Olea A.,University for Development |
Matute I.,University for Development |
Gonzalez C.,University for Development |
Delgado I.,University for Development |
And 13 more authors.
Emerging Infectious Diseases | Year: 2017
An outbreak of meningococcal disease with a case-fatality rate of 30% and caused by predominantly serogroup W of Neisseria meningitidis began in Chile in 2012. This outbreak required a case–control study to assess determinants and risk factors for infection. We identified confirmed cases during January 2012−March 2013 and selected controls by random sampling of the population, matched for age and sex, resulting in 135 case-patients and 618 controls. So-ciodemographic variables, habits, and previous illnesses were studied. Analyses yielded adjusted odds ratios as estimators of the probability of disease development. Results indicated that conditions of social vulnerability, such as low income and overcrowding, as well as familial history of this disease and clinical histories, especially chronic diseases and hospitalization for respiratory conditions, increased the probability of illness. Findings should contribute to direction of intersectoral public policies toward a highly vulnerable social group to enable them to improve their living conditions and health. © 2017, Centers for Disease Control and Prevention (CDC). All rights reserved.
Mundt A.P.,Queen Mary, University of London |
Mundt A.P.,University of Chile |
Mundt A.P.,San Sebastián University |
Chow W.S.,Queen Mary, University of London |
And 11 more authors.
JAMA Psychiatry | Year: 2015
IMPORTANCE In 1939, English mathematician, geneticist, and psychiatrist Lionel Sharples Penrose hypothesized that the numbers of psychiatric hospital beds and the sizes of prison populations were inversely related; 75 years later, the question arises as to whether the hypothesis applies to recent developments in South America. OBJECTIVE To explore the possible association of changes in the numbers of psychiatric hospital beds with changes in the sizes of prison populations in South America since 1990. DESIGN, SETTING, AND PARTICIPANTS We searched primary sources for the numbers of psychiatric hospital beds in South American countries since 1990 (the year that the Latin American countries signed the Caracas Declaration) and compared these changes against the sizes of prison populations. The associations between the numbers of psychiatric beds and the sizes of prison populations were tested using fixed-effects regression of panel data. Economic variables were considered as covariates. Sufficiently reliable and complete data were obtained from 6 countries: Argentina, Bolivia, Brazil, Chile, Paraguay, and Uruguay. MAIN OUTCOMES AND MEASURES The numbers of psychiatric beds and the sizes of prison populations. RESULTS Since 1990, the numbers of psychiatric beds decreased in all 6 countries (ranging from -2.0% to -71.9%), while the sizes of prison populations increased substantially (ranging from 16.1%to 273.0%). Panel data regression analysis across the 6 countries showed a significant inverse relationship between numbers of psychiatric beds and sizes of prison populations. On average, the removal of 1 bed was associated with 5.18 more prisoners (95% CI, 3.10-7.26; P = .001), which was reduced to 2.78 prisoners (95%CI, 2.59-2.97; P < .001) when economic growth was considered as a covariate. The association between the numbers of psychiatric beds and the sizes of prison populations remained practically unchanged when income inequality was considered as a covariate (-4.28 [95%CI, -5.21 to -3.36]; P < .001). CONCLUSIONS AND RELEVANCE Since 1990, the numbers of psychiatric beds have substantially decreased in South America, while the sizes of the prison populations have increased against a background of strong economic growth. The changes appear to be associated because the numbers of beds decreased more extensively when and where the sizes of prison populations increased. These findings are consistent with and specify the assumption of an association between the numbers of psychiatric beds and the sizes of prison populations. More research is needed to understand the drivers of the capacities of psychiatric hospitals and prisons and to explore reasons for their association.
Bendtsen L.,Copenhagen University |
Munksgaard S.B.,Copenhagen University |
Tassorelli C.,University of Pavia |
Nappi G.,University of Pavia |
And 7 more authors.
Cephalalgia | Year: 2014
Objective: The objective of this article is to investigate whether headache-related disability, depression and anxiety can be reduced by detoxification and prophylactic treatment in patients with medication-overuse headache (MOH). Methods: Patients with MOH were included from six centres in Europe and Latin America in a seven-month cohort study. Before and six months after treatment, the degree of disability was measured by the Migraine Disability Assessment (MIDAS) questionnaire, while anxiety and depression were measured by the Hospital Anxiety and Depression Scale (HADS). Results: A total of 694 patients with MOH were included, of whom 492 completed the study. Headache days were reduced by 58.4% from 23.6 to 9.8 days per month at six months (p<0.001). The MIDAS score was reduced by 57.1% from baseline 59.9 to 25.7 (p<0.001). Number of patients with depression was reduced by 50.7% from 195 to 96 and number of those with anxiety was reduced by 27.1% from 284 to 207 (both p<0.001). Conclusions: Disability, depression and anxiety were considerably reduced in patients with MOH by detoxification and prophylactic treatment. This emphasises the urgent need for increased awareness about avoiding overuse of headache medications and demonstrates that not only headache frequency but also disability are remarkably improved by adequate intervention. © 2013 International Headache Society.
Inequalities in the distribution of cardiovascular disease risk factors in argentina. A study from the 2005, 2009 and 2013 national risk factor survey (NRFS) [Desigualdades en la distribución de factores de riesgo en enfermedades cardiovasculares en la Argentina. Un estudio a partir de la Encuesta Nacional de Factores de Riesgo (ENFR) de 2005, 2009 y 2013]
Ferrante D.,Ministry of Health of the Autonomous City of Buenos Aires |
Jorgensen N.,ISALUD University |
Langsam M.,ISALUD University |
Marchioni C.,National University of La Plata |
And 2 more authors.
Revista Argentina de Cardiologia | Year: 2016
Background: Cardiovascular health inequalities have been documented in the literature in both developed and undeveloped countries and there is an inverse association between the incidence and mortality for specific cause of cardiovascular disease and levels of income, education and employment. Objective: The aim of this study was to identify the existence of inequalities in the prevalence of risk factors by socioeconomic status in Argentina. Methods: Data from the 2005, 2009 and 2013 National Risk Factor Surveys (NRFS) were analyzed. The prevalence of obesity, smoking, hypertension and cholesterol were studied. Differences for each risk factor were estimated in relation to socioeconomic status (measured by education, income and health coverage). The independent association between socioeconomic status and risk factors was assessed using logistic regression models. Results: Educational level was inversely associated with the prevalence of obesity (p<0.01), hypercholesterolemia (p<0.01), hypertension (p<0.01) and smoking (p<0.05) and the effect varied by gender and age group. Income level was significantly and inversely associated with the prevalence of hypertension (p<0.01). The temporal evolution of inequalities indicates there was no attenuation between surveys and, on the contrary, it showed an increase in smoking gaps. Conclusions: Deep inequalities were recorded in the distribution of cardiovascular risk factors by educational level. Groups with high burden of risk factors are vulnerable populations upon which preventive policies should be targeted. © 2016, Sociedad Argentina de Cardiologia. All rights reserved.
Tassorelli C.,University of Pavia |
Jensen R.,Copenhagen University |
Allena M.,University of Pavia |
De Icco R.,University of Pavia |
And 8 more authors.
Cephalalgia | Year: 2014
Introduction: The management of medication-overuse headache (MOH) is often difficult and no specific guidelines are available as regards the most practical and effective approaches. In this study we defined and tested a consensus protocol for the management of MOH on a large population of patients distributed in different countries. Subjects and methods: The protocol was based on evidence from the literature and on consolidated expertise of the members of the consensus group. The study was conducted according to a multicentric interventional design with the enrolment of 376 MOH subjects in four centres from Europe and two centres in Latin America. The majority of patients were treated according to an outpatient detoxification programme. The post-detoxification follow-up lasted six months. Results: At the final evaluation, two-thirds of the subjects were no longer overusers and in 46.5% of subjects headache had reverted back to an episodic pattern of headache. When comparing the subjects who underwent out-patient detoxification vs those treated with in-patient detoxification, both regimens proved effective, although the drop-out rate was higher in the out-patient approach. Conclusions: The present findings support the effectiveness and usability of the proposed consensus protocol in different countries with different health care modalities. © International Headache Society 2014.
PubMed | Bioengeneering and Medical Informatics Consortium CBIM, University of Chile, Copenhagen University, Foundation for Combating Neurological Diseases of Childhood and 5 more.
Type: Journal Article | Journal: Cephalalgia : an international journal of headache | Year: 2014
The management of medication-overuse headache (MOH) is often difficult and no specific guidelines are available as regards the most practical and effective approaches. In this study we defined and tested a consensus protocol for the management of MOH on a large population of patients distributed in different countries.The protocol was based on evidence from the literature and on consolidated expertise of the members of the consensus group. The study was conducted according to a multicentric interventional design with the enrolment of 376 MOH subjects in four centres from Europe and two centres in Latin America. The majority of patients were treated according to an outpatient detoxification programme. The post-detoxification follow-up lasted six months.At the final evaluation, two-thirds of the subjects were no longer overusers and in 46.5% of subjects headache had reverted back to an episodic pattern of headache. When comparing the subjects who underwent out-patient detoxification vs those treated with in-patient detoxification, both regimens proved effective, although the drop-out rate was higher in the out-patient approach.The present findings support the effectiveness and usability of the proposed consensus protocol in different countries with different health care modalities.
Meresman S.,Latin American Center for Human Economy |
Rice M.,Pan American Health Organization PAHO WHO |
Vizzotti C.,ISALUD University |
Frassia R.,ISALUD University |
And 2 more authors.
Journal of Urban Health | Year: 2010
This article presents the results of the 1st Regional Survey of Healthy Municipalities, Cities and Communities (HM&C) carried out in 2008 by the Pan American Health Organization (PAHO) and ISALUD University of Argentina. It discusses the responses obtained from 12 countries in the Americas Region. Key informants in Argentina, Brazil, Chile, Colombia, Costa Rica, Cuba, Mexico, Paraguay, Peru, and Uruguay were selected and encouraged to answer the survey, while informants from Canada and Honduras answered voluntarily and were included in this analysis. The discussion of the results of the Survey provides insight into the current status of HM&C in the Region and suggests key topics for repositioning the Regional strategy relative to: (1) the conceptual identity and tools for HM&C; (2) challenging areas in the implementation process (scale, legal framework, and development of capacities); (3) related strategies and participatory processes such as the ways citizen empowerment in governance is supported; (4) the need to monitor and assess the impact of the HM&C strategy on the health and quality of life of the populations involved; and (5) the need for developing a strategic research and training agenda. The analysis and discussion of these results aims to provide useful input for repositioning the strategy in the Region and contributing to the emergence of a second generation of concepts and tools capable of meeting the developing priorities and needs currently faced by the HM&C strategy. © 2010 The New York Academy of Medicine.
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