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1.
J Gerontol Soc Work ; 67(6): 738-755, 2024.
Article in English | MEDLINE | ID: mdl-38739384

ABSTRACT

This study analyzed the 2021 National Health Interview Survey (NHIS) to assess food insecurity among adults aged 65 and older. Among 8,877 older adults, 4 percent (N=287) reported low or very low food security levels. Those who identified as Black or African American and Hispanic or Latino were more likely to experience food insecurity compared to White individuals. The study found that merely surpassing the poverty threshold might not be sufficient to protect against food insecurity. It also underscored socioemotional support's protective role in older adults' food security. Social workers must recognize various factors influencing food security among older adults.


Subject(s)
Food Insecurity , Humans , Male , Aged , Female , United States , Prevalence , Aged, 80 and over , Poverty , Hispanic or Latino/statistics & numerical data , Black or African American/statistics & numerical data , Food Supply/statistics & numerical data , Socioeconomic Factors
2.
Transp Res Rec ; 2677(4): 287-297, 2023 Apr.
Article in English | MEDLINE | ID: mdl-37153206

ABSTRACT

The COVID-19 pandemic has disrupted day-to-day lives and infrastructure across the United States, including public transit systems, which saw precipitous declines in ridership beginning in March 2020. This study aimed to explore the disparities in ridership decline across census tracts in Austin, TX and whether demographic and spatial characteristics exist that are related to these declines. Transit ridership data from the Capital Metropolitan Transportation Authority were used in conjunction with American Community Survey data to understand the spatial distribution of ridership changes caused by the pandemic. Using a multivariate clustering analysis as well as geographically weighted regression models, the analysis indicated that areas of the city with older populations as well as higher percentages of Black and Hispanic populations were associated with less severe declines in ridership, whereas areas with higher unemployment saw steeper declines. The percentage of Hispanic residents appeared to affect ridership most clearly in the center of Austin. These findings support and expand on previous research that found that the impacts of the pandemic on transit ridership have emphasized the disparities in transit usage and dependence across the United States and within cities.

3.
Front Public Health ; 10: 1037242, 2022.
Article in English | MEDLINE | ID: mdl-36407995

ABSTRACT

Since emergency management capabilities with respect to COVID-19 differ across different regions of China, it is necessary to adopt a more comprehensive perspective to study the reasons for these differences and propose corresponding policies. By investigating 287 prefectural-level administrative regions, this study explores the reasons for different levels of COVID-19 prevention performance. The results lead to the following conclusions. The factors influencing pandemic prevention include both structural factors, such as economic and social factors, and the experiences and characteristics of prefectural-level government leaders (party secretaries and mayors), such as grassroots work experience and level of education, which are significantly positively correlated with the progress of pandemic prevention. Based on these findings, we propose suggestions to improve governance capacity in terms of three aspects: the improvement of emergency management capacity, the appointment of cadres in the context of new challenges and missions, and the establishment collocation of prefectural-level leader teams.


Subject(s)
COVID-19 , Humans , COVID-19/epidemiology , COVID-19/prevention & control , Pandemics/prevention & control , Government , China/epidemiology
4.
Brain Behav ; 12(3): e2486, 2022 03.
Article in English | MEDLINE | ID: mdl-35134277

ABSTRACT

INTRODUCTION: The inverse relation between income and depression is well established. Less is understood about the relation between wealth and depression. We therefore conducted a scoping review to answer the question: What is known from the existing literature about the relation between wealth and depression? METHODS: We searched for studies and articles in Medline (via PubMed), Embase, PsycINFO, PsycArticles, EconLit, and SocINDEX from inception through July 19, 2020. Ninety-six articles were included in our review. Key article characteristics were year of publication, sample size, country, study design, definition of depression, definition of wealth, and association between wealth and depression. Thirty-two longitudinal articles were included in a detailed charted review. RESULTS: Depression was defined in a relatively standard manner across articles. In contrast, definitions and measurements of wealth varied greatly. The majority of studies in the full review (n = 56, 58%) and half of the studies in the longitudinal charted review (n = 16, 50%) reported an inverse relation between wealth and depression. The longitudinal charted review showed that (1) macro-economic events influenced depression, (2) wealth status influenced depression across the lifecourse, (3) wealth protected against depression in the face of stressors such as job loss, (4) subjective or psychosocial factors such as perception of wealth, relative comparison, and social status modified the relation between wealth and depression, and (5) savings interventions were successful in reducing depression and varied by context. CONCLUSION: These findings suggest that wealth should be included in our consideration of the forces that shape mental health.


Subject(s)
Depression , Mental Health , Depression/epidemiology
5.
Article in English | MEDLINE | ID: mdl-34068923

ABSTRACT

While farm safety researchers have seldom considered the association between farm parents' background and their children's safety, researchers who have compared first- and multi-generation farmers have found differences that may shape safety outcomes. We draw on the farm safety and family farm bodies of literature and a survey of 203 United States farm parents to assess the role of farming background in farm children risk exposure. Exploratory in nature, the bivariate analysis revealed no statistically significant differences between first- and multi-generation farmers in children injury, agricultural safety perceptions, knowledge, and practices but revealed differences in key demographic characteristics and parenting styles. A range of factors likely explain these findings with meso- and macro-level factors likely impacting farm parents' ability to adopt safety practices. In contrast to the emphasis on knowledge and behaviors, we call for the integration of lived realities in farm safety research and to do so in a way that connects realities and choices to larger contexts. We also call on the need to expand the toolkit of interventions to address meso- and macro-level factors. A shift towards addressing social and economic conditions in agriculture could reduce farm children's injuries while supporting the sustainability of farm labor systems.


Subject(s)
Agriculture , Parenting , Child , Farmers , Farms , Humans , Parent-Child Relations
6.
Can J Public Health ; 112(3): 482-492, 2021 06.
Article in English | MEDLINE | ID: mdl-33417191

ABSTRACT

OBJECTIVE: To examine social, economic, and migratory influences on the health of racial and ethnic minority groups in Canada, with a special focus on Caribbean immigrants. METHODS: Combined annual cycles (2011-2016) of the Canadian Community Health Survey (CCHS) data totaling over 300,000 adult Canadian residents were aggregated. Descriptive statistics and multivariable logistic regression models were used to examine the prevalence and associated factors of (1) cardiovascular disease diagnosed by a healthcare professional, and (2) self-rated general health among racial and ethnic groups. RESULTS: Caribbeans in general, Black and other non-White Canadians had significantly higher odds (adjusted for age/sex) of reporting any cardiovascular disease compared with White Canadians. Only non-Caribbean Blacks had higher odds of self-rated fair or poor general health compared with White Canadians. Multivariate logistic regression models revealed that after controlling for social and demographic factors, immigration status and years since migration, Caribbean non-Blacks and Black Caribbeans were at higher odds of having a doctor-reported cardiovascular health condition compared with White Canadians. Caribbean non-Blacks also had higher odds of fair or poor self-rated health than White Canadians. CONCLUSION: The results of this study highlight the need for additional investigations of other potential influences on physical health statuses, especially among migrants and those of African ancestry who might be more prone to adverse health outcomes.


RéSUMé: OBJECTIF: Examiner les influences socioéconomiques et migratoires sur la santé des minorités raciales et ethniques au Canada, en particulier les immigrants caribéens. MéTHODE: Les données des cycles annuels combinés (2011-2016) de l'Enquête sur la santé dans les collectivités canadiennes (ESCC) totalisant plus de 300 000 résidents canadiens adultes ont été regroupées. Des statistiques descriptives et des modèles de régression logistique multivariée ont été utilisés pour examiner la prévalence et les facteurs connexes 1) des maladies cardiovasculaires diagnostiquées par un professionnel des soins de santé et 2) de la santé générale autoévaluée au sein de groupes raciaux et ethniques. RéSULTATS: Les Caribéens en général, les Noirs et les autres Canadiens non blancs présentaient une probabilité sensiblement plus élevée (ajustée selon l'âge et le sexe) de déclarer n'importe quelle maladie cardiovasculaire que les Canadiens blancs. Seuls les Noirs non caribéens présentaient une probabilité supérieure de faire état d'une santé générale autoévaluée passable ou mauvaise que les Canadiens blancs. Les modèles de régression logistique multivariée ont révélé qu'en tenant compte des facteurs sociodémographiques, du statut d'immigration et du nombre d'années depuis la migration, les Caribéens non noirs et les Caribéens noirs présentaient une probabilité plus élevée d'avoir un trouble de santé cardiovasculaire déclaré par un médecin que les Canadiens blancs. Les Caribéens non noirs présentaient aussi une probabilité plus élevée de faire état d'une santé autoévaluée passable ou mauvaise que les Canadiens blancs. CONCLUSION: Les résultats de l'étude soulignent la nécessité de pousser la recherche sur les autres facteurs susceptibles d'influencer l'état de santé physique, surtout chez les migrants et les personnes d'origine africaine qui pourraient être plus sujets à des résultats sanitaires indésirables.


Subject(s)
Emigrants and Immigrants , Ethnicity , Health Status Disparities , Minority Groups , Racial Groups , Adult , Canada , Emigrants and Immigrants/statistics & numerical data , Ethnicity/statistics & numerical data , Female , Health Surveys , Humans , Male , Middle Aged , Minority Groups/statistics & numerical data , Racial Groups/statistics & numerical data , Socioeconomic Factors
7.
Vet World ; 13(10): 2275-2285, 2020 Oct.
Article in English | MEDLINE | ID: mdl-33281367

ABSTRACT

India has 9 million pigs, of which 45% are in the North eastern (NE) states of India. Viral diseases affecting pigs are a major concern of mortality causing huge loss to the pig farmers. One such disease is African swine fever (ASF) that has already knocked the porous borders of NE states of India. ASF is a highly contagious devastating disease of pigs and wild boars causing 100% mortality. The causative agent African swine fever virus (ASFV) belongs to the genus Asfivirus, family Asfarviridae. Pig is the only species affected by this virus. Soft ticks (Ornithodoros genus) are shown to be reservoir and transmission vectors of ASFV. Transmission is very rapid and quickly engulfs the entire pig population. It is very difficult to differentiate classical swine fever from ASF since clinical symptoms overlap. Infected and in contact pigs should be culled immediately and buried deep, and sheds and premises be disinfected to control the disease. There is no vaccine available commercially. Since its first report in Kenya in 1921, the disease has been reported from the countries in Europe, Russian federation, China, and Myanmar. The disease is a threat to Indian pigs. OIE published the first report of ASF in India on May 21, 2020, wherein, a total of 3701 pigs died from 11 outbreaks (Morbidity - 38.45% and mortality - 33.89%) in Assam and Arunachal Pradesh states of India. ASF is non-zoonotic.

8.
Article in English | MEDLINE | ID: mdl-32422948

ABSTRACT

Social and economic factors relate to the prevention and control of infectious diseases. The purpose of this paper was to assess the distribution of COVID-19 morbidity rate in association with social and economic factors and discuss the implications for urban development that help to control infectious diseases. This study was a cross-sectional study. In this study, social and economic factors were classified into three dimensions: built environment, economic activities, and public service status. The method applied in this study was the spatial regression analysis. In the 13 districts in Wuhan, the spatial regression analysis was applied. The results showed that: 1) increasing population density, construction land area proportion, value-added of tertiary industry per unit of land area, total retail sales of consumer goods per unit of land area, public green space density, aged population density were associated with an increased COVID-19 morbidity rate due to the positive characteristics of estimated coefficients of these variables. 2) increasing average building scale, GDP per unit of land area, and hospital density were associated with a decreased COVID-19 morbidity rate due to the negative characteristics of estimated coefficients of these variables. It was concluded that it is possible to control infectious diseases, such as COVID-19, by adjusting social and economic factors. We should guide urban development to improve human health.


Subject(s)
Built Environment , Coronavirus Infections/epidemiology , Coronavirus , Economic Development , Pandemics , Pneumonia, Viral/epidemiology , Population Density , Urban Renewal , Betacoronavirus , COVID-19 , China/epidemiology , Conservation of Natural Resources , Coronavirus Infections/diagnosis , Coronavirus Infections/transmission , Cross-Sectional Studies , Environment , Humans , Industry , Morbidity , Pneumonia, Viral/diagnosis , Pneumonia, Viral/transmission , SARS-CoV-2 , Social Planning , Spatial Regression
9.
Przegl Epidemiol ; 74(3): 543-549, 2020.
Article in English | MEDLINE | ID: mdl-33576592

ABSTRACT

AIMS: The aim of the research was assessment of the medical and social losses due to socially significant diseases (malignant neoplasms and diseases of the circulatory system) in population living in the ecologically unfavorableregion of Kazakhstan (East Kazakhstan Region (EKR)). MATERIALS AND METHODS: The materials for the research were provided by the Department of Statistics, the Republican Center of Electronic Health Care and the Regional Oncology Center for 5 years depth (2011-2015 yy.). Statistical data of the entire population of the region was analyzed. Years of Life Lost (YLL), YLL due to death integral indicators were calculated according to the standardized methodology recommended by the World Health Organization (WHO). RESULTS AND CONCLUSION: Significant premature loss of years due to socially significant diseases in the study region was observed in the research group of 45-69 years with a gender prevalence in male. The fraction of direct economic loss as a result ofhealth losses due to circulatory system diseases and malignant neoplasms averaged about 5% of the Gross Domestic Product (GDP). The medical and social losses of years depend on a number of social and economic factorsin the region (environmental pollution, population income, centralized water supply and the fraction of economically active population).


Subject(s)
Cardiovascular Diseases/economics , Cardiovascular Diseases/epidemiology , Cause of Death , Neoplasms/economics , Neoplasms/epidemiology , Public Health/statistics & numerical data , Aged , Female , Humans , Kazakhstan/epidemiology , Male , Middle Aged
10.
Rev. argent. cardiol ; 80(1): 47-52, ene. 2012. tab
Article in Spanish | LILACS | ID: lil-639701

ABSTRACT

Introducción Los grandes cambios producidos en las dos últimas décadas en las reglas laborales en salud, los estilos de trabajo, la organización sanitaria, el uso y la importancia de la tecnología y en la consideración social acerca del profesional médico tienen causas complejas y multifactoriales; las mismas presentan elementos comunes como el empeoramiento de la remuneración que perciben los médicos, la disminución absoluta y relativa de los honorarios profesionales y la percepción del médico respecto de su propia profesión y marcan una realidad que exige reconsiderar el lugar del médico en sus nuevos escenarios de trabajo. Objetivos Definimos como "problemática médica" a toda vivencia o situación problemática que experimenta el médico durante el ejercicio de su actividad. Sobre el tema existen abundantes datos y opiniones en los últimos años referidos a la insalubre situación laboral del médico y a la propia percepción negativa sobre su tarea. El objetivo de presente trabajo fue explorar si la problemática médica era tratada en el Congreso Argentino de Cardiología. Material y métodos Estudio observacional, descriptivo, sobre la existencia de temas libres y mesas sobre problemática médica en los últimos tres Congresos Argentinos de Cardiología y su ubicación temática. Algunas de las palabras clave fueron: realidad laboral, trabajo médico, burn out, bioética, ética, condiciones de trabajo y otras. Resultados Hubo en total 2254 temas libres en los tres años, de los cuales 8 (0,35%) trataron sobre elementos de problemática médica. Los temas libres se ubicaron en las categorías "miscelánea", psicosociales, educación médica o salud pública. Hubo 13 mesas, organizadas por el Comité de Bioética, el Área de Investigación de la Sociedad Argentina de Cardiología, CONAREC y la Fundación Cardiológica Argentina. Conclusiones En el período estudiado hubo una proporción muy escasa de mesas y temas libres dirigidos a la problemática médica, estos últimos sin un marco conceptual preestablecido adecuado. Así, la problemática médica no es considerada un objeto de estudio relevante. Es conveniente la discusión e investigación para la búsqueda de planteos y soluciones a múltiples niveles, o no podrá hacerse un diagnóstico y tratamiento del tema, con las eventuales y enormes implicaciones futuras potenciales.


Background The big changes produced during the last two decades have produced a reality that requires physicians to reconsider the role they play in their new working scenario. These changes include regulations in health care working, work styles, health organization, use and importance of technology and how the physician is socially considered. The causes are complex and multifactorial, yet they share common elements as worse payment to physicians, an absolute and relative reduction in professional fees and physicians' perception about their own profession. Objectives A "medical problem" is defined as any problematic experience or situation felt by a physician during his/her practice. In the last years, there are plenty of information and several opinions about this matter, in reference to the working conditions of physicians and to their negative self-perception about medical practice. The goal of the present study was to explore if the Argentine Congress of Cardiology dealt with the medical problem. Material and Methods Observational and descriptive study about open-topic sessions and roundtable sessions dealing with the medical problem -and under which field the medical problem was considered- during the past/latest three Argentine Congresses of Cardiology. The following key words were used: working reality, medical practice, burnout, bioethics, ethics and working conditions, among others. Results Of 2254 open topics presented in the three years, 8 (0.35%) dealt with the medical problem. The open topics were considered under "miscellany", psychosocial, medical education or public health fields. Thirteen roundtable sessions were identified and organized by the Committee on Bioethics, the Research Area of the Argentine Society of Cardiology, the CONAREC and the Argentine Cardiology Foundation. Conclusions We found very few roundtable sessions and opened-topic sessions -and without an adequate preestablished conceptual framework- focused on the medical problem. Thus, the medical problem is not considered an important topic of study. Discussion and investigation are convenient to search for arguments and solutions at multiple levels, otherwise it will not be possible to make a diagnosis and treatment of the topic, with the eventual and important future implications.

11.
Rev. argent. cardiol ; 80(1): 47-52, ene. 2012. tab
Article in Spanish | BINACIS | ID: bin-129567

ABSTRACT

Introducción Los grandes cambios producidos en las dos últimas décadas en las reglas laborales en salud, los estilos de trabajo, la organización sanitaria, el uso y la importancia de la tecnología y en la consideración social acerca del profesional médico tienen causas complejas y multifactoriales; las mismas presentan elementos comunes como el empeoramiento de la remuneración que perciben los médicos, la disminución absoluta y relativa de los honorarios profesionales y la percepción del médico respecto de su propia profesión y marcan una realidad que exige reconsiderar el lugar del médico en sus nuevos escenarios de trabajo. Objetivos Definimos como "problemática médica" a toda vivencia o situación problemática que experimenta el médico durante el ejercicio de su actividad. Sobre el tema existen abundantes datos y opiniones en los últimos años referidos a la insalubre situación laboral del médico y a la propia percepción negativa sobre su tarea. El objetivo de presente trabajo fue explorar si la problemática médica era tratada en el Congreso Argentino de Cardiología. Material y métodos Estudio observacional, descriptivo, sobre la existencia de temas libres y mesas sobre problemática médica en los últimos tres Congresos Argentinos de Cardiología y su ubicación temática. Algunas de las palabras clave fueron: realidad laboral, trabajo médico, burn out, bioética, ética, condiciones de trabajo y otras. Resultados Hubo en total 2254 temas libres en los tres años, de los cuales 8 (0,35%) trataron sobre elementos de problemática médica. Los temas libres se ubicaron en las categorías "miscelánea", psicosociales, educación médica o salud pública. Hubo 13 mesas, organizadas por el Comité de Bioética, el Area de Investigación de la Sociedad Argentina de Cardiología, CONAREC y la Fundación Cardiológica Argentina. Conclusiones En el período estudiado hubo una proporción muy escasa de mesas y temas libres dirigidos a la problemática médica, estos últimos sin un marco conceptual preestablecido adecuado. Así, la problemática médica no es considerada un objeto de estudio relevante. Es conveniente la discusión e investigación para la búsqueda de planteos y soluciones a múltiples niveles, o no podrá hacerse un diagnóstico y tratamiento del tema, con las eventuales y enormes implicaciones futuras potenciales.(AU)


Background The big changes produced during the last two decades have produced a reality that requires physicians to reconsider the role they play in their new working scenario. These changes include regulations in health care working, work styles, health organization, use and importance of technology and how the physician is socially considered. The causes are complex and multifactorial, yet they share common elements as worse payment to physicians, an absolute and relative reduction in professional fees and physicians perception about their own profession. Objectives A "medical problem" is defined as any problematic experience or situation felt by a physician during his/her practice. In the last years, there are plenty of information and several opinions about this matter, in reference to the working conditions of physicians and to their negative self-perception about medical practice. The goal of the present study was to explore if the Argentine Congress of Cardiology dealt with the medical problem. Material and Methods Observational and descriptive study about open-topic sessions and roundtable sessions dealing with the medical problem -and under which field the medical problem was considered- during the past/latest three Argentine Congresses of Cardiology. The following key words were used: working reality, medical practice, burnout, bioethics, ethics and working conditions, among others. Results Of 2254 open topics presented in the three years, 8 (0.35%) dealt with the medical problem. The open topics were considered under "miscellany", psychosocial, medical education or public health fields. Thirteen roundtable sessions were identified and organized by the Committee on Bioethics, the Research Area of the Argentine Society of Cardiology, the CONAREC and the Argentine Cardiology Foundation. Conclusions We found very few roundtable sessions and opened-topic sessions -and without an adequate preestablished conceptual framework- focused on the medical problem. Thus, the medical problem is not considered an important topic of study. Discussion and investigation are convenient to search for arguments and solutions at multiple levels, otherwise it will not be possible to make a diagnosis and treatment of the topic, with the eventual and important future implications.(AU)

12.
Rev. argent. cardiol ; 80(1): 47-52, ene. 2012. tab
Article in Spanish | BINACIS | ID: bin-127743

ABSTRACT

Introducción Los grandes cambios producidos en las dos últimas décadas en las reglas laborales en salud, los estilos de trabajo, la organización sanitaria, el uso y la importancia de la tecnología y en la consideración social acerca del profesional médico tienen causas complejas y multifactoriales; las mismas presentan elementos comunes como el empeoramiento de la remuneración que perciben los médicos, la disminución absoluta y relativa de los honorarios profesionales y la percepción del médico respecto de su propia profesión y marcan una realidad que exige reconsiderar el lugar del médico en sus nuevos escenarios de trabajo. Objetivos Definimos como "problemática médica" a toda vivencia o situación problemática que experimenta el médico durante el ejercicio de su actividad. Sobre el tema existen abundantes datos y opiniones en los últimos años referidos a la insalubre situación laboral del médico y a la propia percepción negativa sobre su tarea. El objetivo de presente trabajo fue explorar si la problemática médica era tratada en el Congreso Argentino de Cardiología. Material y métodos Estudio observacional, descriptivo, sobre la existencia de temas libres y mesas sobre problemática médica en los últimos tres Congresos Argentinos de Cardiología y su ubicación temática. Algunas de las palabras clave fueron: realidad laboral, trabajo médico, burn out, bioética, ética, condiciones de trabajo y otras. Resultados Hubo en total 2254 temas libres en los tres años, de los cuales 8 (0,35%) trataron sobre elementos de problemática médica. Los temas libres se ubicaron en las categorías "miscelánea", psicosociales, educación médica o salud pública. Hubo 13 mesas, organizadas por el Comité de Bioética, el Area de Investigación de la Sociedad Argentina de Cardiología, CONAREC y la Fundación Cardiológica Argentina. Conclusiones En el período estudiado hubo una proporción muy escasa de mesas y temas libres dirigidos a la problemática médica, estos últimos sin un marco conceptual preestablecido adecuado. Así, la problemática médica no es considerada un objeto de estudio relevante. Es conveniente la discusión e investigación para la búsqueda de planteos y soluciones a múltiples niveles, o no podrá hacerse un diagnóstico y tratamiento del tema, con las eventuales y enormes implicaciones futuras potenciales.(AU)


Background The big changes produced during the last two decades have produced a reality that requires physicians to reconsider the role they play in their new working scenario. These changes include regulations in health care working, work styles, health organization, use and importance of technology and how the physician is socially considered. The causes are complex and multifactorial, yet they share common elements as worse payment to physicians, an absolute and relative reduction in professional fees and physicians perception about their own profession. Objectives A "medical problem" is defined as any problematic experience or situation felt by a physician during his/her practice. In the last years, there are plenty of information and several opinions about this matter, in reference to the working conditions of physicians and to their negative self-perception about medical practice. The goal of the present study was to explore if the Argentine Congress of Cardiology dealt with the medical problem. Material and Methods Observational and descriptive study about open-topic sessions and roundtable sessions dealing with the medical problem -and under which field the medical problem was considered- during the past/latest three Argentine Congresses of Cardiology. The following key words were used: working reality, medical practice, burnout, bioethics, ethics and working conditions, among others. Results Of 2254 open topics presented in the three years, 8 (0.35%) dealt with the medical problem. The open topics were considered under "miscellany", psychosocial, medical education or public health fields. Thirteen roundtable sessions were identified and organized by the Committee on Bioethics, the Research Area of the Argentine Society of Cardiology, the CONAREC and the Argentine Cardiology Foundation. Conclusions We found very few roundtable sessions and opened-topic sessions -and without an adequate preestablished conceptual framework- focused on the medical problem. Thus, the medical problem is not considered an important topic of study. Discussion and investigation are convenient to search for arguments and solutions at multiple levels, otherwise it will not be possible to make a diagnosis and treatment of the topic, with the eventual and important future implications.(AU)

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