Latin America

拉丁美洲
  • 文章类型: Journal Article
    覆盖厌氧泻湖(CAL)是拉丁美洲主要的牲畜废物处理系统。墨西哥有680个CAL,其沼气产量低(0.05m3m-3消化器d-1)和COD去除率低(<60%)。这项工作的重点是通过确定和分析操作参数来诊断CAL在奶牛场中的低性能。分析了位于墨西哥主要乳品盆地的七个CAL。每个CAL的采样面积是上清液,活跃区,沉降污泥,和消化器入口和出口。过程参数值的变化证实了CAL出现分层且未按预期工作。污泥区,包含50-58%的总固体含量和1-15%的总CAL体积,显示出适合有机肥料的元素化合物含量(340、48和5kgt-1的C,N,S,分别)。然而,这个区域包含,至少,可缓慢水解的材料的85%;产甲烷潜力小于87mLCH4gVS-1,C/N比范围为4.9至17,超出了最佳范围。产生的沼气不超过60%的甲烷含量和超过3000ppm的H2S。污泥区显着影响泻湖的动态,因为它是一个营养池。此外,缺乏搅拌是导致能量产量低和有机物去除率低的主要原因。这项工作提供了有价值的信息,以解决CAL中的操作问题,从而提高了我们的理解,从而可以提出重新激活的替代方案。
    Covered anaerobic lagoons (CALs) are Latin America\'s main livestock waste treatment systems. Mexico has 680 CALs that present low biogas yields (0.05 m3 m-3 digester d-1) and low COD removal rates (< 60%). This work focused on diagnosing CAL´s low performance in dairy farms by determining and analyzing operational parameters. Seven CALs located in the main dairy basin of Mexico were analyzed. The sampling areas for each CAL were the supernatant, the active zone, settled sludge, and digester inlet and outlet. The variation of the process parameter values corroborated that CALs appeared stratified and not working as expected. The sludge zone, comprising 50-58% of total solids content and 1-15% of total CALs volume, showed an elemental compounds content suitable for organic fertilizer (340, 48, and 5 kg t-1 of C, N, and S, respectively). However, this zone contained, at least, 85% of the slowly hydrolysable material; the methanogenic potential was less than 87 mL CH4 g VS-1, and the C/N ratio ranged from 4.9 to 17, outside of the optimal range. The biogas produced did not exceed 60% of methane content and more than 3000 ppm of H2S. The sludge zone significantly influences the lagoon\'s dynamics since it is a nutrient sink. Furthermore, the lack of agitation is the leading cause for the low energy yield and the low removal of organic matter rate. This work provides valuable information to address the operational problems within the CALs improving our understanding that shall allow proposing reactivation alternatives.
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  • 文章类型: Journal Article
    证据表明,生物和社会因素的组合对女性和男性患痴呆症的风险有不同的影响。在健康的老年女性中,有几个因素可能导致认知改变。
    描述认知健康的老年巴拿马妇女样本中与认知变化相关的特征。
    该研究包括对参加巴拿马老龄化研究倡议-健康差异(PARI-HD)研究的60岁及以上女性的基线(n=357)和17个月(SD=2.0)随访(n=200)认知领域的横断面分析。工具包括临床问卷,生理措施,以及评估全球认知和七个认知领域的神经心理学测试电池。多元回归分析了基线时人口统计学和临床特征与认知之间的关联。重复测量分析用于调查从基线到随访的认知变化。
    平均而言,参与者年龄为68.6岁(SD=5.9),受教育年限为16.1岁(SD=4.7).年龄,收入,和教育显示与基线认知有密切的关联。主观认知障碍与整体认知能力降低有关,口头学习,和内存域。只有注意力领域的表现在随访中下降,主观健康状况和抑郁症状显著预测了注意力的变化。
    我们的研究结果有助于研究西班牙裔老年女性的认知健康,并有助于理解与认知功能减退以及认知功能损害和痴呆进展相关的社会人口统计学和健康相关因素。
    UNASSIGNED: Evidence suggests that a combination of biological and social factors influence risk of dementia differently for women and men. In healthy older women, several factors may contribute to changes in cognition.
    UNASSIGNED: Describe the characteristics associated with variation in cognition in a sample of cognitively healthy older Panamanian women.
    UNASSIGNED: The study includes cross-sectional analyses of cognitive domains at baseline (n = 357) and 17-month (SD = 2.0) follow-up (n = 200) for women aged 60 years and older enrolled in the Panama Aging Research Initiative-Health Disparities (PARI-HD) study. Instruments included clinical questionnaires, physiological measures, and a neuropsychological test battery assessing global cognition and seven cognitive domains. Multiple regression analyses examined the associations between demographic and clinical characteristics and cognition at baseline. Repeated measures analyses were used to investigate changes in cognition from baseline to follow-up.
    UNASSIGNED: On average, participants were 68.6 years of age (SD = 5.9) with 16.1 years of education (SD = 4.7). Age, income, and education showed robust associations with baseline cognition. Subjective cognitive impairment was associated with lower performance in global cognition, verbal learning, and memory domains. Only performance in the attention domain decreased at follow-up, and subjective health state and depressive symptoms significantly predicted the change in attention.
    UNASSIGNED: Our study findings contribute to the investigation of cognitive health in older Hispanic women and to the understanding of sociodemographic and health-related factors associated with cognitive decline and the progression to cognitive impairment and dementia.
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  • 文章类型: Editorial
    暂无摘要。
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  • 文章类型: Journal Article
    背景:侵袭性肺炎球菌病(IPD)与高发病率相关,死亡率,和全世界的医疗费用,特别是在拉丁美洲和加勒比(LAC)。关于导致IPD的血清型分布和肺炎球菌疫苗接种的影响的监测是监测疾病活动趋势的重要流行病学工具。告知公共卫生决策,落实相关防控措施。
    目的:评估IPD的血清型分布和LAC的相关疾病负担,during,以及在LAC实施肺炎球菌疫苗免疫程序后。
    方法:根据Cochrane方法对LAC的研究进行系统文献综述。随着时间的推移,我们评估了肺炎球菌疫苗对因肺炎球菌疾病和血清型特异性疾病导致住院期间或住院后的住院和死亡的影响。我们还分析了肺炎球菌结合疫苗PCV10和PCV13中血清分型IPD的发生率。该协议在PROSPERO(ID:CRD42023392097)中注册。
    结果:对155项流行病学研究进行了筛选,并提供了关于IPD的流行病学数据。对<5岁儿童侵袭性疾病的Meta分析发现,PCV10和PCV13分别占57%-65%和66%-84%的致病血清型。PCV引入后,疫苗血清型在IPD中下降,非疫苗血清型的出现因国家而异。
    结论:肺炎球菌结合疫苗显著降低了IPD,并改变了拉丁美洲和加勒比地区的血清型分布。PCV10/PCV13覆盖了5岁以下儿童的57-84%的血清型,疫苗接种后PCV血清型显着下降。持续监测对于监测不断变化的血清型和告知公共卫生行动仍然至关重要。
    BACKGROUND: Invasive pneumococcal diseases (IPD) are associated with high morbidity, mortality, and health costs worldwide, particularly in Latin America and the Caribbean (LAC). Surveillance about the distribution of serotypes causing IPD and the impact of pneumococcal vaccination is an important epidemiological tool to monitor disease activity trends, inform public health decision-making, and implement relevant prevention and control measures.
    OBJECTIVE: To estimate the serotype distribution for IPD and the related disease burden in LAC before, during, and after implementing the pneumococcal vaccine immunization program in LAC.
    METHODS: Systematic literature review following Cochrane methods of studies from LAC. We evaluated the impact of the pneumococcal vaccine on hospitalization and death during or after hospitalizations due to pneumococcal disease and serotype-specific disease over time. We also analyzed the incidence of serotyped IPD in pneumococcal conjugate vaccine PCV10 and PCV13. The protocol was registered in PROSPERO (ID: CRD42023392097).
    RESULTS: 155 epidemiological studies were screened and provided epidemiological data on IPD. Meta-analysis of invasive diseases in children <5 years old found that 57%-65% of causative serotypes were included in PCV10 and 66%-84% in PCV13. After PCV introduction, vaccine serotypes declined in IPD, and the emergence of non-vaccine serotypes varied by country.
    CONCLUSIONS: Pneumococcal conjugate vaccines significantly reduced IPD and shifted serotype distribution in Latin America and the Caribbean. PCV10/PCV13 covered 57-84% of serotypes in children under 5, with marked decline in PCV serotypes post-vaccination. Continuous surveillance remains crucial for monitoring evolving serotypes and informing public health action.
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  • 文章类型: Journal Article
    面对快速的全球变化,拉丁美洲和加勒比(LAC)的农业部门正处于十字路口。该地区,以其丰富的生物多样性和可观的农业产量而闻名,越来越受到气候变化的挑战,政治和经济压力,以及需要高效和有效的创新来维持农业粮食系统向更可持续的做法的转变。
    In the face of rapid global changes, the agricultural sector in Latin America and the Caribbean (LAC) stands at a crossroads. The region, known for its rich biodiversity and considerable agricultural output, is increasingly challenged by climate change, political and economic pressures, and the need for efficient and effective innovations to sustain the transformation of agrifood systems toward more sustainable practices.
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  • 文章类型: Journal Article
    在高度城市化和不平等的拉丁美洲,城市卫生和卫生公平研究对于有效的决策至关重要。确保在减少城市卫生不平等的努力中应用相关和具体背景的证据,拉丁美洲的城市健康研究必须纳入战略研究翻译工作。从2017年开始,拉丁美洲城市健康(SALURBAL)项目实施了与政策相关的研究,并邀请决策者和公众支持研究成果的翻译。超过6年,来自八个国家的200多名研究人员为Salurbal的跨学科网络做出了贡献。该网络使Salurbal能够根据当地情况和优先事项调整研究和参与活动,从而最大限度地提高研究成果的政策相关性及其应用,以促进政策行动,告知城市干预措施,推动社会变革。SALURBAL在学术和非学术城市卫生利益相关者中取得了显着的知名度和可信度,从而开发了支持城市决策者的证据和工具,规划者,以及整个地区的政策制定过程。这些努力及其成果揭示了在研究中保持灵活性和考虑当地情况的重要经验教训,确保资源专用于政策参与和传播活动,并认识到评估政策影响需要对复杂的决策过程有细微差别的理解。这些思考对于在全球南部和全球范围内促进城市卫生和卫生公平研究的翻译具有重要意义。本文介绍了Salurbal的传播策略和政策翻译,强调创新举措及其成果,讨论吸取的教训,并就未来促进研究成果有效转化的努力提出建议。
    In highly urbanized and unequal Latin America, urban health and health equity research are essential to effective policymaking. To ensure the application of relevant and context-specific evidence to efforts to reduce urban health inequities, urban health research in Latin America must incorporate strategic research translation efforts. Beginning in 2017, the Urban Health in Latin America (SALURBAL) project implemented policy-relevant research and engaged policymakers and the public to support the translation of research findings. Over 6 years, more than 200 researchers across eight countries contributed to SALURBAL\'s interdisciplinary network. This network allowed SALURBAL to adapt research and engagement activities to local contexts and priorities, thereby maximizing the policy relevance of research findings and their application to promote policy action, inform urban interventions, and drive societal change. SALURBAL achieved significant visibility and credibility among academic and nonacademic urban health stakeholders, resulting in the development of evidence and tools to support urban policymakers, planners, and policy development processes across the region. These efforts and their outcomes reveal important lessons regarding maintaining flexibility and accounting for local context in research, ensuring that resources are dedicated to policy engagement and dissemination activities, and recognizing that assessing policy impact requires a nuanced understanding of complex policymaking processes. These reflections are relevant for promoting urban health and health equity research translation across the global south and worldwide. This paper presents SALURBAL\'s strategy for dissemination and policy translation, highlights innovative initiatives and their outcomes, discusses lessons learned, and shares recommendations for future efforts to promote effective translation of research findings.
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  • 文章类型: English Abstract
    The development of public health in Latin America during the 20th century combined, early on, the social medicine framework on the social, political, and environmental origins of disease with the contributions of medical anthropological fieldwork. Despite the hegemony of the medical model, the surge of the preventive medicine framework further legitimized the involvement of social scientists in the study of the multicausality of disease. However, the limitations brought by the preventive medicine model\'s lack of historical and political contextualization gave way to the Latin American social medicine movement, which was grounded in historical materialism, and the development of both critical epidemiology and critical medical anthropology.
    Desde o início, a evolução da saúde pública na América Latina ao longo do século XX combinou o marco teórico da medicina social sobre as origens sociais, políticas e ambientais das doenças com as contribuições derivadas do trabalho de campo da antropologia médica. Apesar da hegemonia do modelo médico, o surgimento do modelo de medicina preventiva legitimou ainda mais a participação dos cientistas sociais no estudo da multicausalidade das doenças. Entretanto, as limitações causadas pela falta de contextualização histórica e política do modelo de medicina preventiva abriram espaço para o movimento latino-americano de medicina social, fundamentado no materialismo histórico, e para o desenvolvimento da epidemiologia crítica e da antropologia médica crítica.
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  • 文章类型: Case Reports
    UNASSIGNED: Identify countries that have legislation on mandatory declarations of food allergens, irradiated foods, and transgenic foods on the nutritional labels of packaged foods.
    UNASSIGNED: Exploratory study reviewing the health regulations and technical standards for foods in Latin American countries in order to gather information on declarations of allergens, trace allergens, irradiated foods, and transgenic foods. The information search was carried out through the countries\' government web pages. Presentation of the results is descriptive and narrative.
    UNASSIGNED: Of the 19 countries reviewed, 89% require a declaration of allergens on their nutrition labeling, 76% have legislation that explicitly require a statement on trace allergens, and 82% follow Codex Alimentarius recommendations with some modifications of food categories.
    UNASSIGNED: Three pending challenges in the Region are: requiring statements on allergens as a food safety measure; making progress toward improved labeling of trace allergens; and ensuring universal availability of epinephrine.
    UNASSIGNED: Identificar os países que têm legislação relacionada à declaração obrigatória de alimentos alergênicos, irradiados e transgênicos na rotulagem nutricional de alimentos embalados.
    UNASSIGNED: Estudo exploratório com revisão dos regulamentos sanitários ou normas técnicas de alimentos dos países da América Latina, a fim de coletar informações sobre a declaração de alimentos alergênicos, traços de alergênicos, alimentos irradiados e transgênicos na rotulagem nutricional. A busca de informações foi realizada por meio dos sites governamentais dos países. Os resultados são apresentados de forma descritiva e narrativa.
    UNASSIGNED: Dos 19 países analisados, 89% declaram alergênicos na rotulagem nutricional, 76% incorporam explicitamente a declaração de traços na legislação e 82% seguem as recomendações do Codex Alimentarius, com algumas modificações nas categorias de alimentos.
    UNASSIGNED: Entre os desafios pendentes na Região estão a implementação da declaração de alergênicos como medida de segurança alimentar e a melhoria da rotulagem de traços de alergênicos e da disponibilidade universal de epinefrina.
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  • 文章类型: Journal Article
    与年龄相关的睡眠障碍与肌肉减少症有着共同的途径。来自拉丁美洲人口的预期数据很少,智利人的睡眠障碍和肌肉减少症之间的关系仍然未知。因此,我们的目的是在一项队列研究中研究睡眠障碍与肌肉减少症之间的纵向关联,该研究纳入了ALEXANDROS队列中1,116名≥60岁的智利社区老年人.排除标准之后,318名受试者被跟踪。社会人口统计数据,自我报告的慢性病,镇静型,睡眠特征,人体测量,握力,和肌肉性能进行了评估。结果表明,在基线时,肌少症患病率为24.10%,无性别差异,自我报告的睡眠问题的患病率为23.3%,女性更高(26.46%,男性17.15%)。调整后的Cox回归模型显示肌少症之间存在关联,睡眠障碍(HR=2.08,95%IC1.14-3.80),和长睡眠时间(HR=2.42,95%IC1.20-4.91)。经过8.24年的随访,每100人年有2.2例肌肉减少症.这项研究表明,睡眠障碍是智利老年人肌肉减少症的独立危险因素。通过自我报告的数据识别睡眠障碍为早期识别风险和具有成本效益的肌少症预防提供了机会。
    Age-related sleep disorders share common pathways with sarcopenia. Prospective data from Latin American populations are scarce, and the association between sleep disorders and sarcopenia in Chileans remains unknown. Thus, we aimed to study the longitudinal association between sleep disorders and sarcopenia in a cohort study of 1116 community-dwelling Chilean older people ≥60 years old from the ALEXANDROS cohorts. After the exclusion criteria, 318 subjects were followed. Sociodemographic data, self-reported chronic diseases, sedentarism, sleep characteristics, anthropometric measurements, handgrip strength, and muscle performance were assessed. Results indicated that at baseline, the prevalence of sarcopenia was 24.10% without gender differences, and the prevalence of self-reported sleep problems was 23.3%, higher in women (26.46% versus 17.15% in men). The adjusted Cox regression models for sarcopenia showed an association between sarcopenia, sleep disorders (HR = 2.08, 95% IC 1.14-3.80), and long sleep duration (HR = 2.42, 95% IC 1.20-4.91). After 8.24 years of follow-up, there were 2.2 cases of sarcopenia per 100 person-years. This study demonstrates that sleep disorders are an independent risk factor for sarcopenia in Chilean older people. The identification of sleep disorders through self-reported data provides an opportunity for early identification of risk and cost-effective sarcopenia prevention.
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  • 文章类型: Journal Article
    背景:在精神病早期干预服务(EIS)中停止治疗对于在精神病早期阶段获得更好的结果构成了重大挑战。低收入和中等收入国家(LMICs)早期脱离EIS的患病率和预测因素仍未得到充分调查。我们旨在研究巴西RibeirãoPreto精神病早期干预计划(RibeirãoPreto-EIP)的脱离率和预测因素。
    方法:我们使用2015年1月1日至2018年12月31日期间转诊到RibeirãoPreto-EIP患者的数据进行了一项回顾性队列研究。排除标准是只有一次咨询的个人,除精神病以外的诊断,并记录了死亡案例。
    结果:我们的样本包括234名患者,总体中位随访时间为14.2个月。早期治疗脱离观察到26.5%(n=62),脱离接触的中位时间为5.25个月。单变量分析确定非白色肤色(HR=2.10,95CI1.26-3.49),THC筛查阳性(HR=2.22,95CI1.23-4.01),和物质诱发的精神病(HR=2.15,95CI1.10-4.21)是显著的预测因子。在多变量分析中,只有非白色肤色仍然是早期脱离的重要预测因子(HR=1.87,95CI1.08-3.27).
    结论:在我们的样本中观察到的早期脱离比率与富裕国家的报告相似,但高于先前报道的LMIC。在我们的样本中,非白色肤色预测早期脱离,可能是由于社会上的不利因素。我们的数据强调了需要加强研究,阐明LMIC中EIS的具体特征。
    BACKGROUND: Treatment discontinuation within Early Intervention Services (EIS) for psychosis poses a significant challenge to achieving better outcomes in the early stages of psychotic disorders. Prevalence and predictors of early disengagement from EIS located in low- and middle-income countries (LMICs) remain poorly investigated. We aimed to examine the rates and predictors of disengagement from the Ribeirão Preto Early Intervention Program for Psychosis (Ribeirão Preto-EIP) in Brazil.
    METHODS: We conducted a retrospective cohort study using data from patients referred to the Ribeirão Preto-EIP between January 01, 2015, and December 31, 2018. Exclusion criteria were individuals with a single consultation, a diagnosis other than a psychotic disorder, and documented cases of death.
    RESULTS: Our sample comprised 234 patients, with an overall median follow-up time of 14.2 months. Early treatment disengagement was observed in 26.5 % (n=62), with a median time to disengagement of 5.25 months. Univariable analysis identified non-white skin color (HR=2.10, 95 %CI 1.26-3.49), positive THC screening (HR=2.22, 95 %CI 1.23-4.01), and substance-induced psychosis (HR=2.15, 95 %CI 1.10-4.21) as significant predictors. In multivariable analysis, only non-white skin color remained a significant predictor of early disengagement (HR=1.87, 95 %CI 1.08-3.27).
    CONCLUSIONS: The observed rates of early disengagement in our sample are similar to those reported in wealthy countries, but higher than previously reported for LMICs. Non-white skin color predicted early disengagement in our sample, probably due to social disadvantages. Our data highlights the need for enhanced research elucidating the specific features of EIS in LMICs.
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