LA Countries Research Articles

Assessment of professional empowerment among midwives in selected LAC: A multisite descriptive study

Objectiveto identify the perception of professional empowerment among midwives in selected Latin American countries (LA). Specifically, this study aimed to compare i) the global level of empowerment among midwives in different LA countries, ii) the scores according to the different dimensions of the scale, and iii) scores according to area the of expertise. DesignA quantitative, observational, analytical, cross-sectional and multisite study using an adaptation of the Perceptions Midwifery Empowerment Scale (PEMS). SettingsClinical, educational and managerial midwifery positions in 5 LA countries belonging to a Latin American Research Network in Midwifery. All the participating countries reported a similar profile regarding type of education, association and regulation procedures. ParticipantsA total of 1127 responses from midwives with different professional backgrounds were included in the study. FindingsA total mean score of 73.28 (74.23–72.03) points was reported. Chile reported the lowest score of empowerment compared to the other countries, while Argentina reported the highest. Midwives' perceptions of empowerment within their area of expertise, primary health care (PHC) was the area of reference, and gynaecology reported a significantly lower score. Midwives working in management were significantly more empowered compared with those in other areas. Midwives who had continuous education and postgraduate studies were the most empowered. Regarding the provision of woman-centred Care, Chile and El Salvador differed significantly from Argentina (reference), while Uruguay reported a significantly higher score in this dimension. Midwives working in hospital wards reported significantly lower scores compared to those working in PHC. Key conclusions and implications for practiceThis study suggests that midwifery programmes in the LA countries would benefit from prioritising professional empowerment, especially in the areas of hospital practice, where midwives' perceptions of empowerment were most limited.

State Support for Commercialization of Intellectual Activity Results in Socially Significant Industries

The pharmaceutical industry is one of the leaders in terms of the intensity of commercialization of the intellectual activity results (IAR). Its development as a socially significant industry is a priority in the state policy of countries with developing economies, in particular, the countries of the Latin American region (LA). A number of economic conditions for the development of commercialization of the IAR in these countries are similar to the Russian economy. Common barriers to development include dependence on imported substances, inefficient interaction between science and business, lack of public and private investment in R&D, and insufficient development of the intellectual property (IP) institution. At the same time, it is possible to identify common growth drivers: the growth potential of the consumer market, unique natural resources, relatively high scientific potential, and the concentration of R&D in research institutes and universities. The similarity of the conditions helps to suggest that it is possible to adapt the best practices of IAR commercialization formed in the LA, to the Russian economy. The research method used in this article include analyzing published legislative and statistical materials on financial institutions of the LA countries in order to identify problems and experience in overcoming them in the field of commercialization of intellectual property. The analysis of state support for imitation, closed and open models of commercialization of IAR used by pharmaceutical companies in developing economies made it possible to identify successful support mechanisms, as well as positive and negative results of the application of each model. On this basis, as the results of the research recommendations for state support for the commercialization in socially significant industries of the Russian economy are suggested.

Latin America's Export Trade Prospect of Agricultural Products to China

The objective of this research is to analyze the trade prospect of Latin America countries’ exporting agricultural products to China combining the dimensions of competitiveness and trade potential, and using the Boston Matrix. Based on the agricultural product trade data from 2000 to 2019, three categories are analyzed based on Harmonized System: animal, plant, and food processing product. The results show there are 4 LA countries in the zone of bright prospect trading agricultural products with China, which are Mexico, Brazil, Uruguay and Argentina. And 16 countries in the zone of promising prospect, 6 countries in the zone of bottleneck prospect, 5 countries in the zone of dark prospect. From the perspective of the category of agricultural products, plant agricultural product is the category in which there are the most countries with bright prospect. From the perspective of trading region, South America is the area in which countries with bright prospect concentrate. Countries with dark prospect mainly concentrate in Central America and South America. Countries with bottleneck prospect evenly distribute in different regions. Countries with promising prospect mainly concentrate in the West Indies. To promote Sino-LA agricultural trade, trade categories should be expanded and trade potential should be improved. Plans could be made for cooperation according to local conditions. LA should improve the quality control of exported agricultural products. China and LA should promote regional integration and strengthen technology cooperation in agricultural industry.

Management of radioiodine refractory differentiated thyroid cancer: the Latin American perspective.

Radioiodine (RAI) refractory differentiated thyroid cancer is an uncommon and challenging situation that requires a multidisciplinary approach to therapeutic strategies. The definition of RAI-refractoriness is usually a clear situation in specialized centers. However, the right moment for initiation of multikinase inhibitors (MKI), the time and availability for genomic testing, and the possibility of prescribing MKI and selective kinase inhibitors differ worldwide.Latin America (LA) refers to the territories of the world that stretch across two regions: North America (including Central America and the Caribbean) and South America, containing 8.5% of the world's population. In this manuscript, we critically review the current standard approach recommended for patients with RAI refractory differentiated thyroid cancer, emphasizing the challenges faced in LA. To achieve this objective, the Latin American Thyroid Society (LATS) convened a panel of experts from Brazil, Argentina, Chile, and Colombia. Access to MKI compounds continues to be a challenge in all LA countries. This is true not only for MKI but also for the new selective tyrosine kinase inhibitor, which will also require genomic testing, that is not widely available. Thus, as precision medicine advances, significant disparities will be made more evident, and despite efforts to improve coverage and reimbursement, molecular-based precision medicine remains inaccessible to most of the LA population. Efforts should be undertaken to alleviate the discrepancies between the current state-of-the-art care for RAI-refractory differentiated thyroid cancer and the present situation in Latin America.

A structural decomposition analysis of “Latin American decade” for selected countries

The 2003-2014 period for Latin America refers to the recent boom period within the growth cycles of the region and is called as “Latin American decade”. Given that, the purpose of the paper is to analyze this specific period based on structural transformation dynamics. In this context, structural decomposition methods are evaluated to outline structural transformation patterns. For this analysis, the Groningen Growth and Development Centre (GGDC) Economic Transformation Database (ETD), which provides annual data on employment and real value added by 12 sub-sectors, is used for 8 LA countries (Argentina, Bolivia, Brazil, Chile, Colombia, Ecuador, Mexico, Peru). The decomposition analysis is applied for three main periods (1990-2018, 1990-2003 and 2003-2014) within the growth cycles of the region. So it is predicted to define whether the “Latin American decade” differs from the previous period, regarding structural dynamics. During the “Latin American decade”, the region has gone commodity-led growth pattern and deindustrialization. Moreover, this pattern is not so homogenous. Specifically, the mining sector and non-tradeable sectors dominate the structural dynamics of some countries. Due to these patterns, the results underlie that productivity gains remained at low levels. Latin American countries need to design growth strategies that focus on escaping from productivity traps.

Reassessing the feasibility of adopting dollarization in Latin America

PurposeThis paper analyses the possibility of Latin America's (LA) major economies adopting dollarization, considering that in the last decade macroeconomic instability has once again challenged the ability of certain economies to properly manage their own currency.Design/methodology/approachTo determine the feasibility of adopting the US dollar as official currency, the author uses the framework of optimum currency area (OCA) theory, since, in fact, dollarization is an incomplete monetary union. The author uses a structural vector autoregressive (SVAR) model to identify what type of structural shock — country-specific, regional or global — prevails in LA economies. For this purpose, the US output is used to represent the global output and determine how the shocks of the US influence the output trajectory of each LA nation. The higher the influence of the US product, the lower the costs of adopting the US dollar.FindingsThe results of the variance decomposition show that the influence of the US shocks in the gross domestic product (GDP) trajectory of LA countries has significantly decreased over the last two decades, even in the currently dollarized economies. The estimates for Venezuela and Argentina show that the importance of US shocks in the trajectory of their GDP is low. Therefore, the cost of adopting the US dollar as the official currency would be high.Originality/valueIn view of hyperinflation and macroeconomic imbalances in certain LA nations, the dollarization debate has resurfaced in recent years. However, the literature that empirically evaluates the feasibility of adopting dollarization as a monetary system under current economic conditions is limited.

Creation of a Latin-American Dementia Advance Care Planning Guide

The LEAD Guide (Life-Planning in Early Alzheimer’s and Dementia) is an advance care planning conversation guide for use within the context of dementia (Dassel et al., 2019). Considering that Latino adults have the highest risk of ADRD, a culturally sensitive and translated Spanish version of the LEAD Guide was needed. Therefore, the objective of this study was to: 1) translate the LEAD Guide into a Latin-American Spanish version (i.e., LA LEAD) and 2) assess the applicability and acceptability of the LA LEAD through focus groups with Latino older adults. First, the LEAD Guide was translated into a “neutral” Spanish version. Second, forward and backward translation was conducted to create the LA LEAD. Third, two 1.5-hour focus groups with Spanish-speaking Latino adults age 50+ who were: a) healthy adults (N=7) or b) current or previous dementia caregivers (N=7) were held. The focus groups were recorded, translated, and transcribed for descriptive analysis, which revealed three domains regarding the LA LEAD: 1) Family Dynamics: the guide could help prevent family conflict, designate a health care proxy, and reduce burden; 2) Cultural Expectations: acknowledgement of cultural nuances between LA countries, the familial responsibility of caring for family in the home, and the influence of religion on end-of-life care decisions, and 3) Health Literacy: lack of knowledge about advance care planning conversations, documentation, and dissemination. This process resulted in the creation of a validated LA LEAD Guide, which is a culturally and linguistically appropriate and acceptable advance care planning tool for Latino older adults.

Creation of a Latin-American Dementia Advance Care Planning Guide

American Heart Association’s (AHA) Life’s Simple 7 (LS7), an index of cardiovascular health risks, has been associated with worse brain outcomes but few examined this relationship in midlife. We examined whether LS7 scores at midlife were associated with brain morphometry in early old age. Participants were 471 men who participated in the Vietnam Era Twin Study of Aging. The LS7 index was assessed at mean age 62 (range 55-66) and 68 (range 61-71) and included smoking, physical activity, diet, body mass index, cholesterol, glucose, and blood pressure. Each factor was coded, per AHA criteria, on a 3-point scale (0/poor-2/ideal) and summed to create a composite score (0-14). At mean age 68, participants underwent structural magnetic resonance imaging, which was used to create the previously validated brain measures. Scores included: the ratio of abnormal white matter to white matter, and two Alzheimer’s disease brain signatures (cortical thickness/volume signature and a mean diffusivity (MD) signature). Analyses controlled for age, education, income, ethnicity, and APOE genotype. Concurrently at mean age 68, the LS7 was associated with cortical thickness/volume (F=4.85, p = .028), MD (F=10.89, p = .001) signatures and abnormal white matter ratio (F=14.04, p < .001). Prospectively, the LS7 at mean 62 was significantly associated with age 68 cortical thickness/volume (F=5.08, p = .025) and MD (F=5.54, p = .019) signatures but not with abnormal white matter ratio. These results suggest that prevention strategies that promote heart healthy behaviors could have implications for healthy brain aging.

The Role of Higher Education Institutions in the Implementation of Circular Economy in Latin America

Circular economy (CE) describes a sustainable alternative approach to the current linear economy system. It is a growing topic among scholars, practitioners, and decisionmakers; it encompasses several concepts related to sustainability and requires the synergy of multiple actors for success, including higher education institutions (HEIs) as one of the most relevant ones. Current CE is based mostly on experiences in Global North developed countries, where the concept has gained great attention and has already influenced policies and strategies. However, CE in Latin American countries (LA countries) have not yet received such attention. Thus, some “unique problems” may remain unattended, and efforts to attain a CE are more likely to fail. Likewise, the study shows how the role of HEIs in CE in LA countries has not yet been fully explored, as the literature on this topic is scarce. This paper aims to address the main research question: what is the role of HEIs in the transition to a CE in Latin American countries? For this, a two-fold methodology was performed: (i) a systematic review which allows understanding of the trends of CE research in LA and the extent of the HEIs involvement; and (ii) a narrative review, which provides insights into the state of the art of CE research (gaps, drivers, and barriers) in LA countries and how this relates to HEIs. This approach drew implications for the role of HEIs in the implementation of CE in LA countries. HEIs are key actors in this transition, contributing in several ways to the CE by collaborating with industry, assisting policy makers, building human and intellectual capital, supporting community engagement projects, influencing campus culture, linking with international CE networks, and promoting an inclusive CE discourse. This research contributes to the CE body of knowledge from a Latin-American Global South perspective by discussing the factors that aim to define the role of HEIs in the CE transition in LA countries.

Labor and informal work in North-South relations: a study on Iberian countries and Latin-America

Departing from the North/South dialogue, and considering the historical relations between the Iberian countries and Latin America (LA), the aim is to analyze trends, contrasts and asymmetries in different scales. Asymmetric powers and dynamic tensions and negotiations are discussed both in the world-system scale and in the European Union context. In the light of recent transformations in international capitalism, our paper addresses, on the one hand, the phenomenon of informality/labor precariousness and, on the other, resorting to a more prospective record, diagnoses some of the recent challenges of technological innovation and digitalization. Considering an ongoing project related to these issues (Latwork), our analysis encompasses the sociological knowledge developed by diverse research teams on the labor field, namely regarding informality and technological innovation. For this purpose, we also gather quantitative data on research teams from the universities of la countries (Brazil, Argentine and Chile) using factorial analysis. The aim is to foster decent work, particularly in the Latin American countries under study, where, as we know, the scourge of informality and vulnerability of the working classes is a structural feature that remains from colonial heritage till the early peripheral industrialization. Thus, the spirit of our study lies in the effort to understand the changes taking place in the field of labor relations at a time when global capitalism is at a crossroads in the face of the brutal impacts of the Covid-19 pandemic.

Pediatric Critical Care Transport: Survey of Current State in Latin America. Latin American Society of Pediatric Intensive Care Transport Committee.

An electronic, anonymous, multicenter survey housed by Monkey Survey was sent to physicians in LA and included questions about hospital and pediatric critical transport, resources available and level of car. Nineteen Latin-American countries were asked to complete the survey. A total of 212 surveys were analyzed, achieving a representativity of 19 LA countries, being most participants (59.4%, n = 126) from South America (Argentina, Bolivia, Brazil, Chile, Colombia, Ecuador, Paraguay, Peru, Uruguay and Venezuela). Most surveys were conducted by physicians of tertiary level centers (60.8%, n = 129), most of the institutions were classified by the participants as public health care centers (81.6%, n = 173). Most of the surveyed physicians (63.7%, n = 135) reported that there is a coordination center for critical care transport (CCT). In most cases, physicians report that a unified transport system for pediatric critical patients does not exist in their countries (67.45%, n = 143). Only 59 (30.7%) surveys reported the use of an exclusively pediatric critical care transport system. Most of these transport systems are described as a mixture of public and private efforts (51.56%, n = 99), but there is also a considerable involvement of government-funded critical transport systems (43.75%, n = 84). Specific training for personnel devoted to transportation of critically ill patients is reported in 55.6% (90), and the medical equipment necessary to carry out the transport is available in 67.7%. The majority (83.95%, n = 136) mentioned that access to advanced life support courses is possible. Training in triage and disaster is available in 44.1%. Physicians and registered nurse were identified as the transport providers in 41.5%, and only one third were made by pediatricians-pediatric nurse. The main reasons for transfers were respiratory illness, neonatal pathologies, trauma, infectious diseases, and neurological conditions. Overall, pediatric transport was reported as insufficient (70.19%, n = 148) by the surveyed physicians in LA and nonexisting by some of them (6.83%, n = 15). There were no regulations or laws in the majority of the surveyed countries (63.13%), and in the places where physicians reported regulatory laws, there were no dissemination (84.9%) by the local authorities. In LA, there is a great variability in personnel training, equipment for pediatric-neonatal transport, transport team composition, and characterization of critical care transport systems. Continued efforts to improve conditions in our countries by generating documents that standardize practices and generating scientific information on the epidemiology of pediatric transfers, especially of critically ill patients, may help reduce patient morbidity and mortality.

Effectiveness of interventions related to continuity of health care in five Latin America countries

Abstract Background Evaluation of interventions to improve continuity of care across care levels is scarce in Latin America. The Aim to analyse the impact of implemented interventions on the perception of continuity of care of chronic patients in public health care networks of five LA countries (Brazil, Chile, Colombia, Mexico, and Uruguay). Methods Quasi-experimental study (controlled before and after design). Comparable networks, one intervention (IN) and one control (CN) were selected in each country. Baseline (2015) and evaluation (2017) surveys were conducted applying CCAENA questionnaire® to a sample of patients with chronic conditions (392/network; 784/country/year). Result variables: information continuity (exchange of clinical information) and clinical management continuity (repetition of exams, accessibility of primary care (PC) and secondary care (SC), perception of agreement between PC and SC doctors and of collaboration between PC and SC doctors. Descriptive analysis were conducted, and chi-square test was calculated to determine significant changes. Results An increase in the perception of continuity of information between care levels was observed in the IN of all countries, but Colombia. Clinical management continuity: decrease in the repetition of exams and increase in accessibility of consultation with the specialist in all countries but Mexico. The accessibility of PC doctor decreased in the IN in all countries. No differences in the perception of agreement between PC and SC doctors regarding diagnosis, treatment and recommendations were found. The perception of collaboration between PC and SC doctors increased in the five countries. Conclusions Consistent with expected results, the level of perceived information continuity and clinical management continuity increased in the IN, with differences between countries. Further multivariate analyses will be conducted to explore the differences between the IN and CN. Key messages Provides a cross-country comparison of the perception of continuity of care in patients with chronic conditions. Contributes to fill the knowledge gap on the effectiveness of participatory interventions improving continuity of care.

Latin American Direction of Ukrainian Economic Diplomacy: The Overview of Successes and Failings

In the article, the authors analyzed successes and failings of the Ukrainian economic diplomacy in Latin America region. Such results were achieved by analyzing the degree of scientific investigation the possibilities, features and basic characteristics of economic diplomacy by contemporary Ukrainian and foreign researchers, as well as by analyzing the websites of Ukrainian embassies in Latin American countries and using the information of the State Statistics Service of Ukraine and mass media. Researchers drew attention to the peculiarities of economic relations between Ukraine and Latin America countries. It has been found that bilateral relations between Ukraine and Latin American countries are generally poorly developed, the embassies of Ukraine exist only in five countries: Mexico, Cuba, Argentina, Brazil and Chile, and these embassies in turn represent Ukraine’s national interests in 15 other Latin American countries. Ukraine has the most well-established economic relations with the first five above-mentioned countries as a result of economic diplomacy. It was concluded that Ukrainian economic diplomacy has some achievements (the developing of volume of export-import operations between Ukraine and all regional countries, except Cuba, and the opening of the honorary consulate in Chile) and failings (the lack of diplomatic missions in all LA countries, problems with updating information on planned activities in the economic sphere (2015, 2016) on the embassies’ web-site, negative trade balance for Ukraine).

Combining Carbon Taxation and Offset Payments: A New Approach to Climate Policy in Low-Income Countries

I consider a “low-ambition” (LA) country with no current climate policy, with two sectors. Sector 1 can in principle sell an unlimited amount of carbon offsets to a bloc of “high-ambition” (HA) countries. A condition for access to the right for sector 1 to sell unlimited offsets is that sector 2 of the LA country implements a comprehensive carbon tax. When the two sectors have equal size, and public and private revenues are valued equally by the LA government, a carbon tax in sector 2, equal to the offset price for sector 1, can be incentivized. The HA country bloc then buys offsets from the LA country at a price equaling its carbon externality cost. When sector 1 is larger (smaller) than sector 2, the offset price in sector 1 will be lower (higher) than the carbon tax in sector 2. When public funds are more valuable than private funds to the LA government, the implementable carbon tax is higher, and the optimal offset price lower. The model provides a novel mechanism by which a bloc of HA countries can incentivize LA countries to implement enhanced greenhouse gas mitigation.

Abstract O-59: KAWASAKI DISEASE SHOCK SYNDROME (KDSS) IN CHILDREN FROM 16 LATIN AMERICAN (LA) COUNTRIES: A 5-YEAR RETROSPECTIVE MULTICENTER STUDY OF THE REKAMLATINA NETWORK (JANUARY 2009-DECEMBER 2013)

Aims & Objectives: KD is the leading cause of pediatric acquired cardiac disease in developed countries. KDSS occurs approximately in 5–7% of KD cases; however, its recognition is difficult even among experienced clinicians. We describe the first retrospective multinational multicenter study of KDSS in LA children. Methods Retrospective descriptive study of pts with a discharge diagnosis of classic or incomplete (atypical) KD who met KDSS criteria at 39 main referral hospitals from 16 LA countries. Study period: January-1st-2009 to December-31st-2013. Results Among 976 enrolled KD pts, 8(0.81%) developed a KDSS. Classic and incomplete (atypical) KD was diagnosed in 6(75%) and 2(25%) pts, respectively. 5(62.5%) were female pts. 5(62.5%) pts were <60 months of age. Median length of hospitalization was 14(8–35) days. Median length of fever at admission was 6(4–8) days. In 3(37.5%) pts, sepsis/shock but not KDSS was the initial admission diagnoses. Antibiotics were given in all 8 pts prior to both final KD and KDSS diagnoses. On admission, 5(62.5%) pts looked poorly perfused, 5(62.5%) had thrombocytopenia, and 6(75%) hypoalbuminemia. IVIG, aspirin and steroids were given in 8(100%), 7(87.5%), and 5(62.5%) pts respectively. A second dose of IVIG was required in 4(50%) pts. Baseline echocardiograms showed: coronary artery dilations and/or aneurysms, 2(25.0%) pts; pericardial effusion, 2(25.0%); valvular insufficiency, 2(25.0%). No deaths occurred. Conclusions Our incidence of KDSS is lower than reports from developed countries. However, difficulties in diagnosing KD and KDSS, misdiagnosis with sepsis/shock, and the retrospective nature probably reveal underestimates. KDSS cases were associated with prolonged hospitalizations, high rates of antibiotic use, and IVIG-resistance.

FRAX-based intervention and assessment thresholds in seven Latin American countries.

Intervention thresholds are proposed using the Fracture Risk Assessment (FRAX) tool. We recommended their use to calculate the ten-year probability of fragility fracture (FF) in both, men and women with or without the inclusion of bone mineral density (BMD). The purpose of this study is to compute FRAX-based intervention and BMD assessment thresholds for seven Latin American countries in men and women ≥ 40years. The intervention threshold (IT) was set at a 10-year probability of a major osteoporotic fracture (MOF) equivalent to a woman with a prior FF and a body mass index (BMI) equal to 25.0kg/m2 without BMD or other clinical risk factors. The lower assessment threshold was set at a 10-year probability of a MOF in women with BMI equal to 25.0kg/m2, no previous fracture and no clinical risk factors. The upper assessment threshold was set at 1.2 times the IT. For the seven LA countries, the age-specific IT varied from 1.5 to 27.5% in Argentina, 3.8 to 25.2% in Brazil, 1.6 up to 20.0% in Chile, 0.6 to 10.2% in Colombia, 0.9 up to 13.6% in Ecuador, 2.6 to 20.0% in Mexico, and 0.7 up to 22.0% in Venezuela at the age of 40 and 90years, respectively. In the LA countries, FRAX-based IT offers a substantial advance for the detection of men and women at high fracture risk, particularly in the elderly. The heterogeneity of IT between the LA countries indicates that country-specific FRAX models are appropriate rather than a global LA model.

Energy Efficiency and Renewable Energy in Latin America : Policies towards Sustainable Development

Latin America possesses great natural resources and many opportunities are emerging for new investments and innovation, since many countries are planning to modify the structure of their energy networks in order to give a greater role to renewables. High electricity prices in most of the region, growing demand, problems of energy security have been the main drivers for the recent expansion of the renewable energy market. Socio-economic issues are priority targets in LA countries, social inequality and poverty are still major challenges in the region. On the other hand, technological developments have permitted innovative approaches, including private participation, the creation of social enterprises and business models to provide for electricity services to low income populations and small business. In spite of the recent progress regarding the widespread dissemination of the ‘new renewable’ and energy efficient technologies, the reduction of CO2 emissions, in major LA countries have not been significant along the past decade. We suggest in this paper an area which deserves attention so that these technologies can play a relevant role towards the sustainable development of the region.

El Registro Latinoamericano de Diálisis y Trasplante Renal: la importancia del desarrollo de los registros nacionales en Latinoamérica

IntroductionThe Latin American Dialysis and Renal Transplantation Registry (LADRTR), collects and annually reports the data of the affiliated countries to the Latin American Society of Nephrology and Hypertension (SLANH), having positioned itself as one of the more important regional registries of dialysis and transplantation worldwide. It's happened thanks to the effort and dedication of the successive committees and representatives of the national registries of dialysis and transplantation (DTR) that are its source of information. ObjectiveThe objective of this article is to describe the situation of the national DTR in Latin America and the Caribbean, to present the latest regional report with data from the year 2013 and to summarise the activities carried out by the LADRTR in the past two years, including particular measures which to improve the quality of those Registries. ConclusionsDTR constitute a useful tool for epidemiological research, health care planning and the improvement of the quality of care. The heterogeneity or even absence of registries in some LA countries is congruent with the inequities in access of ESRD patients to RRT in such countries as well as the availability of qualified personnel. The Pan American Health Organization and SLANH convened the Committee of the LADRTR in 2014, to dictate courses of training and certification for the creation and development of the DTR in the countries of Latin America and the Caribbean.

Migraciones en países de América Latina. Características de la población pediátrica

IntroductionMigration is a growing phenomenon among Latin American countries (LAC) as well as others; however, scarce information is available studying its impact on paediatric groups and its association with socioeconomic variables. ObjectiveTo study the association among socioeconomic variables and the immigration rate of paediatric population in LAC. Material and methodsOfficial rates of migration of LAC were obtained from: International Organization for Migration, Pan American Health Organization, and United Nations Development Programme. Demographic and socioeconomic information was also obtained for: gross domestic product (GDP), human development index (HDI), Gini coefficient of inequality (GC), alphabetization rate for adults (AA), net migration rate (NMR), and immigration of children<15 years (IM15). Description, linear correlations and analysis of differences between groups of countries were assessed. ResultsThe NMR was positive for Costa Rica, Panama, Venezuela, Chile and Argentina. No association among NMR and GDP, HDI, GC, AA was found. A correlation of IM15 was found with: GC (r=0.668, P=.01), with GDP (r=−0.720; P=.01), AA (r=−0.755; P=.01) and with HDI (r=−0.799; P=.01). Rate of IM15 was lower in LA countries with advanced/medium development (GDP>median) vs those with low development (Fisher, P<.0001). ConclusionsThere is a direct inverse association between GDP per capita, HDI, AA and GC and the proportion of each country IN15. We did not observe an association between NMR and HDI, AA, and GC. The health impact of these migrations should be analysed.

Prevalence and incidence of perinatal depression and depressive symptoms among Mexican women

BackgroundThe aim of this study was to assess point and period prevalence and incidence of perinatal depression in Mexican women. MethodsThe Structured Clinical Interview for DSM-IV and the Patient Health Questionnaire (PHQ-9) were administered at three points in time to 210 women: during the third trimester of pregnancy, at six weeks and at six months after delivery. ResultsPrevalence of prenatal depression was 9.0%, and 13.8% at six weeks and 13.3% at six months postpartum. Incidence of postpartum depression (PPD) was 10.0% at six weeks and 8.2% at six months. Prevalence of prenatal depressive symptoms was 16.6%; and 17.1% at six weeks and 20.0% at six months postpartum. Incidence of postpartum depressive symptoms (PPDS) was 11.4% at six weeks and 9.0% at six months. At six months postpartum, women with depression were younger (OR=2.45, p=0.02), had fewer years׳ schooling (OR=5.61, p=0.00), were unpartnered (OR=3.03, p=0.01), unemployed (OR=3.48, p=0.00) and poorer (OR=4.00, p=0.00) than women without depression. Limitations25% of the initial sample was not retained to complete the three assessments. Non completers were younger, less educated and reported more depressive symptoms. This may have resulted in an underestimation of prevalence. ConclusionsThis is the first longitudinal study in Latin America to assess perinatal depression at three different points in times, reporting point and period prevalence and incidence of clinical depression and depressive symptoms. Most LA countries have yet to recognize the importance of providing mental health care for expectant and postpartum mothers to reduce disability in mothers and infants.