RESUMEN
Rotavirus (RV) is the main cause of acute gastroenteritis (AGE) in young children. The San Luis province of Argentina introduced RV vaccination in May 2013. We estimate vaccine impact (RVI) using real-world data. Data on all-cause AGE cases and AGE-related hospitalisations for San Luis and the adjacent Mendoza province (control group) were obtained and analysed by interrupted time-series methods. Regardless of the model used for counterfactual predictions, we estimated a reduction in the number of all-cause AGE cases of 20-25% and a reduction in AGE-related hospitalisations of 55-60%. The vaccine impact was similar for each age group considered (<1 year, <2 years and <5 years). RV vaccination was estimated to have reduced direct medical costs in the province by about 4.5 million pesos from May 2013 to December 2014. Similar to previous studies, we found a higher impact of RV vaccination in preventing severe all-cause AGE cases requiring hospitalisation than in preventing all-cases AGE cases presenting for medical care. An assessment of the economic value of RV vaccination could take other benefits into account in addition to the avoided medical costs and the costs of vaccination.
Asunto(s)
Gastroenteritis/prevención & control , Infecciones por Rotavirus/prevención & control , Vacunas contra Rotavirus , Enfermedad Aguda , Argentina/epidemiología , Preescolar , Análisis Costo-Beneficio , Femenino , Gastroenteritis/economía , Gastroenteritis/epidemiología , Gastroenteritis/virología , Costos de la Atención en Salud/estadística & datos numéricos , Hospitalización/economía , Hospitalización/estadística & datos numéricos , Humanos , Lactante , Recién Nacido , Masculino , Infecciones por Rotavirus/economía , Infecciones por Rotavirus/epidemiología , Vacunas contra Rotavirus/economía , Resultado del Tratamiento , Vacunación/economíaRESUMEN
BACKGROUND: The striking increase in caesarean section rates in middle- and high-income countries has been partly attributed to maternal request. We conducted a systematic review and meta-analysis of women's preferences for caesarean section. OBJECTIVES: To review the published literature on women's preferences for caesarean section. SEARCH STRATEGY: A systematic search of MEDLINE, EMBASE, LILACS and PsychINFO was performed. References of all included articles were examined. SELECTION CRITERIA: We included studies that quantitatively evaluated women's preferences for caesarean section in any country. We excluded articles assessing health providers' preferences and qualitative studies. DATA COLLECTION AND ANALYSIS: Two reviewers independently screened abstracts of all identified citations, selected potentially eligible studies, and assessed their full-text versions. We conducted a meta-analysis of proportions, and a meta-regression analysis to determine variables significantly associated with caesarean section preference. MAIN RESULTS: Thirty-eight studies were included (n = 19,403). The overall pooled preference for caesarean section was 15.6% (95% CI 12.5-18.9). Higher preference for caesarean section was reported in women with a previous caesarean section versus women without a previous caesarean section (29.4%; 95% CI 24.4-34.8 versus 10.1%; 95% CI 7.5-13.1), and those living in a middle-income country versus a high-income country (22.1%; 95% CI 17.6-26.9 versus 11.8%; 95% CI 8.9-15.1). AUTHORS' CONCLUSIONS: Only a minority of women in a wide variety of countries expressed a preference for caesarean delivery. Further research is needed to better estimate the contribution of women's demand to the rising caesarean section rates.
Asunto(s)
Cesárea/psicología , Prioridad del Paciente , Mujeres Embarazadas/psicología , Estudios Transversales , Femenino , Humanos , Embarazo , Análisis de RegresiónRESUMEN
Rhinoclemmysnema n. g. and three new species of atractid nematodes, namely, Atractis costaricaensis n. sp., Orientatractis asymmetrica n. sp. and Rhinoclemmysnema multilabiatum were recovered from the small and large intestine of Rhinoclemmys pulcherrima, the painted wood turtle in the Guanacaste Conservation Area, Costa Rica. The genera and three species are characterized by the features of the cephalic region and male tail. Neopolystoma fentoni (conjuctival sac) and Heronimus mollis (lungs) were also collected.
Asunto(s)
Nematodos/anatomía & histología , Tortugas/parasitología , Animales , Costa Rica , Femenino , Interacciones Huésped-Parásitos , MasculinoAsunto(s)
Características Culturales , Prejuicio , Relaciones Raciales , Políticas de Control Social , Problemas Sociales , Evolución Cultural , Odio , Historia del Siglo XVIII , Humanos , Indígenas Norteamericanos/educación , Indígenas Norteamericanos/etnología , Indígenas Norteamericanos/historia , Indígenas Norteamericanos/legislación & jurisprudencia , Indígenas Norteamericanos/psicología , Indígenas Sudamericanos/educación , Indígenas Sudamericanos/etnología , Indígenas Sudamericanos/historia , Indígenas Sudamericanos/legislación & jurisprudencia , Indígenas Sudamericanos/psicología , América del Norte/etnología , Relaciones Raciales/historia , Relaciones Raciales/legislación & jurisprudencia , Relaciones Raciales/psicología , Conducta Social , Cambio Social/historia , Clase Social , Políticas de Control Social/economía , Políticas de Control Social/historia , Políticas de Control Social/legislación & jurisprudencia , Identificación Social , Problemas Sociales/economía , Problemas Sociales/etnología , Problemas Sociales/historia , Problemas Sociales/legislación & jurisprudencia , Problemas Sociales/psicología , América del Sur/etnología , Reino Unido/etnología , Población Blanca/educación , Población Blanca/etnología , Población Blanca/historia , Población Blanca/legislación & jurisprudencia , Población Blanca/psicologíaRESUMEN
Specimens collected from the large intestine of the side-necked turtle Podocnemis unifilis Troschel, 1848 in the region of Cuminá and Trombetas rivers near Pará, Brazil are assigned to a new genus and new species of the nematode superfamily Cosmocercoidea and family Atractidae and named Paraorientatractis semiannulata. The new genus is separated from the nearest genus Orientatractis by the funnel-shaped mouth opening, the presence of 4 distinct lips, 4 papillae in the internal cycle, one on each lip margin, 2 lateral amphids with large amphidial pores and absence of submedian papillae. It is also separated from Orientatractis and Proatractis by the presence of striated lateral alae which curve dorsally extending from mid oesophagus to mid tail, the difference in size of the vulvar opening and the presence of large transverse ridges or semiannules on the dorsal surface. The new species can be separated from the species of the genera Orientatractis and Proatractis by the characters that distinguish the genera and the arrangement of the caudal papillae on the male. A host/parasite list for Podocnemis spp. is included.