1
|
Chuvileva YE, Manangan A, Chew A, Rutherford G, Barillas-Basterrechea M, Barnoya J, Breysse PN, Blanck H, Liburd L. What North American retail food environment indices miss in Guatemala: Cultural considerations for the study of place and health. Appl Geogr 2024; 164:10.1016/j.apgeog.2024.103204. [PMID: 38532832 PMCID: PMC10964928 DOI: 10.1016/j.apgeog.2024.103204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 03/28/2024]
Abstract
We evaluated the cross-context validity and equivalence of the US- and Canada-originated Retail Food Environment Index (RFEI) and modified RFEI (mRFEI) against a retail food environment dataset from the indigenous-majority city of Quetzaltenango (Xela), Guatemala. The RFEI/mRFEI failed to identify 77% of retailers and misclassified the healthiness of 42% of the remaining retailers in Xela, inaccurately labeling the city a food swamp. The RFEI/mRFEI are not currently suitable for mapping retail food environments in places like Quetzaltenango. Alternative functional and temporal classifications of retail food environments may provide measures with greater contextual fit, highlighting important cultural considerations for the study of place and dietary health.
Collapse
Affiliation(s)
- Yulia E. Chuvileva
- Division of Adolescent and School Health (DASH), National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Centers for Disease Control and Prevention (CDC), USA
| | - Arie Manangan
- Division of Environmental Health Science and Practice (DEHSP), National Center for Environmental Health (NCEH), CDC, Atlanta, GA, USA
| | - Aiken Chew
- Universidad del Valle de Guatemala, Guatemala City, Guatemala
| | - George Rutherford
- University of California San Francisco (UCSF), San Francisco, CA, USA
| | | | - Joaquín Barnoya
- Unidad de Cirugía Cardiovascular de Guatemala and Universidad Rafael Landivar, Guatemala City, Guatemala
| | - Patrick N. Breysse
- NCEH/Agency for Toxic Substances and Disease Registry (ATSDR), CDC, Atlanta, GA, USA
| | - Heidi Blanck
- Division of Nutrition, Physical Activity, and Obesity (DNPAO), NCCDPHP, CDC, Atlanta, GA, USA
| | - Leandris Liburd
- Office of Minority Health and Health Equity (OMHHE), CDC, Atlanta, GA, USA
| |
Collapse
|
2
|
Aburto TC, Romieu I, Stern MC, Barquera S, Corvalán C, Hallal PC, Reynales-Shigematsu LM, Barnoya J, Cavalcante TM, Canelo-Aybar C, Santero M, Feliu A, Espina C, Rivera JA. Latin American and the Caribbean Code Against Cancer 1st edition: Weight, physical activity, diet, breastfeeding, and cancer. Cancer Epidemiol 2023; 86 Suppl 1:102436. [PMID: 37852731 DOI: 10.1016/j.canep.2023.102436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 07/06/2023] [Accepted: 07/13/2023] [Indexed: 10/20/2023]
Abstract
In Latin America and the Caribbean a considerable proportion of the population have excess body weight, do not meet the recommendations of physical activity and healthy diet, and have suboptimal rates of breastfeeding. Excess body weight is associated with at least 15 cancer sites, physical activity protects against three cancers, with some evidence suggesting a protective effect for eight more cancer sites, and sedentary behavior probably increases the risk of five cancer sites. Fiber and wholegrains protect against colorectal cancer, high intake of fruits and vegetables could reduce the risk of aerodigestive cancers; processed and red meat increase the risk of colorectal cancer; and very hot beverages are associated with esophageal cancer. Moreover, sugar-sweetened beverages and ultra-processed foods are a convincing cause for excess body weight, increasing cancer risk through this pathway, with some emerging evidence suggesting also direct pathways. Breastfeeding protects against breast cancer, and could protect against ovarian cancer. Taking this evidence into account, the Latin America and the Caribbean Code Against Cancer recommends the general public to maintain a healthy body weight, be physically active and limit sedentary behavior, eat a healthy diet (eat plenty of vegetables, fruits, wholegrains and legumes; avoid sugar-sweetened beverages and processed meat; and limit ultra-processed foods, red meat and very hot beverages), and breastfeed. Moreover, the Latin America and the Caribbean Code Against Cancer also includes a set of public policy recommendations for cancer prevention to inform policy makers and civil society about the need of policies to shape healthy environments and create opportunities to facilitate the adoption of the recommendations directed to the public.
Collapse
Affiliation(s)
- Tania C Aburto
- Center for Research on Nutrition and Health, National Institute of Public Health, 62100 Cuernavaca, Mexico
| | - Isabelle Romieu
- Center for Population Health Research, National Institute of Public Health, 62100 Cuernavaca, Mexico
| | - Mariana C Stern
- Department of Preventive Medicine and Urology, Keck School of Medicine of USC, 90033 Los Angeles, United States
| | - Simón Barquera
- Center for Research on Nutrition and Health, National Institute of Public Health, 62100 Cuernavaca, Mexico
| | - Camila Corvalán
- Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago, Chile
| | - Pedro C Hallal
- Department of Kinesiology and Community Health, University of Illinois Champaign-Urbana, Illinois, United States
| | - Luz M Reynales-Shigematsu
- Center for Population Health Research, National Institute of Public Health, 62100 Cuernavaca, Mexico
| | - Joaquín Barnoya
- Research Department, Integra Cancer Institute, Guatemala City, Guatemala; Department of Environmental and Occupational Health, Colorado School of Public Health, CU Anschutz, United States
| | - Tania M Cavalcante
- Instituto Nacional de Câncer José de Alencar Gomes da Silva, Secretaria Executiva da Comissão Nacional para a Implementação da Convenção-Quadro para o Controle do Tabaco, Rio de Janeiro, RJ, Brasil
| | - Carlos Canelo-Aybar
- Department of Clinical Epidemiology and Public Health, Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Marilina Santero
- Department of Clinical Epidemiology and Public Health, Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Ariadna Feliu
- International Agency for Research on Cancer (IARC/WHO), Environment and Lifestyle Epidemiology Branch, 25 avenue Tony Garnier CS 90627, 69366 Lyon CEDEX 07 France
| | - Carolina Espina
- International Agency for Research on Cancer (IARC/WHO), Environment and Lifestyle Epidemiology Branch, 25 avenue Tony Garnier CS 90627, 69366 Lyon CEDEX 07 France
| | - Juan A Rivera
- Center for Population Health Research, National Institute of Public Health, 62100 Cuernavaca, Mexico.
| |
Collapse
|
3
|
Rozas L, Castronuovo L, Busse P, Mus S, Barnoya J, Garrón A, Tiscornia MV, Guanieri L. Data on the Facebook marketing strategies used by fast-food chains in four Latin American countries during the COVID-19 lockdowns. BMC Res Notes 2021; 14:463. [PMID: 34930460 PMCID: PMC8686095 DOI: 10.1186/s13104-021-05870-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 11/30/2021] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES During the COVID-19 pandemic, most countries implemented lockdowns that motivated changes in the dietary patterns, physical activity, and body mass index (BMI) of consumers worldwide, as well as the emergence of new food marketing strategies in social media. We sought to design and validate a methodology for monitoring and evaluating the Facebook marketing strategies of multinational fast-food chains in response to the COVID-19 pandemic. DATA DESCRIPTION We developed three datasets. First, a dataset with the Uniform Resource Locators (URLs) of 1015 Facebook posts of five fast-food chains present in Argentina, Bolivia, Guatemala, and Peru. Second, a dataset of 106 content-analyzed posts we used in a pilot to determine intercoder reliability using statistical tests. Third, a dataset of a final sample of the 1015 content-analyzed posts that we used to determine the variables most frequently used. Following a mixed-methods approach, we developed 29 variables that recorded general information, as well as the marketing strategies we identified in the posts, including 14 COVID-19 specific variables. These data should help to monitor the social media marketing strategies that fast-food chains have introduced during the COVID-19 lockdowns, thus providing initial evidence about how they could be contributing to an unhealthy food environment.
Collapse
Affiliation(s)
- Lucila Rozas
- Instituto de Investigación Científica, Grupo de Investigación en Comunicación y Salud, Universidad de Lima, 4600 Javier Prado Este Avenue, Tower A, 11th Floor, 15023 Lima, Peru
| | - Luciana Castronuovo
- Fundación Interamericana del Corazón Argentina (FIC-Argentina), Arévalo 2364—1 A, C1425DBR Buenos Aires, Argentina
| | - Peter Busse
- Instituto de Investigación Científica, Grupo de Investigación en Comunicación y Salud, Carrera de Comunicación, Universidad de Lima, 4600 Javier Prado Este Avenue, Tower A, 11th Floor, 15023 Lima, Peru
| | - Sophia Mus
- Departamento de Investigación, Unidad de Cirugía Cardiovascular de Guatemala, 9a Av 8-00 zona 11, Ciudad de Guatemala, 01011 Guatemala
| | - Joaquín Barnoya
- Departamento de Investigación, Unidad de Cirugía Cardiovascular de Guatemala, 9a Av 8-00 zona 11, Ciudad de Guatemala, 01011 Guatemala
| | - Alejandra Garrón
- Fundación Interamericana del Corazón—Bolivia, Mariscal Santa Cruz Avenue, La Primera Building, Tower B, 10th Floor, Office No. 7, La Paz, Bolivia
| | - María Victoria Tiscornia
- Fundación Interamericana del Corazón Argentina (FIC-Argentina), Arévalo 2364—1 A, C1425DBR Buenos Aires, Argentina
| | - Leila Guanieri
- Fundación Interamericana del Corazón Argentina (FIC-Argentina), Arévalo 2364—1 A, C1425DBR Buenos Aires, Argentina
| |
Collapse
|
4
|
Pérez A, Thrasher J, Monzón JC, Arillo-Santillán E, Barnoya J, Mejía R. La escala de afluencia familiar en la investigación sobre inequidades sociales en salud en adolescentes latinoamericanos. Salud Publica Mex 2021; 63:201-210. [PMID: 33989488 DOI: 10.21149/11793] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 10/06/2020] [Indexed: 11/06/2022] Open
Abstract
Objetivo. Evaluar la escala de afluencia familiar (EAF), que consiste en el autorreporte sobre número de computadoras y automóviles del hogar, dormitorio propio y vacaciones, como indicador de nivel socioeconómico (NSE) familiar en adolescentes escolarizados de tres países latinoamericanos. Material y métodos. Fueron encuestados 14 717 estudiantes de secundaria de Argentina, México y Guatemala. Se evaluó la asociación de la EAF con otros indicadores de NSE a nivel familiar (nivel educativo parental, posesión de bienes y servicios tecnológicos) y de entorno escolar (índice de marginación, escuela pública o privada y matrícula escolar). Resultados. La EAF mostró menos datos faltantes que los otros indicadores familiares de NSE. Además, mostró asociaciones en la dirección esperada con los otros indicadores de NSE. Conclusiones. La EAF parece constituir un indicador válido tanto de la riqueza material familiar como del NSE a nivel de la escuela, útil para estudios sobre inequidades en salud en adolescentes latinoamericanos.
Collapse
Affiliation(s)
- Adriana Pérez
- Grupo de Bioestadística Aplicada, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires. Buenos Aires, Argentina; Centro de Estudios de Estado y Sociedad. Buenos Aires, Argentina..
| | - James Thrasher
- Department of Health Promotion, Education & Behavior, Arnold School of Public Health, University of South Carolina. Columbia, USA; Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México..
| | - José Carlos Monzón
- Instituto de Investigación y Estudios Superiores en Ciencias de la Salud, Universidad Rafael Landívar. Guatemala, Guatemala..
| | - Edna Arillo-Santillán
- Departamento de Prevención y Control del Tabaquismo, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México..
| | - Joaquín Barnoya
- Instituto de Investigación y Estudios Superiores en Ciencias de la Salud, Universidad Rafael Landívar. Guatemala, Guatemala; Unidad de Cirugía Cardiovascular de Guatemala. Guatemala, Guatemala.
| | - Raúl Mejía
- Centro de Estudios de Estado y Sociedad. Buenos Aires, Argentina..
| |
Collapse
|
5
|
Martínez C, Castellano Y, Company A, Guillen O, Margalef M, Alicia Arrien M, Sánchez C, Cáceres P, Barnoya J, Fernández E. Impact of an online training program in hospital workers’ smoking cessation interventions in Bolivia, Guatemala and Paraguay. Gaceta Sanitaria 2018; 32:236-243. [DOI: 10.1016/j.gaceta.2017.10.020] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 10/25/2017] [Accepted: 10/31/2017] [Indexed: 11/25/2022]
|
6
|
Zamorano A, Barnoya J, Gharzouzi E, Chrisman Robbins C, Mutch D. Compliance After Treatment Is a Major Barrier to the Optimal Treatment of Cervical Cancer in Guatemala. Gynecol Oncol 2017. [DOI: 10.1016/j.ygyno.2017.07.048] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
7
|
García-Trabanino R, Cerdas M, Madero M, Jakobsson K, Barnoya J, Crowe J, Jarquín E, Guzmán-Quilo C, Correa-Rotter R. Nefropatía mesoamericana: revisión breve basada en el segundo taller del Consorcio para el estudio de la Epidemia de Nefropatía en Centroamérica y México (CENCAM). Nefrología Latinoamericana 2017. [DOI: 10.1016/j.nefrol.2016.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
|
8
|
García-Trabanino R, Jakobsson K, Guzmán Quilo C, Brooks DR, Crowe J, Barnoya J, Madero M, González Quiroz M, Wesseling C, Wegman DH, Correa-Rotter R. In reply to: "Should we consider renaming 'Mesoamerican Nephropathy' as Nephropathy of Unknown Cause in Agricultural Labourers (NUCAL)?". Occup Environ Med 2016; 73:802-803. [PMID: 27566784 DOI: 10.1136/oemed-2016-104005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Accepted: 08/10/2016] [Indexed: 11/04/2022]
Affiliation(s)
- Ramón García-Trabanino
- Centro de Hemodiálisis, San Salvador, El Salvador Emergency Social Fund for Health of Tierra Blanca, Tierra Blanca, El Salvador
| | - Kristina Jakobsson
- Section of Occupational and Environmental Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Goteborg, Sweden
| | | | - Daniel R Brooks
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Jennifer Crowe
- Regional Institute for Studies on Toxic Substances (IRET), Program on Health, Work and Environment (SALTRA), Universidad Nacional, Heredia, Costa Rica
| | - Joaquín Barnoya
- Research Department, Cardiovascular Surgery Unit, Guatemala, Guatemala Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Magdalena Madero
- Division of Nephrology, Department of Medicine, Instituto Nacional de Cardiologia Ignacio Chavez, Mexico city, Mexico
| | - Marvin González Quiroz
- Research Center on Health, Work and Environment (CISTA), National Autonomous University of Nicaragua at León (UNAN-León), León, Nicaragua Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Catharina Wesseling
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - David H Wegman
- Department of Work Environment, University of Massachusetts Lowell, Lowell, Massachusetts, USA
| | - Ricardo Correa-Rotter
- Department of Nephrology and Mineral Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición, Salvador Zubirán, Mexico city, Mexico
| |
Collapse
|
9
|
Halford B, Barnoya J, Melendez R, Escobar EH, Rothstein M. Dialysis impact on quality of life of patients with chronic kidney
disease in Guatemala. A pilot study. Ann Glob Health 2016. [DOI: 10.1016/j.aogh.2016.04.170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
10
|
Koolwal P, Madrigal L, Rothstein M, Barnoya J. Identifying perceptions of chronic kidney disease in a hemodialysis
population in Guatemala. Ann Glob Health 2016. [DOI: 10.1016/j.aogh.2016.04.654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
|
11
|
Barnoya J, Monzon JC, Briz P, Navas-Acien A. Compliance to the smoke-free law in Guatemala 5-years after implementation. BMC Public Health 2016; 16:318. [PMID: 27138959 PMCID: PMC4852414 DOI: 10.1186/s12889-016-2960-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2015] [Accepted: 03/15/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Smoke-free environments decrease smoking prevalence and consequently the incidence of heart disease and lung cancer. Due to issues related to poor enforcement, scant data is currently available from low/middle income countries on the long-term compliance to smoke-free laws. In 2006, high levels of secondhand smoke (SHS) were found in bars and restaurants in Guatemala City. Six months after a smoking ban was implemented in 2009, levels significantly decreased. However, in 2010, poor law compliance was observed. Therefore, we sought to assess long-term compliance to the ban using SHS measurements. METHODS In 2014 we assessed SHS exposure using airborne nicotine monitors in bars (n = 9) and restaurants (n = 12) for 7 days using the same protocol as in 2006 and in 2009. Nicotine was measured using gas-chromatography (μg/m(3)) and compared to levels pre- (2006) and post-ban (2009). Employees responded to a survey about SHS exposure, perceived economic impact of the ban and customers' electronic cigarette use. In addition, we estimated the fines that could have been collected for each law infringement. RESULTS Most (71 %) venues still have a smoking section, violating the law. The percentage of samples with detectable nicotine concentrations was 100, 85 and 43 % in 2006, 2009 and 2014, respectively. In bars, median (25(th) and 75(th) percentiles) nicotine concentrations were 4.58 μg/m(3) (1.71, 6.45) in 2006, 0.28 (0.17, 0.66) in 2009, and 0.59 (0.01, 1.45) in 2014. In restaurants, the corresponding medians were 0.58 μg/m(3) (0.44, 0.71), 0.04 (0.01, 0.11), and 0.01 (0.01, 0.09). Support for the law continues to be high (88 %) among bar and restaurant employees. Most employees report no economic impact of the law and that a high proportion of customers (78 %) use e-cigarettes. A total of US$50,012 could have been collected in fines. CONCLUSIONS Long-term compliance to the smoking ban in Guatemala is decreasing. Additional research that evaluates the determinants of non-compliance is needed and could also contribute to improve enforcement and implementation of the smoke-free law in Guatemala.
Collapse
Affiliation(s)
- Joaquín Barnoya
- Research Department, Cardiovascular Surgery Unit of Guatemala, 9th Avenue, 8-00, Zone 11, 01011, Guatemala City, Guatemala. .,Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, 660 S Euclid Ave., St. Louis, MO, 63110, USA.
| | - Jose C Monzon
- Research Department, Cardiovascular Surgery Unit of Guatemala, 9th Avenue, 8-00, Zone 11, 01011, Guatemala City, Guatemala
| | - Paulina Briz
- Research Department, Cardiovascular Surgery Unit of Guatemala, 9th Avenue, 8-00, Zone 11, 01011, Guatemala City, Guatemala
| | - Ana Navas-Acien
- Department of Environmental Health Sciences and Institute for Global Tobacco Control, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
| |
Collapse
|
12
|
Tres P, Barnoya J, Asturias AL. Relationship between postnatal weight and premature retinopathy in Guatemala. ACTA ACUST UNITED AC 2015; 91:153-4. [PMID: 26678824 DOI: 10.1016/j.oftal.2015.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Accepted: 10/18/2015] [Indexed: 10/22/2022]
Affiliation(s)
- P Tres
- Unidad Nacional de Oftalmología, Hospital Roosevelt, Universidad de San Carlos de Guatemala, Guatemala, Guatemala.
| | - J Barnoya
- Unidad Nacional de Oftalmología, Hospital Roosevelt, Universidad de San Carlos de Guatemala, Guatemala, Guatemala
| | - A L Asturias
- Unidad Nacional de Oftalmología, Hospital Roosevelt, Universidad de San Carlos de Guatemala, Guatemala, Guatemala
| |
Collapse
|
13
|
Corral JE, Arnold LD, Argueta EE, Ganju A, Barnoya J. Clinical preventive services in Guatemala: a cross-sectional survey of internal medicine physicians. PLoS One 2012; 7:e48640. [PMID: 23119077 PMCID: PMC3485332 DOI: 10.1371/journal.pone.0048640] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2012] [Accepted: 09/28/2012] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Guatemala is currently undergoing an epidemiologic transition. Preventive services are key to reducing the burden of non-communicable diseases, and smoking counseling and cessation are among the most cost-effective and wide-reaching strategies. Internal medicine physicians are fundamental to providing such services, and their knowledge is a cornerstone of non-communicable disease control. METHODS A national cross-sectional survey was conducted in 2011 to evaluate knowledge of clinical preventive services for non-communicable diseases. Interns, residents, and attending physicians of the internal medicine departments of all teaching hospitals in Guatemala completed a self-administered questionnaire. Participants' responses were contrasted with the Guatemalan Ministry of Health (MoH) prevention guidelines and the US Preventive Services Task Force (USPSTF) recommendations. Analysis compared knowledge of recommendations within and between hospitals. RESULTS In response to simulated patient scenarios, all services were recommended by more than half of physicians regardless of MoH or USPSTF recommendations. Prioritization was adequate according to the MoH guidelines but not including other potentially effective services (e.g. colorectal cancer and lipid disorder screenings). With the exception of colorectal and prostate cancer screening, less frequently recommended by interns, there was no difference in recommendation rates by level. CONCLUSION Guatemalan internal medicine physicians' knowledge on preventive services recommendations for non-communicable diseases is limited, and prioritization did not reflect cost-effectiveness. Based on these data we recommend that preventive medicine training be strengthened and development of evidence-based guidelines for low-middle income countries be a priority.
Collapse
Affiliation(s)
- Juan E. Corral
- Research Department, Cardiovascular Unit of Guatemala, Guatemala City, Guatemala
| | - Lauren D. Arnold
- Division of Public Health Sciences, Department of Surgery, Washington University in St. Louis, School of Medicine, St. Louis, Missouri, United States of America
| | - Erwin E. Argueta
- Research Department, Cardiovascular Unit of Guatemala, Guatemala City, Guatemala
| | - Akshay Ganju
- Division of Public Health Sciences, Department of Surgery, Washington University in St. Louis, School of Medicine, St. Louis, Missouri, United States of America
| | - Joaquín Barnoya
- Research Department, Cardiovascular Unit of Guatemala, Guatemala City, Guatemala
- Division of Public Health Sciences, Department of Surgery, Washington University in St. Louis, School of Medicine, St. Louis, Missouri, United States of America
| |
Collapse
|
14
|
Corral JE, Cornejo JA, Barnoya J. Bars' and restaurants' compliance with the Guatemalan smoke-free law during the 2010 Soccer World Cup: a missed opportunity. Tob Control 2011; 20:445-6. [DOI: 10.1136/tobaccocontrol-2011-050053] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
15
|
Braun S, Mejia R, Barnoya J, Gregorich SE, Pérez-Stable EJ. Tobacco advertising and press coverage of smoking and health in 10 years of Argentinean newspapers. CVD Prev Control 2011; 6:71-80. [PMID: 24032052 PMCID: PMC3769192 DOI: 10.1016/j.cvdpc.2011.04.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To describe the extent and content of tobacco-related images, advertising and articles published in the largest Argentinean newspapers before and after a voluntary advertising ban implemented in 2001. METHODS Issues from four months of each year of the four main national newspapers were examined from 1995 to 2004. We recorded the number of tobacco images (advertisement or not), tobacco-focused articles, space used, and placement within the newspaper. Regression analyses evaluated time trends. RESULTS We identified 1800 images and articles from 4828 different issues. Non-advertisement images were the most frequent (71.2%), followed by articles (20%) and advertisement images (8.8%). Advertisements only appeared in the two best selling newspapers with a majority (57%) in the Sunday magazine and 21% in the sports sections. Non-advertisement images were published in the sports and entertainment sections (55%) and showed a public figure in 88%. Of 336 articles, 39% focused on health topics and 55% emphasized the negative effects of tobacco on health. Regression models showed that prior to 2001 there were significant time-related decreases in ad images and articles and significant increases in non-ad images. The trend of each outcome changed direction beginning in 2001 and the magnitude of the change in trend was significant for ad images and non-ad images. The number of non-ad images dropped significantly in 2001 from a model-predicted value of 178 per year to 103 non-ad images and remained constant thereafter. CONCLUSIONS Tobacco images exceeded information about tobacco hazards in Argentinean newspapers over this period. Advertisement increased from 2001 to 2005, following the voluntary advertisements ban. Partial advertisement bans are ineffective and a total ban is imperative.
Collapse
Affiliation(s)
- Sandra Braun
- Programa de Medicina Interna General, Hospital de Clinicas, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Raul Mejia
- Programa de Medicina Interna General, Hospital de Clinicas, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Joaquín Barnoya
- Department of Surgery, Prevention and Control, Washington University in St. Louis, School of Medicine, United States
| | - Steven E. Gregorich
- Division of General Internal Medicine, Department of Medicine, Medical Effectiveness Research Center for Diverse Populations, University of California, San Francisco (UCSF), United States
| | - Eliseo J. Pérez-Stable
- Division of General Internal Medicine, Department of Medicine, Medical Effectiveness Research Center for Diverse Populations, University of California, San Francisco (UCSF), United States
- Center for Tobacco Control Research and Education, Helen Diller Family Comprehensive Cancer Center, UCSF, United States
| |
Collapse
|
16
|
Kummerfeldt CE, Barnoya J, Bero L. Philip Morris involvement in the development of an air quality laboratory in El Salvador. Tob Control 2009; 18:241-4. [PMID: 19211614 PMCID: PMC2679184 DOI: 10.1136/tc.2008.026989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Background: The tobacco industry has organised research institutions to generate misleading data on indoor air quality, including second-hand smoke exposure and health effects. Objectives: To describe tobacco industry involvement in the organisation and financial support of an air quality research laboratory in El Salvador. Methods: Tobacco industry documents on the internet were systematically searched from August 2007 to February 2008 for air quality studies undertaken in El Salvador, and laboratory personnel were interviewed. Results: Philip Morris sought to establish a network of air quality laboratories throughout Latin America. In El Salvador, in 1997, through Tabacalera de El Salvador (a subsidiary of Philip Morris) and the Salvadoran Foundation for Economic Development (FUSADES), the industry organised an air quality research laboratory. FUSADES was part of the industry’s Latin American Scientific Network, which consisted of doctors hired as consultants who would send air samples from their research to FUSADES. Philip Morris Scientific Affairs personnel hired LabStat, a Canadian-based laboratory, to provide technical assistance to FUSADES (train and assist the laboratory in air quality measurements). In addition, the Washington-based HMS Group successfully implemented a plan to upgrade the laboratory and obtain international certifications. HMS Group also assisted in searching for sustainable funding for FUSADES, including seeking funds from international aid for Hurricane Mitch. Conclusion: Air quality studies that have used the FUSADES laboratory should be carefully interpreted, given the support that this laboratory received from Philip Morris.
Collapse
Affiliation(s)
| | - J Barnoya
- Cardiovascular Unit of Guatemala, Guatemala City, Guatemala
- University of California, San Francisco, Center for Tobacco Control Research and Education and Department of Epidemiology, San Francisco, California, USA
| | - L Bero
- University of California, San Francisco, California, USA
| |
Collapse
|
17
|
Wattenwyl RV, Siepe M, Barnoya J, Löffelbein F, Beyersdorf F, Schlensak C. Progression of a congenital heart program in a low income country on the example of the VSD. Thorac Cardiovasc Surg 2009. [DOI: 10.1055/s-0029-1191507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
18
|
Abstract
OBJECTIVE To evaluate the processes and outcomes of tobacco litigation in Argentina and to analyse the strategies of the tobacco industry to oppose litigation using tobacco industry documents. METHODS A systematic search of tobacco industry documents on the internet dating from 1978 to 2002. Law library searches using Argentinean official and unofficial reports systems were combined with computerised online searches. RESULTS There have been at least 15 failed litigation cases in Argentina and the tobacco industry presented a concerted defence in every claim regardless of cost. We categorised 11 cases as product liability and nicotine addiction, two as health care reimbursement, and two as criminal law and secondhand smoke. Industry strategies included hiring legal consultants from prestigious international and Argentinean law firms and developing litigation prevention programmes. Industry monitored legal academic meetings, controlled the development of new product liability legislation, obtained favourable opinions from experts, and closely observed the development of litigation in Argentina. CONCLUSION The strategies used by the industry have been successful in preventing recovery for tobacco injuries through litigation. Argentinean health advocates and lawyers need to be aware of the roles and strategies of the tobacco industry in order to develop effective litigation in Argentina.
Collapse
Affiliation(s)
- M L Flores
- Division of General Internal Medicine, Department of Medicine, Medical Effectiveness Research Center for Diverse Populations, University of California, San Francisco, California, USA
| | | | | | | | | |
Collapse
|
19
|
Abstract
OBJECTIVE To evaluate how transnational tobacco companies, working through their local affiliates, influenced tobacco control policymaking in Argentina between 1966 and 2005. METHODS Analysis of internal tobacco industry documents, local newspapers and magazines, internet resources, bills from the Argentinean National Congress Library, and interviews with key individuals in Argentina. RESULTS Transnational tobacco companies (Philip Morris International, British American Tobacco, Lorillard, and RJ Reynolds International) have been actively influencing public health policymaking in Argentina since the early 1970s. As in other countries, in 1977 the tobacco industry created a weak voluntary self regulating code to avoid strong legislated restrictions on advertising. In addition to direct lobbying by the tobacco companies, these efforts involved use of third party allies, public relations campaigns, and scientific and medical consultants. During the 1980s and 1990s efforts to pass comprehensive tobacco control legislation intensified, but the organised tobacco industry prevented its enactment. There has been no national activity to decrease exposure to secondhand smoke. CONCLUSIONS The tobacco industry, working through its local subsidiaries, has subverted meaningful tobacco control legislation in Argentina using the same strategies as in the USA and other countries. As a result, tobacco control in Argentina remains governed by a national law that is weak and restricted in its scope.
Collapse
Affiliation(s)
- E M Sebrié
- Division of General Internal Medicine, Department of Medicine, University of California San Francisco, USA
| | | | | | | |
Collapse
|
20
|
Barnoya J, Glantz SA. Cardiovascular Effects of Secondhand Smoke Nearly as Large as Those of Smoking—and How about Renal Effects? J Am Soc Nephrol 2006; 17:3-11. [PMID: 37000945 DOI: 10.1681/01.asn.0000926776.43858.54] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2023] Open
|
21
|
Abstract
BACKGROUND Congenital cardiac disease is the greatest cause of death in patients with Down's syndrome during the first two years of life, with from two-fifths to two-thirds of those with Down's syndrome also having congenital cardiac malformations. The lesions within the heart can be single or multiple. Our objective was to evaluate the frequency and type of such congenital cardiac malformations in patients born with Down's in Guatemala, and to provide baseline information for further research. METHODS We reviewed all patients with Down's syndrome who underwent a cardiologic screening examination between January, 1997, and December, 2003, in the only department dealing with Paediatric Cardiology in Guatemala. RESULTS Of the 349 patients reviewed, 189 (54.1 per cent) also had an associated congenital cardiac malformation. The median age at diagnosis was 6 months, with a range from 2 to 13 months. In 152 patients (80.4 per cent), the cardiac lesion was isolated, while 37 patients (19.6 per cent) had multiple defects. The most common single defect was patency of the arterial duct, found in 54 of the 189 patients (28.6 per cent), followed by ventricular septal defect in 27.5 per cent, atrial septal defect in 12.7 per cent, and atrioventricular septal defect with common atrioventricular junction in 9.5 per cent. The most frequent concomitant malformation found co-existing with other congenital cardiac lesions was patency of the arterial duct, found in 17.5 per cent. CONCLUSIONS As far as we are aware, ours is the first epidemiologic study concerning the frequency and type of congenital cardiac disease found in Guatemalan children with Down's syndrome. The high frequency of patency of the arterial duct, and the differential distribution of the cardiac malformations associated with Down's syndrome among Guatemalan children, differ from what has been reported in the United States of America, Europe, and Asia. This difference warrants further research.
Collapse
Affiliation(s)
- Vladimiro L Vida
- Unidad de Cirugía Cardiovascular de Guatemala (Pediatria), Gautemala
| | | | | | | | | | | |
Collapse
|
22
|
Abstract
OBJECTIVE To examine the tobacco industry's strategy to avoid regulations on secondhand smoke exposure in Latin America. METHODS Systematic search of tobacco industry documents available through the internet. All available materials, including confidential reports regarding research, lobbying, and internal memoranda exchanged between the tobacco industry representatives, tobacco industry lawyers, and key players in Latin America. RESULTS In Latin America, Philip Morris International and British American Tobacco, working through the law firm Covington & Burling, developed a network of well placed physicians and scientists through their "Latin Project" to generate scientific arguments minimising secondhand smoke as a health hazard, produce low estimates of exposure, and to lobby against smoke-free workplaces and public places. The tobacco industry's role was not disclosed. CONCLUSIONS The strategies used by the industry have been successful in hindering development of public health programmes on secondhand smoke. Latin American health professionals need to be aware of this industry involvement and must take steps to counter it to halt the tobacco epidemic in Latin America.
Collapse
Affiliation(s)
- J Barnoya
- Center for Tobacco Control Research and Education, Cardiovascular Research Institute and Institute for Health Policy Studies, University of California, San Francisco, California, USA
| | | |
Collapse
|
23
|
Affiliation(s)
- R Sakhuja
- Harvard Medical School/Kennedy School of Government, USA
| | | |
Collapse
|