Caracterización de estrategias de mercadeo de alimentos y bebidas no alcohólicas dirigidas a la población infantil y adolescente en puntos de venta, Costa Rica 2018

El objetivo del presente estudio fue caracterizar en los puntos de venta de Costa Rica las estrategias de mercadeo utilizadas en alimentos y bebidas no alcohólicas dirigidas a la población infantil, adolescente y a sus padres o tutores (compradores), que influyen en la compra de productos de alto contenido energético y bajo valor nutricional. La recolección de datos se realizó en el 2018 mediante una guía de observación aplicada al punto de venta (n:12) y un cuestionario dirigido a los padres o tutores (n: 72) de la población infantil y adolescente. Se encontró que la estrategia de mercadeo utilizada con mayor frecuencia en el área de entrada, caja y salida del punto de venta fue la reducción de precios (79,0; 87,5 y 88,0%, respectivamente). En los puntos de venta existe un empleo frecuente y variado de estrategias de mercadeo de productos alimenticios densamente calóricos y con un exceso de nutrientes críticos que son relevantes en salud pública por su asociación con la obesidad y enfermedades no transmisibles.

The aim of this study was to characterize in the retail outlets the marketing strategies used in food and non-alcoholic beverages aimed at children, adolescents, and their parents or guardians (shoppers) which influence the purchase of products of high energy content and low nutritional value in Costa Rica. Data collection was carried out in 2018 with an observation guide applied at the retail outlets (RO) (n: 12) and a questionnaire aimed at parents or guardians (shoppers) (n: 72) of the child and adolescent population. The study found that the marketing strategy most frequently used in the entry, cash and exit area the retail outlets was price reduction (79,0, 87.5 and 88,0%, respectively).There is a frequent and varied use of marketing strategies in retail outlets for calorie-dense food products with an excess of critical nutrients that are relevant in public health due to their association with obesity and non-communicable diseases.

The spatial relationship between tuberculosis and alcohol outlets in the township of Mamelodi, South Africa

Background: The availability of alcohol in society is known to increase the risk of a range of negative health outcomes. Objectives: The aim of this research is to determine if there is a spatial association between tuberculosis and alcohol outlets in Mamelodi, South Africa. We also aim to examine whether the socio-economic characteristics of the neighbourhood in which an alcohol outlet was located was related to the magnitude of tuberculosis in the immediate vicinity of the alcohol outlet. Methods: Location quotient analysis is used to compare the extent of tuberculosis within a series of buffer intervals (100m, 200m, 300m) immediately surrounding alcohol outlets with tuberculosis across the township of Mamelodi as a whole. Results: The density of tuberculosis around alcohol outlets in Mamelodi at all buffer distances was found to be substantially higher than across the township as a whole. These findings indicate that the risk of tuberculosis in Mamelodi is higher around alcohol outlets. Alcohol outlets located in more deprived areas of Mamelodi were significantly associated with higher density of tuberculosis relative to alcohol outlets located in more affluent neighbourhoods. Conclusion: Despite alcohol outlets forming an integral part of the urban landscape in townships in South Africa, they may facilitate the transmission of tuberculosis.

Produção de riscos, consumo, necropolítica e desigualdades: expressividades midiáticas da pandemia no contexto brasileiro / Risk production, consumption, necropolitics and inequalities: media expressiveness of the pandemic in the brazilian context

A pandemia do novo coronavírus (SARS-CoV-2) produziu, e permanece produzindo, diversas significações em torno da vida da população brasileira, onde as mídias comunicacionais permanecem presentes nas veiculações acerca dos desdobramentos dessa conjuntura. Este estudo objetiva analisar informações veiculadas no contexto da pandemia, buscando compreender e explicitar aspectos ancorados nas produções dos discursos, os sentidos produzidos, bem como as materialidades expressas através do comportamento de consumo e acumulação da população, suscitados pela pandemia. Foram analisadas dez matérias jornalísticas, veiculadas na internet entre março e abril de 2020, à luz da psicossociologia do risco, inspirados em autores como Ulrich Beck e Mary Jane Spink; dos comportamentos de consumo, principalmente a partir de Jurandir Freire Costa, e sob as lentes da necropolítica de Achille Mbembe. Os comportamentos analisados expõem problemas sociais crônicos, onde o consumo exacerbado procura sustentar o cenário ilusório de segurança frente ao avanço do vírus, esvaziando prateleiras, em atos que desassistem aqueles que não têm recursos financeiros para garantir seus próprios insumos, operando em favor de tecnologias necropolíticas. Na atividade midiática encontram-se incitações ao consumo e uma amplificação da sensação de medo diante da suposta escassez anunciada.

The new coronavirus (SARS-CoV-2) pandemic produced and continues to produce, several meanings around the life of the Brazilian population, where the communication media remain present in the news about the developments of this situation. This study aims to analyze information conveyed in the context of the pandemic, seeking to understand and explain aspects anchored in the production of the speeches, the meanings produced, as well as the materialities expressed through consumption and accumulation behavior of the population, raised by the pandemic. Ten journalistic articles, published on the Internet between March and April 2020, were analyzed in the light of risk psychosociology, inspired by authors such as Ulrich Beck and Mary Jane Spink; consumer behavior, mainly from Jurandir Freire Costa, and under the necropolitics' lens of Achille Mbembe. The analyzed behaviors expose chronic social problems, where the exacerbated consumption seeks to sustain the illusory scenario of security face the advance of the virus, emptying shelves, in acts that neglect those who do not have financial resources to guarantee their inputs, operating in favor of necropolitical technologies. In media activity, there are incitements to consumption and amplification of the feeling of fear in the face of the supposed shortage announced.

Availability of Selected Essential Prescription Medicines and Trained Dispensers in Accredited Drug Dispensing Outlets in Tanzania. A Case Study of Hanang District Council in Manyara Region Northern Tanzania

Introduction: The accredited drug dispensing outlet(ADDO), popularly known in Swahili as Duka la DawaMuhimu (DLDM) are shops controlled by Pharmacy councilunder Pharmacy Act number 1 of 2011.The Act has specificpremise standards for ADDO shops, and the owners musthave a dispenser trained in ADDO programs. The purpose ofthis study was to determine the presence of selected essentialprescription medicines and trained dispensers in AccreditedDrug Dispensing Outlets shops.Material and methods: A cross section survey was conductedin 44 Accredited Drug Dispensing Outlets out of 46 in fiveDivisions of Hanang district in Manyara region northernTanzania. These Divisions were Balangda, Bassutu, Simbay,Endasack and Katesh.Results: The study found 44(82%) of the intervieweddispensers were trained in Accredited Drug Dispensing Outletsprograms. Also out of 14 selected essential prescriptionmedicines which were assessed, only 60% were available inthese shops.Conclusion: Availability of selected essential prescriptionmedicines is not adequate, as 40% of the assessed medicineswere not available, despite of 82% of Accredited DrugDispensing Outlets shops having trained dispensers, thereis still a significant percent (18%) of them which are run byuntrained dispenser posing risks of irrational treatment toclients of these shops.

Biventricular repair of complete artioventricular septal defect associated with tetralogy of Fallot or double right ven-tricular outlets / 中华胸心血管外科杂志

Objective To summarize the surgical results and experience of patients with complete atrioventricular septal defect associated with tetralogy of Fallot or double right ventricular outlets. Methods From April 2013 to June 2017, 10 pa-tients with complete atrioventricular septal defect associated with tetralogy of Fallot or double right ventricular outlets underwent biventricular repair at Guangzhou Women and Children Medical Center. Seven were male, and 3 were female. The age and body weight at surgery was 2 months to 13 years and 3. 7-23. 6 kg. Repair was performed with modified one-patch technique in 3 patients, modified two-patch technique in 6 patients, two-patch technique in 1 patient. Results There was no hospital mortality. The ICU stay and hospital stay after operation were 2～5 days and 7～10 days. The follow-up duration was 16 to 65 months. All patients were alive and free from left ventricular outlet obstruction. The left atrioventricular valve function were nor-mal in 2 patients, mild regurgitation in 6 patients, moderate regurgitation in 1 patient and severe regurgitation in 1 patient. Conclusion The outcomes of biventricular repair for patients with complete atrioventricular septal defect associated with Tet-ralogy of Fallot or double right ventricular outlets were satisfied, and long-term follow-up was demanded.

Biventricular repair of complete artioventricular septal defect associated with tetralogy of Fallot or double right ventricular outlets / 中华胸心血管外科杂志

Objective@#To summarize the surgical results and experience of patients with complete atrioventricular septal defect associated with tetralogy of Fallot or double right ventricular outlets.@*Methods@#From April 2013 to June 2017, 10 patients with complete atrioventricular septal defect associated with tetralogy of Fallot or double right ventricular outlets underwent biventricular repair at Guangzhou Women and Children Medical Center. Seven were male, and 3 were female. The age and body weight at surgery was 2 months to 13 years and 3.7-23.6 kg. Repair was performed with modified one-patch technique in 3 patients, modified two-patch technique in 6 patients, two-patch technique in 1 patient.@*Results@#There was no hospital mortality. The ICU stay and hospital stay after operation were 2~5 days and 7~10 days. The follow-up duration was 16 to 65 months. All patients were alive and free from left ventricular outlet obstruction. The left atrioventricular valve function were normal in 2 patients, mild regurgitation in 6 patients, moderate regurgitation in 1 patient and severe regurgitation in 1 patient.@*Conclusion@#The outcomes of biventricular repair for patients with complete atrioventricular septal defect associated with Tetralogy of Fallot or double right ventricular outlets were satisfied, and long-term follow-up was demanded.

Calidad microbiológica de ensaladas crudas que se expenden en puestos ambulantes de comida rápida de la ciudad de Maracaibo-Venezuela / Microbiological quality of raw salads that are sold at roadside food stalls quick Maracaibo-Venezuela

Las ensaladas crudas juegan un papel importante en las enfermedades transmitidas por alimentos, sobre todo si durante su procesamiento no se cumplen con las condiciones higiénicas necesarias para impedir su contaminación. El objetivo es determinar la calidad microbiológica de ensaladas crudas que se expenden en puestos ambulantes de comida rápida de Maracaibo, Venezuela. 15 establecimientos fueron estudiados mediante el doble muestreo con intervalo de un mes. Para el estudio microbiológico, las muestras fueron preparadas según la Comisión Venezolana de Normas Industriales (COVENIN N°1126-89). Del homogenizado, se determinó el contaje Aerobios Mesόfilos, Salmonella, Coliformes Totales, Fecales y Escherichia coli. En relación a Aerobios Mesofilos, de las 30 muestras, 2 (6,67%) mostraron contajes de 225.000 UFC/g; y 28 (93, 33%) con recuentos incontables. Para Coliformes Totales, 28 (93.3%) mostraron contajes que oscilaron entre 350 x 107 hasta 730 x 107 y en 2 (6.6%) el contaje promedio fue 197 UFC/g. En el 93,3% (28) de las muestras se observó recuentos elevados para Escherichia coli, y en 2 (6,6%) fue menor a 1 UFC/g. Salmonella se detectó en 4 (13,3%) muestras. Las ensaladas estudiadas no son aptas para el consumo humano, por no cumplir con los requerimientos mínimos de inocuidad, según las normativas establecidas.

Raw salads play an important role in foodborne, especially during processing is not necessary meet to prevent its contamination hygienic conditions. The objective is to determine the microbiological quality of raw salads that are sold in fast food stalls Maracaibo, Venezuela. 15 establishments were studied by double sampling interval of one month. For microbiological study, samples were prepared according to the Venezuelan Industrial Standards Commission (COVENIN No. 1126-1189). Homogenate, counting mesophilic aerobics, Salmonella, Total and Fecal Coliforms and Escherichia coli by the method most probable number and rehydratable plate with dry films was determined. Regarding mesophilic aerobics, of the 30 samples, 2 (6.67%) showed counts of 225,000 CFU/g; and 28 (93, 33%) had countless counts. For Total Coliforms, 28 (93.3%) showed counts ranging from 350 to 730 x107 x 107 and 2 (6.6%) the average count was 197 CFU/g. Escherichia coli in 93.3% (28) of the samples was observed high counts, and in 2 (6.6%) counting was less than 1 CFU/g. Salmonella was detected in 4 (13.3%) samples. The salads studied are unfit for human consumption, not to meet the minimum safety requirements, according to established regulations.

Environmental surveillance of Legionella pneumophila in distal water supplies of a hospital for early identification & prevention of hospital-acquired legionellosis

Background & objectives: Legionella pneumophila, a ubiquitous aquatic organism is found to be associated with the development of the community as well as hospital-acquired pneumonia. Diagnosing Legionella infection is difficult unless supplemented with, diagnostic laboratory testing and established evidence for its presence in the hospital environment. Hence, the present study was undertaken to screen the hospital water supplies for the presence of L. pneumophila to show its presence in the hospital environment further facilitating early diagnosis and prevention of hospital-acquired legionellosis. Methods: Water samples and swabs from the inner side of the same water taps were collected from 30 distal water outlets present in patient care areas of a tertiary care hospital. The filtrate obtained from water samples as well as swabs were inoculated directly and after acid buffer treatment on plain and selective (with polymyxin B, cycloheximide and vancomycin) buffered charcoal yeast extract medium. The colonies grown were identified using standard methods and confirmed for L. pneumophila by latex agglutination test. Results: About 6.66 per cent (2/30) distal water outlets sampled were found to be contaminated with L. pneumophila serotype 2-15. Isolation was better with swabs compared to water samples. Interpretation & conclusions: The study showed the presence of L. pneumophila colonization of hospital water outlets at low levels. Periodic water sampling and active clinical surveillance in positive areas may be done to substantiate the evidence, to confirm or reject its role as a potential nosocomial pathogen in hospital environment.

Access to Essential Medicines in Ghana: A Survey of Availability of Children’s Medicines in Medicine Outlets in the Ashanti Region.

The objective of this study was to assess the availability of 42 children’s essential medicines contained in the Standard Treatment Guidelines (STG) of Ghana in the 27 districts of Ashanti Region. Five hundred medicine outlets comprising of hospitals/health centers/clinics, community pharmacies and chemical shops were surveyed using a validated structured questionnaire. The results were analysed and the availability of the 42 medicines in each district was determined. The average availability of children’s medicines across the region was 41.3% (range: 26.4-52%), with the Kumasi Metropolis (KM) and Bosome Freho (BF) district having the highest and lowest availabilities, respectively. Six (14.3%) of the medicines, omeprazole, tinidazole, furosemide and spironolactone suspensions, and praziquantel and thiabendazole syrups had zero availability in the Region while ferrous sulphate syrup (95%), albendazole suspension (90%) and paracetamol syrup (88.8%) had the highest availabilities. Three hundred and twenty three different formulations of the 42 medicines were identified with foreign and local manufacturers accounting for 198 (61.3%) and 125 (38.7%) formulations, respectively. India (38.7%) and United Kingdom (35.5%) were the major foreign manufacturers. The duration of stock-outs was shorter for private than public/government facilities and generally ranged from up to one week (68.4 %) to over one month (3%). Reasons for the low or non-availability of children’s medicines included the lack of funds, non-prescription by physicians, unavailability of medicines at wholesalers and lack of awareness of medicine outlets staff.

Associations between Exposure to Unhealthy Food Outlets Within Residential District and Obesity: Using Data from 2013 Census on Establishments and 2013-2014 Korea National Health and Nutrition Examination Survey / 대한지역사회영양학회지

OBJECTIVES: Environmental, social and personal factors influence eating patterns. This study aimed to investigate the relationship between unhealthy food outlets within a residential area and obesity using nationally representative Korean survey data and data from the Census on Establishments. METHODS: Data on the food intakes and socioeconomic variables of a total of 9,978 adults aged ≥ 19 years were obtained from the 2013-2014 Korea National Health and Nutrition Examination Survey. Geographic locations of restaurants were obtained from the 2013 Census on Establishments in Korea. Administrative area was categorized into tertiles of count of unhealthy food outlets based on the distribution of number of unhealthy food outlets among all urban (Dong) and rural (Eup or Myun) administrative districts in Korea. Multilevel logistic regressions model were used to assess the association between the number of unhealthy food outlets and obesity. RESULTS: People living in the district with the highest count of unhealthy food outlets had higher intakes of fat (45.8 vs. 44.4 g/day), sodium (4,142.6 vs. 3,949.8 mg/day), and vitamin A (753.7 vs. 631.6 µgRE/day) compared to those living in the district with the lowest count of unhealthy food outlets. A higher count of unhealthy food outlets was positively associated with frequent consumption of instant noodles, pizza, hamburgers and sandwiches, sweets and sour pork or pork cutlets, fried chicken, snacks, and cookies. Higher exposure to unhealthy food outlets was associated with increased odds of obesity (1st vs. 3rd tertile; OR 1.689; 95% CI 1.098-2.599). CONCLUSIONS: A high count of unhealthy food outlets within a residential area is positively associated with the prevalence of obesity in Korea. The results suggest that food environmental factors affects the health outcomes and interventions aiming to restrict the availability of unhealthy food outlets in local neighborhoods may be a useful obesity prevention strategy.

¿Cuál es el impacto de contar con una farmacia privada sin fines de lucro, en comparación a una con fines de lucro?: síntesis rápida de evidencia / What is the impact of having a private not-for-profit pharmacy versus a for-profit one?: rapid evidence synthesis

ANTECEDENTES Y OBJETIVO La Municipalidad de Recoleta ha decidido implementar una farmacia local, que funcione de manera paralela a los centros de Atención Primaria, de manera de otorgar una oferta más económica de medicamentos a los vecinos de la comuna. La iniciativa permitiría el acceso a medicamentos importados, sin pagar por intermediarios, lo que reduciría sustancialmente el precio de adquisición para la población. En este contexto el Departamento de Políticas Farmacéuticas y Profesiones Médicas solicitan esta síntesis de evidencia con el objetivo de comparar los resultados de las farmacias privadas con y sin fines de lucro. METODOLOGÍA Se formuló una estrategia de búsqueda para ser utilizada en las bases de datos Epistemonikos, Health Systems Evidence, Health Evidence, Cochrane, PubMed, EVIPNet Global, LILACS, Google Scholar, PsycInfo y CINAHL, con el objetivo de identificar revisiones sistemáticas del tema. Al no encontrarse, se procedió a buscar estudios primarios que abordaran la pregunta estudiada, donde se seleccionaron 5. Se excluyeron estudios que incorporaban prescripción de medicamentos por parte de los farmacéuticos, venta de alcohol y cigarros, y estudios de casos aislados. Consultando al solicitante, se decidió excluir estudios que incorporaban farmacias mayoristas, además de no considerar comparaciones contra farmacias públicas RESULTADOS Se utilizan 3 estudios primarios, de los cuales se obtuvieron los siguientes resultados: -No fue posible agrupar resultados, la evidencia encontrada muestra que las farmacias sin fines de lucro contarían con una menor mediana de precios, en comparación con establecimientos con fines de lucro. -No fue posible agrupar resultados, la evidencia encontrada muestra que en farmacias sin fines de lucro se gastaría una menor proporción de sueldos diarios para adquirir tratamientos, que en farmacias con fines de lucro. -La evidencia encontrada muestra que las farmacias sin fines de lucro tendrían un menor stock disponible, en comparación a las farmacias con fines de lucro (La certeza de la evidencia es Muy Baja). -En general, la calidad de la evidencia es incierta, puesto que este resumen no realiza una evaluación de ésta.

Comparative Availability of Selected Essential Medicines for Selected Chronic Diseases in Bhiwani District, Haryana, India.

Medicines represent a substantial proportion of the economic costs for treating chronic diseases. In low and middle income countries (LMIC), 50–90% of the population have to pay for medicines themselves. Inappropriate access and availability of essential medicines contribute substantially to out-of-budget expense. A significant population of developing countries (upto 90%) purchase medicines through out-of-pocket payments. This research study was conducted to investigate the comparative availability of selected essential medicines for selected chronic diseases in Bhiwani district. Standardized methodology of World Health Organization and Health Action International was employed. The research study was conducted on retail pharmacy outlets of Bhiwani District i.e. residential areas of Bhiwani city and five administrative areas of Bhiwani district. Overall percent availability of the most of the surveyed medicines used in the treatment of chronic diseases was found to be less than 50%. Dissemination of well documented information on availability medicine consumers in all residential areas may enhance consumer demand for lower price medicine and thus may serve to enhance the availability of demanded medicine (lowest priced) in all the areas of Bhiwani district.

Propuesta de implementación de sistema de vigilancia sanitaria de medicamentos de uso veterimario en etapa postcomercialización / Proposed implementation of health surveillance system for veterinary use drugs on stage postmarketing

El presente trabajo de grado tiene como objetivo general: Proponer la implementación del sistema de vigilancia sanitaria de medicamentos de uso veterinario en etapa postcomercialización en los expendios agropecuarios de los mercados principales del Municipio Bolivariano Libertador, Distrito Capital. Metodológicamente, la investigación se ubicó dentro del paradigma cuantitativo y cualitativo, bajo la modalidad de proyecto factible, de tipo descriptiva y con un diseño de campo. La elección de la muestra respondió al criterio de la investigadora, estuvo representada por el total de la población de los expendios agropecuarios que comercializan en los mercados principales del Municipio Bolivariano Libertador, Distrito Capital. La recolección de datos se realizó a través de la técnica de la entrevista y como instrumento el cuestionario estructurado y una guía de observación durante el segundo trimestre Mayo-Junio 2013. Luego de la aplicación de los procedimientos de análisis a través de la matriz DOFA, se concluye que: los alcances de la acción reguladora del sistema de vigilancia, no responde de manera eficiente al fortalecimiento de los vínculos interinstitucionales para la vigilancia, prevención y control en los expendios agropecuarios. Posterior a ello, se hizo necesaria la elaboración de una propuesta para la implementación del sistema de vigilancia sanitaria de medicamentos de uso veterinario mediante la creación de dos coordinaciones dentro de la dirección de Salud Animal del ente regulador y el diseño de instrumentos de inspección enmarcados dentro de la Ley para dar cumplimiento al objetivo general de la propuesta: Proponer un sistema de vigilancia sanitaria para medicamentos de uso veterinario en la etapa post-comercialización en los expendios agropecuarios de los mercados principales del Municipio Bolivariano Libertador del Distrito Capital..

The present degree work has as general aim: To propose the implementation of the sanitary surveillance system of medicines for veterinary use in the post-marketing stage in the agricultural expenditures of the principal markets of the Bolivarian Municipality of Libertador, Capital District. Methodologically, the investigation was located inside the quantitative and qualitative paradigm, under the modality of feasible project of descriptive type with a field design. The election of the sample answered to the criterion of the investigator, it was represented by the whole population of the agricultural expenditures that commercialize inside the principal markets of the Bolivarian Municipality of Libertador, Capital District. The compilation of the information was performed applying the interview and as a resource the constructed questionnaire and observation guide during the second trimester of the year, May - June, 2013. After the application of the analysis procedures by the SWOT analysis, there concludes that: the goals of the regulatory action of the surveillance system, does not answer in a very efficient way to the strengthening of the interinstitutional links for the surveillance, prevention and control inside the agricultural expenditures. Later, it was necessary the elaboration of a proposal for the implementation of the sanitary surveillance system of medicines for veterinary use by means of the creation of two coordinations Inside the Animal Health Direction of the regulatory entity and the design of inspection instruments framed inside the Law, in order to fulfill the general aim of the proposal: To propose a sanitary surveillance system of medicines for veterinary use in the post-marketing stage inside the agricultural expenditures of the principal markets of the Bolivarian Municipality of Libertador, Capital District.