE DATOS Y METODOLOGÍA -- III.1. Marco muestral y características de la encuesta -- III.2. Instrumentos de medición del desarrollo infantil -- III.3. Evaluación de la situación nutricional de los niños -- IV. PRINCIPALES RESULTADOS -- IV.1. Caracterización general de los hogares -- IV.2. Caracterización general de las madres -- IV.3. Cuidados, prácticas de crianza y asistencia a centros de educación preescolar -- IV.4. Salud infantil -- IV.5. Evaluación del desarrollo infantil -- IV.6. Acceso a programas públicos -- V. COMENTARIOS FINALES -- VI. REFERENCIAS BIBLIOGRÁFICAS -- VII. ANEXO I. Análisis y calibración de la muestra de ucc -- Presentación de los datos usados -- Referencias bibliográficas -- VIII. ANEXO II. Cuadros y gráficos adicionales -- IX. ANEXO III. Algunas consideraciones sobre los instrumentos de tamizaje utilizados en la endis, alcance de los resultados obtenidos y potencia de los dato

Identification of 12 new susceptibility loci for different histotypes of epithelial ovarian cancer.

To identify common alleles associated with different histotypes of epithelial ovarian cancer (EOC), we pooled data from multiple genome-wide genotyping projects totaling 25,509 EOC cases and 40,941 controls. We identified nine new susceptibility loci for different EOC histotypes: six for serous EOC histotypes (3q28, 4q32.3, 8q21.11, 10q24.33, 18q11.2 and 22q12.1), two for mucinous EOC (3q22.3 and 9q31.1) and one for endometrioid EOC (5q12.3). We then performed meta-analysis on the results for high-grade serous ovarian cancer with the results from analysis of 31,448 BRCA1 and BRCA2 mutation carriers, including 3,887 mutation carriers with EOC. This identified three additional susceptibility loci at 2q13, 8q24.1 and 12q24.31. Integrated analyses of genes and regulatory biofeatures at each locus predicted candidate susceptibility genes, including OBFC1, a new candidate susceptibility gene for low-grade and borderline serous EOC

Colorectal Cancer Stage at Diagnosis Before vs During the COVID-19 Pandemic in Italy

IMPORTANCE Delays in screening programs and the reluctance of patients to seek medical attention because of the outbreak of SARS-CoV-2 could be associated with the risk of more advanced colorectal cancers at diagnosis. OBJECTIVE To evaluate whether the SARS-CoV-2 pandemic was associated with more advanced oncologic stage and change in clinical presentation for patients with colorectal cancer. DESIGN, SETTING, AND PARTICIPANTS This retrospective, multicenter cohort study included all 17 938 adult patients who underwent surgery for colorectal cancer from March 1, 2020, to December 31, 2021 (pandemic period), and from January 1, 2018, to February 29, 2020 (prepandemic period), in 81 participating centers in Italy, including tertiary centers and community hospitals. Follow-up was 30 days from surgery. EXPOSURES Any type of surgical procedure for colorectal cancer, including explorative surgery, palliative procedures, and atypical or segmental resections. MAIN OUTCOMES AND MEASURES The primary outcome was advanced stage of colorectal cancer at diagnosis. Secondary outcomes were distant metastasis, T4 stage, aggressive biology (defined as cancer with at least 1 of the following characteristics: signet ring cells, mucinous tumor, budding, lymphovascular invasion, perineural invasion, and lymphangitis), stenotic lesion, emergency surgery, and palliative surgery. The independent association between the pandemic period and the outcomes was assessed using multivariate random-effects logistic regression, with hospital as the cluster variable. RESULTS A total of 17 938 patients (10 007 men [55.8%]; mean [SD] age, 70.6 [12.2] years) underwent surgery for colorectal cancer: 7796 (43.5%) during the pandemic period and 10 142 (56.5%) during the prepandemic period. Logistic regression indicated that the pandemic period was significantly associated with an increased rate of advanced-stage colorectal cancer (odds ratio [OR], 1.07; 95%CI, 1.01-1.13; P = .03), aggressive biology (OR, 1.32; 95%CI, 1.15-1.53; P &lt; .001), and stenotic lesions (OR, 1.15; 95%CI, 1.01-1.31; P = .03). CONCLUSIONS AND RELEVANCE This cohort study suggests a significant association between the SARS-CoV-2 pandemic and the risk of a more advanced oncologic stage at diagnosis among patients undergoing surgery for colorectal cancer and might indicate a potential reduction of survival for these patients

From food waste to sustainable fashion: the reaction of the consumer to a new circular economy perspective

The paper aims to analyze the circular economy and, in particular, the possibilities to reuse food Organization, approximately one-third of all the food produced in the world becomes waste. The reduction of waste in the agri-food industry is one important goal. Finding innovative ways to use food waste for productive use, improves, on one side, sustainable development and, on the other side, creates new business models. The generation of waste can take place in every phase of the value chain, such as production, processing, distribution, food services, and finally domestic the second-largest polluter in the world, just after the oil industry. To mitigate this problem the fashion industry is developing new solutions to change the image of a polluting industry to a regenerative industry. A circular business model can give a new life and a new value to what was previously considered a mere waste and cost, contributing to the reduction of waste generation. To understand the reaction of the consumer, a survey with fifteen questions was conducted and we had 266 participants. The questions are divided into three categories. The first category of questions is age-related (such as age, nationality, work, etc.)- The second category is based on purchasing behavior and on consumer habits. The last part of the survey is more focused on the re -use of food waste in the fashion sector. We analyzed the consumer awareness of the existence of the problems of the reduction of waste and we understood that there is still a long way to go to raise awareness and inform the final consumer. The over 55s are more focused on environmental problems at the time of a purchase than Generation Z, however, generation Z is declared to be the age group most informed about the existence of fabrics that reuse food waste. These data go against the trend

Circular economy for sustainable fashion: From food to fashion,

The aim of the paper is to analyse an increasingly problem connected with the generation of waste created along the entire food industry chain and transform it in an opportunity. The reuse of this waste to produce fashion items it gives new life to the waste itself. This is the principle of the circular economy. In order to be competitive companies are today facing the needs to change the entire production model by trying to extract the maximum value that each resource has at its disposal, avoiding the creation of waste. The shift from the linear model to the circular one needs social and economic instruments that regulate its functioning as well as the sensitization of the entire social system. The transition to this circular model has become of fundamental importance and one can no longer afford to procrastinate. In the research particular attention is paid on the possibilities of recovering by-products, through the analysis of 5 best practices: Orange Fiber, Duedilatte, Vegea, Pi\uf1atex and S. Caf\ue9. The paper investigates the companies\u2019 business models adopted in order to transform what is considered waste and a mere cost into a new resource with a new value and the application of the Social Development Goals (SDGs). Two research questions have been investigated: - Can the use of food waste in fashion industry reduce the impact of the polluting? - What SDGs follow the companies of the fashion circular economy? Food and fashion, apparently so far apart, are today collaborating more and more in creating new value, while at the same time helping our planet to reach sustainable long-lasting goals by promoting, at the same time, a fundamental shift from traditional fashion to sustainable fashion able to apply the principles of reduce, reuse and recycle for offering to consumers new opportunities for a sustainable approach to fashion demand

Cambios en el índice de masa corporal en adolescentes y adultas entre el embarazo y el posparto BMI changes in adolescents and adults women between pregnancy and pospartum

Los objetivos fueron evaluar las consecuencias del embarazo en el IMC de las adolescentes en comparación con adultas e identificar los factores que aumentan el riesgo de un IMC bajo en el posparto. Se estudiaron 742 adolescentes (13 a 19 años) y 779 adultas (25 a 34 años) de Guatemala, República Dominicana y Uruguay. Se midieron variables demográficas, sociales, obstétricas, ganancia de peso e IMC antes de las 14 semanas de gestación y a los 4 ± 1 mes posparto. El IMC en adultas se clasificó según la OMS y en adolescentes según NCHS/OMS. Por análisis logístico uni y multivariado se estimó el riesgo de un IMC bajo en el posparto. Al inicio se observó mayor prevalencia de bajo peso en adolescentes y de sobrepeso y obesidad en adultas (p Te aim of the study was to evaluate pregnancy nutritional consequences in adolescent pregnant women and to identify factors which increase risk of an adverse postpartum nutritional result. We conducted a prospective cohort study in 742 adolescent and 779 adult pregnant women in Guatemala, Dominican Republic and Uruguay, assessing demographic, social, obstetric, weight gain and BMI at first prenatal control, and 4 + 1 month post partum. BMI in adults was classified according to WHO recommendations and NCHS/WHO in adolescents. We assessed changes of BMI between the beginning and postpartum time and a logistic model analysis was applied about the risk of having low BMI at postpartum time. At the beginning of pregnancy the prevalence of low weight was higher in adolescent group and the overweight and obesity higher in adults (p< 0.001). Weight gain was significantly higher in adolescents at same nutritional BMI, except for low weighted. Adolescents had a significant change in their BMI at postpartum time, showing a tendency to increase weight and a higher prevalence of overweight and obesity (p< 0.001). Higher risk of low BMI in postpartum was associated with low prenatal BMI (OR 25,6, CI 12,6 - 52), adolescence (OR 3,3 CI 1,6 - 6,6) and gestational weight gain < 300 g. per week (OR 1,4 CI 1,1 - 3,9). In conclusion adolescent nutritional status was not damaged after pregnancy. The strongest variable associated with postpartum low BMI was BMI which mothers begin pregnancy as equal of adult mothers

Health goals in Uruguay: results of “Good Feeding Practices”.

La reforma de la salud, incluye pagar por el cumplimiento de metas asistenciales. En 1996 se implementó un programa de mejora de la calidad, la Acreditación de servicios de salud en Buenas Prácticas de Alimentación (BPA), que en 2009 el Ministerio de Salud Pública lo incorporó como meta. El objetivo de este trabajo fue estudiar los resultados de las BPA. Se realizó un análisis secundario de los datos de encuestas aplicadas por UNICEF sobre una muestra representativa de la población. Se procesaron las tasas de lactancia exclusiva al sexto mes sobre las bases de los años 1996, 1999, 2003, 2007 y 2011. Se calculó la evolución de las tasas por acreditación de los prestadores de salud, tipo de prestador y región. Posteriormente se aplicó un modelo binario probit, para medir los factores asociados al resultado de lactancia. Los resultados muestran un incremento en la lactancia en los servicios que aplican BPA en todo el período (37% a 67%). La regresión probit muestra a la acreditación en BPA como la variable que mayormente incrementa la probabilidad de lactancia exclusiva al 6 mes, llegando a un 17% con un desvío estándar de alrededor 2% (p<0.05). La diferencia de lactancia materna entre 2007 y 2011, es de 10 puntos (57 Y 67% respectivamente). Los resultados de las BPA han sido satisfactorios y la acreditación parece ser una herramienta que mejora la lactancia

Study of Food Intake and Physical Activity Patterns in the Working Population of the Uruguayan State Electrical Company (UTE): Design, Protocol and Methodology

Noncommunicable diseases are the main cause of death globally, and most are potentially preventable; they are long term diseases and generally evolve slowly. In Uruguay 64.9% of the population between 25 and 64 years of age are either overweight or obese. The available scientific data show that workplaces are good for developing food-intake interventions for a healthier life. The present study aims to report the design, protocol and methodology for the evaluation of the food intake and physical activity patterns of the Uruguayan State Electrical Company (UTE) workers, as it is distributed across the whole country, and has established associations with overweight and obesity in order to establish institutional strategies to improve the situation. This study uses a population and a cross-sectional, randomized, representative sample of UTE workers with a precision of 3% and a confidence level of 95%. The considered anthropometric variables are weight, height, waist circumference, percentage of fat mass and percentage of visceral fat. A questionnaire on frequency of consumption of different foods and two 24-h dietary recalls (24-h DR) will be performed to evaluate the food intake. Accelerometry will be used to evaluate physical activity, and the International physical activity questionnaire (IPAQ) will be applied. Clinical data will be obtained from the UTE clinical charts. This is the first study of its kind that will be undertaken in Uruguay. It is registered under ClinicalTrials.gov Identifier nº NCT04509908.UT

Cambios en el índice de masa corporal en adolescentes y adultas entre el embarazo y el posparto

Los objetivos fueron evaluar las consecuencias del embarazo en el IMC de las adolescentes en comparación con adultas e identificar los factores que aumentan el riesgo de un IMC bajo en el posparto. Se estudiaron 742 adolescentes (13 a 19 años) y 779 adultas (25 a 34 años) de Guatemala, República Dominicana y Uruguay. Se midieron variables demográficas, sociales, obstétricas, ganancia de peso e IMC antes de las 14 semanas de gestación y a los 4 ± 1 mes posparto. El IMC en adultas se clasificó según la OMS y en adolescentes según NCHS/OMS. Por análisis logístico uni y multivariado se estimó el riesgo de un IMC bajo en el posparto. Al inicio se observó mayor prevalencia de bajo peso en adolescentes y de sobrepeso y obesidad en adultas (p < 0,001). El incremento de peso en la gestación fue mayor en las adolescentes (p < 0,01). Hubo cambios significativos en el IMC posparto de las adolescentes, con aumento del sobrepeso y obesidad (p < 0,001). Las variables que más se asociaron con bajo IMC en el posparto fueron el IMC bajo al inicio del embarazo (OR 25,6 IC 12,6 - 52), la adolescencia (OR 3,5 IC 1,7 - 7,1) y una ganancia de peso < a 300 g. semanales (OR 2,2 IC 1,1 - 4,1). En conclusión no se observó deterioro del estado nutricional de las adolescentes luego de la gestación y la variable que más se asoció con bajo IMC post parto fue el IMC con que la madre inició el embarazo