Título del artículo:

A structural study of the hydrogen absorption properties by replacing vanadium with zirconium in metal alloys

Hydrogen storage and microstructure the TiCrV0.9, TiCrV0.9Zr0.2 and TiCrV0.7Zr0.4 alloys were investigated. The alloys were melted in arc furnace, the structure was analysed by X- ray diffraction and hydrogen absorption times were analysed by Sievert\'s type apparatus. The results showed that the addition of Zr replacing the V decreases in the absorption capacity passing of 3.8%wt to 2.0%wt in contrast the speed of hydrogen absorption increases considerably.

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Journal of Physics: Conference Series

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Brain Circuitry Supporting Multi-Organ Autonomic Outflow in Response to Nausea

While autonomic outflow is an important co-factor of nausea physiology, central control of this outflow is poorly understood. We evaluated sympathetic (skin conductance level) and cardiovagal (high-frequency heart rate variability) modulation, collected synchronously with functional MRI (fMRI) data during nauseogenic visual stimulation aimed to induce vection in susceptible individuals. Autonomic data guided analysis of neuroimaging data, using a stimulus-based (analysis windows set by visual stimulation protocol) and percept-based (windows set by subjects\' ratings) approach. Increased sympathetic and decreased parasympathetic modulation was associated with robust and anti-correlated brain activity in response to nausea. Specifically, greater autonomic response was associated with reduced fMRI signal in brain regions such as the insula, suggesting an inhibitory relationship with premotor brainstem nuclei. Interestingly, some sympathetic/parasympathetic specificity was noted. Activity in default mode network and visual motion areas was anti-correlated with parasympathetic outflow at peak nausea. In contrast, lateral prefrontal cortical activity was anti-correlated with sympathetic outflow during recovery, soon after cessation of nauseogenic stimulation. These results suggest divergent central autonomic control for sympathetic and parasympathetic response to nausea. Autonomic outflow and the central autonomic network underlying ANS response to nausea may be an important determinant of overall nausea intensity and, ultimately, a potential therapeutic target.

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Cerebral Cortex

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Corrigendum to \"heart failure in low- and middle-income countries: Background, rationale, and design of the INTERnational Congestive Heart Failure Study (INTER-CHF)\" (Am Heart J. (2015) 170:4 (627-634))

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American Heart Journal

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Heart Failure in Africa, Asia, the Middle East and South America: The INTER-CHF study

Background There are few data on heart failure (HF) patients from Africa, Asia, the Middle East and South America. Methods INTER-CHF is a prospective study that enrolled HF patients in 108 centers in 16 countries from 2012 to 2014. Consecutive ambulatory or hospitalized adult patients with HF were enrolled. Baseline data were recorded on sociodemographics, clinical characteristics, HF etiology and treatments. Age- and sex-adjusted results are reported. Results We recruited 5813 HF patients: mean(SE) age = 59(0.2) years, 39% female, 65% outpatients, 31% from rural areas, 26% with HF with preserved ejection fraction, with 1294 from Africa, 2661 from Asia, 1000 from the Middle-East, and 858 from South America. Participants from Africa - closely followed by Asians - were younger, had lower literacy levels, and were less likely to have health or medication insurance or be on beta-blockers compared with participants from other regions, but were most likely to be in NYHA class IV. Participants from South America were older, had higher insurance and literacy levels, and, along with Middle Eastern participants, were more likely to be on beta-blockers, but had the lowest proportion in NYHA IV. Ischemic heart disease was the most common HF etiology in all regions except Africa where hypertensive heart disease was most common. Conclusions INTER-CHF describes significant regional variability in socioeconomic and clinical factors, etiologies and treatments in HF patients from Africa, Asia, the Middle East and South America. Opportunities exist for improvement in health/medication insurance rates and proportions of patients on beta blockers, particularly in Africa and Asia.

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International Journal of Cardiology

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Relationship between cardiac vagal activity and mood congruent memory bias in major depression

Background Previous studies suggest that autonomic reactivity during encoding of emotional information could modulate the neural processes mediating mood-congruent memory. In this study, we use a point-process model to determine dynamic autonomic tone in response to negative emotions and its influence on long-term memory of major depressed subjects. Methods Forty-eight patients with major depression and 48 healthy controls were randomly assigned to either neutral or emotionally arousing audiovisual stimuli. An adaptive point-process algorithm was applied to compute instantaneous estimates of the spectral components of heart rate variability [Low frequency (LF), 0.04-0.15 Hz; High frequency (HF), 0.15-0.4 Hz]. Three days later subjects were submitted to a recall test. Results A significant increase in HF power was observed in depressed subjects in response to the emotionally arousing stimulus (p=0.03). The results of a multivariate analysis revealed that the HF power during the emotional segment of the stimulus was independently associated with the score of the recall test in depressed subjects, after adjusting for age, gender and educational level (Coef. 0.003, 95%CI, 0.0009-0.005, p=0.008). Limitations These results could only be interpreted as responses to elicitation of specific negative emotions, the relationship between HF changes and encoding/recall of positive stimuli should be further examined. Conclusions Alterations on parasympathetic response to emotion are involved in the mood-congruent cognitive bias observed in major depression. These findings are clinically relevant because it could constitute the mechanism by which depressed patients maintain maladaptive patterns of negative information processing that trigger and sustain depressed mood.

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Journal of Affective Disorders

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Storage system scheduling effects on the life of lead-acid batteries

Storage systems are a key element to take advantage of renewable energy due to its ability to transfer energy consumption from one time period to another. With high charge/discharge ratios one can increase the short term revenue stream from a renewable energy system whereas with a low charge/discharge ratios one can increase the long term benefits. Hence, when compared against nominal charge or discharge operation, the storage system life can be increased/reduced with a low/high charge or discharge ratios. In order to quantify this fact for different storage management strategies, this work analyze the effect on the life of a lead-acid battery system of three scheduling strategies: linear programming, crisp logic and fuzzy logic. The three cases will be compared against a reference strategy which consist on solving a linear optimization problem with perfect forecast of load, energy price and renewable availability. A photovoltaic system is taken as the renewable source and historic values for eight months are used to study the trend in the life of the storage system. it can be concluded that higher storage capacity leads to higher overall benefits, however, this cannot be said for the maximum storage system power, even when considering only the costs benefits, which suggest that a proper strategy and parameter selection can be better than high power ratio.

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2015 IEEE PES Innovative Smart Grid Technologies Latin America, ISGT LATAM 2015

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Assessing the loss due to working in the informal sector in Venezuela

In Venezuela, 40% of the workers are employed in the informal sector. This sector is known for being underproductive, meaning that the income received by its workers is less than what they could earn working in formal sector jobs. This paper uses data from the Household Sample Survey (2012-2013) to estimate difference-in-differences linear and quantile regression models, controlling for some demographic characteristics, to quantify the loss associated with working in this market, as an indirect way to quantify the size of the informal sector. The parallel trend assumption is satisfied through propensity score matching, exception made for the highest quartile. The results suggest that informal sector workers lose about 34% of their potential income, loss that is larger for women and with an ambiguous behavior across levels of education. The study also indicates that the average difference in wages between the two sectors tends to narrow over time.

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Lecturas de Economia

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Metabolic syndrome and subclinical left ventricular dysfunction

Recent studies using both conventional and tissue Doppler echocardiography have gathered evidence of myocardial dysfunction in individuals with metabolic syndrome. Recently, two-dimensional speckle-tracking echocardiography (2D-STE) has become a robust method for the detection of subclinical left ventricular dysfunction through quantitative assessment of myocardial deformation. Some studies suggest that metabolic syndrome is associated with longitudinal deformation of the left ventricle and that global longitudinal strain measured by 2D-STE is impaired in individuals with metabolic syndrome. It may be inferred that the early identification of subclinical left ventricular dysfunction and the determination of the role of the components of metabolic syndrome in impaired myocardial contractility can help elucidate and predict the risk of cardiovascular diseases in this syndrome.

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Scientia Medica

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Use of molecular biomarkers in studies of aquatic environmental impact

Molecular biomarkers refer to specific genes and/or its products present in ecosystems which have been exposed to physic or chemical alterations as a result of anthropogenic activities. These molecules are useful to estimate both change and spread of the damage level. The studies of DNA specific sequences, gene expression and proteins production allow to understand the consequences of the presence of specific pollutants or its mixtures in different ecosystems, but mainly in aquatic environments. To date, different gene targets have been used to understand the consequences derived by the introduction of specific pollutants into the environment and serve as excellent tools for environmental toxicology studies. In this review, some of the most commonly reported molecular biomarkers used to monitor the environmental impact in aquatic ecosystems and the pertinent considerations when they are used in environmental risk assessment studies are described.

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Journal of Industrial Pollution Control

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Use of molecular tools to monitor microbial communities during the bioremediation of polycyclic aromatic hydrocarbon-contaminated soils

One of the priority environmental pollutants, because of its high toxicity and persistence, are the polycyclic aromatic hydrocarbons (PAHs). PAHs are recalcitrant compounds exhibiting high hydrophobicity and therefore readily absorbed in the gastrointestinal tract of mammals, also having a rapid distribution in a variety of tissues with a marked tendency to fatty deposits. Because of its importance as environmental pollutants, soil contamination with PAHs is a priority environmental issue. In recent years, there have been great advances in the understanding of the mechanisms of degradation of PAHs and the techniques for the monitoring of these processes in polluted soils. However, the validation and performance of a bioremediation strategy should be based not only on the effect of the microorganisms in soil (biodegradation of the contaminant), but also in the detection and monitoring of the inoculated microorganisms. This review presents an overview of the strategies for the bioremediation of soils contaminated with PAHs, focusing on the molecular biology methods that can be used for the monitoring of these soils in the field.

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Journal of Industrial Pollution Control

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Neck circumference as a predictor of metabolic syndrome, insulin resistance and low-grade systemic inflammation in children: The ACFIES study

Background: The current study aims to evaluate the association between neck circumference (NC) and several cardio-metabolic risk factors, to compare it with well-established anthropometric indices, and to determine the cut-off point value of NC for predicting children at increased risk of metabolic syndrome, insulin resistance and low-grade systemic inflammation. Methods: A total of 669 school children, aged 8-14, were recruited. Demographic, clinical, anthropometric and biochemical data from all patients were collected. Correlations between cardio-metabolic risk factors and NC and other anthropometric variables were evaluated using the Spearman\'s correlation coefficient. Multiple linear regression analysis was applied to further examine these associations. We then determined by receiver operating characteristic (ROC) analyses the optimal cut-off for NC for identifying children with elevated cardio-metabolic risk. Results: NC was positively associated with fasting plasma glucose and triglycerides (p = 0.001 for all), and systolic and diastolic blood pressure, C-reactive protein, insulin and HOMA-IR (p < 0.001 for all), and negatively with HDL-C (p = 0.001). Whereas, other anthropometric indices were associated with fewer risk factors. Conclusions: NC could be used as clinically relevant and easy to implement indicator of cardio-metabolic risk in children.

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BMC Pediatrics

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Characteristics of innovation in services at companies inside the textile sector and características de la innovación en servicios en compañías del sector textil

This article aims to describe the characteristics of innovation in services at small and medium companies (SMEs) in the textile sector at Valledupar, Colombia. The characteristic of innovation are: (1) the formalization and systematization of innovation processes related with the economics activities, (2) The difficulty of make any difference between product innovations and process innovations, (3) The preference in the organizational innovations face to the technological innovations, (4) The difficulty of protecting the innovations, (5) the incremental and flexible role of the innovation, and (6) The origin concentrated on the market. The research is the type descriptive, not experimental and cross-sectional. The population of this research is fifteen small and medium companies at the textile sector of Valledupar, Colombia. The research uses a Likert type questionnaire applied to the managers. The results indicate that the predominant characteristics are the difficult to protect innovations, the difficulty for differentiate between product and process innovation, and its incremental and flexible role. However, the companies analyzed lacks of formalization and systematization in the innovation process.

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International Journal of Applied Business and Economic Research

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Evaluation of native microorganisms for biodegradation of oil and grease in palm oil refinery effluents

The use of novel mixed microbial consortia composed of native yeast and bacteria was evaluated for the treatment of palm oil mill effluents (POME) from an oil refining process. For this purpose, 31 native yeast and bacteria isolates demonstrating the ability to remove fats, oils and greases were evaluated, either as single organisms or mixed inocula, for the treatment of POMEs. Molecular and biochemical characterizations revealed that isolates corresponded to Candida, Bacillus and Pseudomonas genera. Seven mixed inocula, containing the 6 most degrading isolates, were established and tested for the removal of palm oil in liquid culture, achieving 68 to 84 % removal after 48 h. The inoculum constituted by all of the isolates produced the best results with an overall COD reduction from 1840 to 260 mg/L (84 %), evidencing a synergic effect of the microorganisms. The use of the same inoculum for the treatment of a palm oil mill effluent led to a removal of 75 % organic matter and 72 % oil and grease after 48 h. Our results demonstrated the ability of these isolates to use palm oil as sole carbon source and effectively decrease the concentration of pollutants in palm oil mill effluents in a short period of time. The use of these microorganisms may provide adaptive advantages that could improve POME remediation processes, especially with mixtures of native bacteria and yeast able to degrade palm oil as sole carbon source.

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Biotecnologia Aplicada

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Social disparities explain differences in hypertension prevalence, detection and control in Colombia

Objective: Hypertension is the principal risk factor for cardiovascular diseases. The global Prospective Urban Rural Epidemiology study showed that the levels of awareness, treatment and control of this condition are very low worldwide and show large regional variations related to a country\'s income index. The aim of the present analysis was to identify associations between sociodemographic, geographic, anthropometric, behavioral and clinical factors and the awareness, treatment and control of hypertension within Colombia - a high-middle income country which participated in the global Prospective Urban Rural Epidemiology study. Methods and results: The sample comprised 7485 individuals aged 35-70 years (mean age 50.8 years, 64% women). Mean SBP and DBP were 129.12±21.23 and 80.39±11.81 mmHg, respectively. The overall prevalence of hypertension was 37.5% and was substantially higher amongst participants with the lowest educational level, who had a 25% higher prevalence (<0.001). Hypertension awareness, treatment amongst those aware, and control amongst those treated were 51.9, 77.5 and 37.1%, respectively. The prevalence of hypertension was higher amongst those with a higher BMI (<0.001) or larger waist-hip ratio (<0.001). Being male, younger, a rural resident and having a low level of education was associated with significantly lower hypertension awareness, treatment and control. The use of combination therapy was very low (27.5%) and was significantly lower in rural areas and amongst those with a low income. Conclusion: Overall Colombia has a high prevalence of hypertension in combination with very low levels of awareness, treatment and control; however, we found large variations within the country that appear to be associated with sociodemographic disparities.

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Journal of Hypertension

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The financial burden of family care of the chronically ill in the Colombian Andean region

Objective: To describe and analyze the financial burden of family care of the chronically ill in the Colombian Andean region. Materials and methods: This study is part of the Program for the Reduction of the burden of chronic disease in Colombia. The sample included 92 families residing in the Colombian Andean region. The Instruments “gcpc-un-d” were used to characterize the subjects and the Survey Financial cost of chronic disease care of Montoya et al, to identify the real effective household consumption. The financial burden attributable to family care was determined under the Caracol methodology. Results: Costs that most afflict families of the Colombian Andean Region are in their order health, transportation, housing, food and communications. Family caring for a person with chronic illness affects its effective household consumption. Discussion: Colombian families residing in the Andean region of the country have a high financial burden attributable to caring for a person with chronic disease.

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Revista Ciencias de la Salud

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Phenotype resistance to methicillin, macrolides and lincosamides in staphylococcus aureus, isolated in a hospital in Valledupar, Colombia

Introduction: Infections with methicillin-resistant S. aureus are a public health problem due to the multi-resistance profile presented by this pathogen. Objective: To determine resistance phenotypes to methicillin, macrolides and lincosamides in S. aureus. Materials and methods: 50 S. aureus strains, isolated from patients of the Hospital Rosario Lopez Pumarejo in the city of Valledupar, were analyzed. Susceptibility tests to methicillin, erythromycin and clindamycin were performed using microdilution and agar diffusion methods. Methicillin resistance was determined through agar dilution technique and inducible clindamycin resistance D-Test. Results: Methicillin resistance reached 50%, five phenotypes were established in the analyzed macrolides and lincosamides: phenotype sensitive to erythromycin and clindamycin (78%); phenotype resistant to erythromycin and clindamycin (16%) with constitutive resistance for both cMLSB antimicrobials, which lead the resistance phenotypes; phenotype with intermediate resistance to both antimicrobials (2%); the intermediate result phenotype resistant to erythromycin and clindamycin (2%); and the RS phenotype resistant to erythromycin and sensitive to clindamycin (2%) that show inducible iMLSB clindamycin resistance with positive D test. Conclusions: The inducible resistance to macrolides, lincosamides and streptogramines is not established through the standard antimicrobial susceptibility test. Not identifying the inducible resistance can lead to clindamycin treatment failure.

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Revista Ciencias de la Salud

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Technological change in the case of smart textiles: An approach from the dynamic capabilities

Garment making industry belongs to one of the more traditional sectors of the economy, precisely because they are linked to a basic need of human beings: the dress. However, during the last decade is improving the offer of new textile called \"smart\" by their interactions with the environment, since integrated sensors and actuators that allow to detect and respond to different stimuli, becoming increasingly more lightweight, durable and above all: useful. The emergence of this new era of textiles gives rise to countless applications and the possibility for traditional textile and clothing enterprises to explore new markets, supported by the development of dynamic capabilities that enable them maintain sustainable competitive advantages. This work proposes a model under which a set of learning skills coupled with certain capacities of absorption and innovation, can gestate a technological change in the textile making, we must necessarily be supported in another sector as that of technologies of information and communications.

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Espacios

Título del artículo:

Innovation activities in services in small and medium business enterprises in the textile sector of Valledupar, Colombia

The article aims to describe the service\'s activities of innovation in small and medium enterprises (PYMES) in the textile sector in Valledupar, Colombia. The activities include the knowledge\'s acquisition and machines, preparations for innovation, market research and training processes. This research is descriptive, a field research, non-experimental and transactional. The CEO answers a Likert questionnaire. The results indicate the predominant activity is the acquisition of machinery. In contrast, there is a low acquisition of knowledge from abroad and preparation to innovate. The conclusions are the suggestion of innovation\'s plans; market\'s analyses and diversify sources of knowledge.

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Espacios

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Microbial activity of essential oils of Lippia alba and cymbopogon citratus on streptococcus mutans and cytotoxicity in cho cells

Background: Dental caries is a complex infectious disease of multifactorial origin in which interactions occur between plaque, tooth, biological determinants such as salivary flow, buffering capacity and pH of saliva, predominant organisms, diet and behavioral socioeconomic factors; prevails in the 60-90% of the world’s school-age population. The existing prevention and treatment are not completely effective and generate some side effects, so the search for complementary strategies is necessary for handling. Objetives: To evaluate the capability of essential oils on Lippia alba (Mill). N.E.Br and Cymbopogon citratus (DC.) Stapf to eradicate S. mutans biofilms and its toxicity on eukaryotic cells. Methods: Essential oils were extracted from plant material through steam distillation. Its chemical composition was determined for gas chromatography with mass selective detector (GC-MS). It was used the MBEC-high-throughput technique to determine the removal concentration of S. mutans biofilms. Cytotoxicity was evaluated on CHO cells through The MTT 3-(4,5-dimethylthiazol- 2-yl)-2,5-diphenyltetrazolium. Results: The major components in both essential oils were Geraniol and Citral. Lippia alba essential oil applied in concentration of 0.01 mg / 100 mL removed 95.8% of S. mutans biofilm and C. citratus essential oil showed a removal activity of 95.4% in the concentrations 0.1, 0.01mg/100 mL and 93.1% in concentration 0.001 mg / 100 mL. None of the essential oils showed toxicity to CHO cells in a 24-hour treatment, with significant differences in relation to the control with methanol (P = 0.00) which inhibits most cells. Conclusions: The L. alba and C. citratus essential oils showed eradication activity against S. mutans biofilms and null cytotoxicity, evidencing a potential use in treating and preventing dental caries.

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Vitae

Título del artículo:

The role of adiponectin in cardiometabolic diseases: Effects of nutritional interventions

Adiponectin is an adipocyte-derived hormone abundantly present in plasma that exerts its effects through the activation of 3 receptors. Its concentrations are negatively regulated by the accumulation of visceral fat, and clinical studies implicate hypoadiponectinemia in the pathogenesis of diabetes mellitus type 2, coronary artery disease, hypertension, and left ventricular hypertrophy. In contrast, high concentrations of adiponectin are associated with a decreased risk of coronary artery disease, with an improvement in the differentiation of preadipocytes into adipocytes, and with increased endothelial nitric oxide production. Therefore, adiponectin appears to be an important molecule involved in limiting the pathogenesis of obesity-linked disorders, and it may have potential benefits in the treatment and prevention of cardiovascular disease. Caloric restriction, moderate alcohol consumption, and consuming a Mediterranean diet increase adiponectin concentrations, and current evidence suggests a positive, dose-dependent relation between ω-3 (n-3) fatty acid intake and circulating concentrations of adiponectin. Recently, it was reported that the administration of aged garlic extract and a single food intervention with pistachios can increase adiponectin concentrations in individuals with metabolic syndrome. Moreover, the Mediterranean diet is associated with higher adiponectin concentrations. Additional studies are needed to evaluate the potential benefits of increasing adiponectin by nutritional interventions in the treatment and prevention of cardiometabolic diseases.

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Journal of Nutrition

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Hyperglycaemia is associated with worse outcomes in Latin-American individuals with acute myocardial infarction

Background: Alterations in glucose metabolism have been reported as risk and poor prognostic factors for acute myocardial infarction (AMI); however in Latin-American population this information is limited. Thus, an evaluation was performed on the association between glycaemic status and short- and long-term outcomes in patients with a first AMI. Methods: A multicentre, prospective, observational, cohort study was conducted in 8 hospitals from Colombia and Ecuador. Results: A total of 439 patients with confirmed AMI were included, of which 305 (69.5%) had prediabetes or type 2 diabetes mellitus (DM2). Compared with normal glycaemia group, patients with known DM2 had greater risk of prolonged hospital stay (HR: 2.60, 95% CI: 1.38-4.92, P = .003), Killip class iii/. iv (HR: 9.46, 95% CI: 2.20-40.62, P = .002), and in-hospital heart failure (HR: 10.76, 95% CI: 3.37-34.31, P < .001). Patients with prediabetes, new DM2, and known DM2 showed higher rates of major adverse cardiovascular events after 3 years follow-up. Conclusion: Glucose metabolism abnormalities have an important significance in the short- and long-term prognosis in Latin-American patients that survive a first AMI.

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Clinica e Investigacion en Arteriosclerosis

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Peridomestic Infection as a Determining Factor of Dengue Transmission

Background: The study of endemic dengue transmission is essential for proposing alternatives to impact its burden. The traditional paradigm establishes that transmission starts around cases, but there are few studies that determine the risk. Methods: To assess the association between the peridomestic dengue infection and the exposure to a dengue index case (IC), a cohort was carried out in two Mexican endemic communities. People cohabitating with IC or living within a 50-meter radius (exposed cohort) and subjects of areas with no ICs in a 200-meter radius (unexposed cohort) were included. Results: Exposure was associated with DENV infection in cohabitants (PRa 3.55; 95%CI 2.37–5.31) or neighbors (PRa 1.82; 95%CI 1.29–2.58). Age, location, toilets with no direct water discharge, families with children younger than 5 and the House Index, were associated with infection. Families with older than 13 were associated with a decreased frequency. After a month since the IC fever onset, the infection incidence was not influenced by exposure to an IC or vector density; it was influenced by the local seasonal behavior of dengue and the age. Additionally, we found asymptomatic infections accounted for 60% and a greater age was a protective factor for the presence of symptoms (RR 0.98; 95%CI 0.97–0.99). Conclusion: The evidence suggests that dengue endemic transmission in these locations is initially peridomestic, around an infected subject who may be asymptomatic due to demographic structure and endemicity, and it is influenced by other characteristics of the individual, the neighborhood and the location. Once the transmission chain has been established, dengue spreads in the community probably by the adults who, despite being the group with lower infection frequency, mostly suffer asymptomatic infections and have higher mobility. This scenario complicates the opportunity and the effectiveness of control programs and highlights the need to apply multiple measures for dengue control.

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PLoS Neglected Tropical Diseases

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The environmental profile of a community’s health: A cross-sectional study on tobacco marketing in 16 countries

Objective To examine and compare tobacco marketing in 16 countries while the Framework Convention on Tobacco Control requires parties to implement a comprehensive ban on such marketing. Methods Between 2009 and 2012, a kilometre-long walk was completed by trained investigators in 462 communities across 16 countries to collect data on tobacco marketing. We interviewed community members about their exposure to traditional and non-traditional marketing in the previous six months. To examine differences in marketing between urban and rural communities and between high-, middle- and low-income countries, we used multilevel regression models controlling for potential confounders. Findings Compared with high-income countries, the number of tobacco advertisements observed was 81 times higher in low-income countries (incidence rate ratio, IRR: 80.98; 95% confidence interval, CI: 4.15–1578.42) and the number of tobacco outlets was 2.5 times higher in both low- and lower-middle-income countries (IRR: 2.58; 95% CI: 1.17–5.67 and IRR: 2.52; CI: 1.23–5.17, respectively). Of the 11 842 interviewees, 1184 (10%) reported seeing at least five types of tobacco marketing. Self-reported exposure to at least one type of traditional marketing was 10 times higher in low-income countries than in high-income countries (odds ratio, OR: 9.77; 95% CI: 1.24–76.77). For almost all measures, marketing exposure was significantly lower in the rural communities than in the urban communities. Conclusion Despite global legislation to limit tobacco marketing, it appears ubiquitous. The frequency and type of tobacco marketing varies on the national level by income group and by community type, appearing to be greatest in low-income countries and urban communities.

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Bulletin of the World Health Organization

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Alcohol consumption and cardiovascular disease, cancer, injury, admission to hospital, and mortality: A prospective cohort study

Summary Background Alcohol consumption is proposed to be the third most important modifiable risk factor for death and disability. However, alcohol consumption has been associated with both benefits and harms, and previous studies were mostly done in high-income countries. We investigated associations between alcohol consumption and outcomes in a prospective cohort of countries at different economic levels in five continents. Methods We included information from 12 countries participating in the Prospective Urban Rural Epidemiological (PURE) study, a prospective cohort study of individuals aged 35-70 years. We used Cox proportional hazards regression to study associations with mortality (n=2723), cardiovascular disease (n=2742), myocardial infarction (n=979), stroke (n=817), alcohol-related cancer (n=764), injury (n=824), admission to hospital (n=8786), and for a composite of these outcomes (n=11 963). Findings We included 114 970 adults, of whom 12 904 (11%) were from high-income countries (HICs), 24 408 (21%) were from upper-middle-income countries (UMICs), 48 845 (43%) were from lower-middle-income countries (LMICs), and 28 813 (25%) were from low-income countries (LICs). Median follow-up was 4·3 years (IQR 3·0-6·0). Current drinking was reported by 36 030 (31%) individuals, and was associated with reduced myocardial infarction (hazard ratio [HR] 0·76 [95% CI 0·63-0·93]), but increased alcohol-related cancers (HR 1·51 [1·22-1·89]) and injury (HR 1·29 [1·04-1·61]). High intake was associated with increased mortality (HR 1·31 [1·04-1·66]). Compared with never drinkers, we identified significantly reduced hazards for the composite outcome for current drinkers in HICs and UMICs (HR 0·84 [0·77-0·92]), but not in LMICs and LICs, for which we identified no reductions in this outcome (HR 1·07 [0·95-1·21]; pinteraction<0·0001). Interpretation Current alcohol consumption had differing associations by clinical outcome, and differing associations by income region. However, we identified sufficient commonalities to support global health strategies and national initiatives to reduce harmful alcohol use. Funding Population Health Research Institute, the Canadian Institutes of Health Research, Heart and Stroke Foundation of Ontario, AstraZeneca (Canada), Sanofi-Aventis (France and Canada), Boehringer Ingelheim (Germany and Canada), Servier, GlaxoSmithKline, Novartis, King Pharma, and national or local organisations in participating countries.

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The Lancet

Título del artículo:

Behaviour change strategies for reducing blood pressure-related disease burden: Findings from a global implementation research programme

Background: The Global Alliance for Chronic Diseases comprises the majority of the world\'s public research funding agencies. It is focussed on implementation research to tackle the burden of chronic diseases in low- and middle-income countries and amongst vulnerable populations in high-income countries. In its inaugural research call, 15 projects were funded, focussing on lowering blood pressure-related disease burden. In this study, we describe a reflexive mapping exercise to identify the behaviour change strategies undertaken in each of these projects. Methods: Using the Behaviour Change Wheel framework, each team rated the capability, opportunity and motivation of the various actors who were integral to each project (e.g. community members, non-physician health workers and doctors in projects focussed on service delivery). Teams then mapped the interventions they were implementing and determined the principal policy categories in which those interventions were operating. Guidance was provided on the use of Behaviour Change Wheel to support consistency in responses across teams. Ratings were iteratively discussed and refined at several group meetings. Results: There was marked variation in the perceived capabilities, opportunities and motivation of the various actors who were being targeted for behaviour change strategies. Despite this variation, there was a high degree of synergy in interventions functions with most teams utilising complex interventions involving education, training, enablement, environmental restructuring and persuasion oriented strategies. Similar policy categories were also targeted across teams particularly in the areas of guidelines, communication/marketing and service provision with few teams focussing on fiscal measures, regulation and legislation. Conclusions: The large variation in preparedness to change behaviour amongst the principal actors across these projects suggests that the interventions themselves will be variably taken up, despite the similarity in approaches taken. The findings highlight the importance of contextual factors in driving success and failure of research programmes. Forthcoming outcome and process evaluations from each project will build on this exploratory work and provide a greater understanding of factors that might influence scale-up of intervention strategies.

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Implementation Science