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In a context of rapid technological innovation and expensive new products, the paper calls for the generation of real-world data to inform decision-making and an international discussion on the affordability of new medicines, particularly for low- and middle-income countries. Without these, the challenges of health judicialization will continue to grow. [ABSTRACT FROM AUTHOR]

Copyright of Movimento (0104754X) is the property of Movimento, da Escola de Educacao, Fisica, Fisioterapia e Danca and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Irrational antimicrobial consumption (AMC) became one of the main global health problems in recent decades. Objective: In order to understand AMC in Latin-American Region, we performed the present research in 6 countries. Methods: Antimicrobial consumption (J01, A07A, P01AB groups) was registered in Argentina, Chile, Colombia, Costa Rica, Paraguay, and Peru. Source of information, AMC type, DDD (Defined Daily Doses), DID (DDD/1000 inhabitants/day), population were variables explored. Data was analyzed using the Global Antimicrobial Resistance and Use Surveillance System (GLASS) tool. Results: Source of information included data from global, public, and private sectors. Total AMC was highly variable (range 1.91-36.26 DID). Penicillin was the most consumed group in all countries except in Paraguay, while macrolides and lincosamides were ranked second. In terms of type of AMC according to the WHO-AWaRe classification, it was found that for certain groups like "Reserve," there are similarities among all countries. Conclusion and Relevance: This paper shows the progress that 6 Latin-American countries made toward AMC surveillance. The study provides a standardized approach for building a national surveillance system for AMC data analysis. These steps will contribute to the inclusion of Latin-America among the regions of the world that have periodic, regular, and quality data of AMC. [ABSTRACT FROM AUTHOR]

Regulatory processes and debates are often informed by competition assessments issued by antitrust agencies, who advocate against potentially anticompetitive governmental regulations. While these opinions are usually not binding for regulators, the participation of antitrust agencies may have significant influence over the outcome of regulatory processes. This article examines whether antitrust agencies use their competition assessments to link regulation and development. The research addresses two research questions: first, do antitrust agencies consider development, directly or indirectly, as a guiding criterion in their competition assessments of regulatory projects? And second, what does development mean for these agencies in the context of competition assessments? A case study approach was used to answer the research questions, analyzing the cases of three countries of Latin America: Argentina, Colombia, and El Salvador. Based on the examination of over 300 competition assessments published by the antitrust agencies and on the semi-structured interviews of antitrust agencies' former and current officials, we report four main findings: (i) the studied agencies frequently used the term "development" in their competition assessments to explain the policy context, the objectives of the regulatory proposals, and the potential benefits of competitive markets.; (ii) the meaning of "development" that prevailed among the three cases studies corresponds to a narrow understanding of "economic development" (e.g. a synonym of economic growth); (iii) the case of Colombia stands out because some of the competition assessments explicitly recognize the importance of broader conceptions of development, including sustainability; and, (iv) competition advocacy was used by the studied agencies to link regulation and development through their reports and recommendations on regulatory projects. [ABSTRACT FROM AUTHOR]

We simulate the short- and long-term distributional consequences of COVID-19 in the four largest Latin American economies: Argentina, Brazil, Colombia, and Mexico. We show that the short-term impact on income inequality and poverty can be very significant, but that additional spending on social assistance more than offsets the effect in Brazil. The offsetting effect is significant in Argentina and Colombia and nil in Mexico, where there has been no such expansion. We find that a universal basic income that would have produced the same reduction in the poverty gap as actual policies would have cost slightly more but would have benefited the poor (the nonpoor) slightly less (more). To project the longterm consequences, we estimate the impact of the pandemic on school achievement and its intergenerational persistence. We use information on school closures, educational mitigation policies, and account for educational losses related to health shocks and parental job loss. Our findings show that in all four countries the impact is strongly asymmetric and affects particularly the high-school completion rates of children from disadvantaged families. Our simulations suggest that mitigation policies seem to have a minor impact on containing these negative effects. [ABSTRACT FROM AUTHOR]

Recent studies on income inequality have some characteristics that differentiate them from their earlier counterparts. The spotlight on high incomes has illuminated a new angle from which to view income inequality. Because estimates of top income shares can be used as a proxy for power inequality, they can enrich our comprehension of the role of the elite in Latin America's economic development. However, scholars interested in studying the history of economic inequality in Latin America face certain methodological and theoretical problems of their own: (1) because food and other commodities such as minerals represent the lion's share of exported goods in Latin America, cycles in commodity prices have shaped the region's economic history. Thus, the crux of income inequality in Latin America is who becomes richer and who becomes poorer when exports prices rise and fall; and (2) the sort of fiscal statistics typically used capture only a few countries and sometimes only limited periods. Thus, as I argue, scholars should use dynamic social tables to produce new information. I exemplify both points with a historical analysis of three Latin American countries: Chile, Colombia, and Argentina. [ABSTRACT FROM AUTHOR]

Background: The participation of health professionals in designing interventions is considered vital to effective implementation, yet in areas such as clinical coordination is rarely promoted and evaluated. This study, part of Equity-LA II, aims to analyse the design process of interventions to improve clinical coordination, taking a participatory-action-research (PAR) approach, in healthcare networks of Argentina, Brazil, Chile, Colombia, Mexico and Uruguay. This participatory process was planned in four phases, led by a local steering committee (LSC): (1) dissemination of problem analysis results and creation of professionals' platform, (2) selection of problems and intervention (3) intervention design and planning (4) adjustments after evaluation of first implementation stage. Methods: A descriptive qualitative study based on documentary analysis, using a topic guide, was conducted in each intervention network. Documents produced regarding the intervention design process were selected. Thematic content analysis was conducted, generating mixed categories taken from the topic guide and identified from data. Main categories were LSC characteristics, type of design process (phases, participants' roles, methods) and associated difficulties, coordination problems and interventions selected. Results: LSCs of similar composition (managers, professionals and researchers) were established, with increasing membership in Chile and high turnover in Argentina, Colombia and Mexico. Following results dissemination and selection of problems and interventions (more participatory in Chile and Colombia: 200–479 participants), the interventions were designed and planned, resulting in three different types of processes: (1) short initial design with adjustments after first implementation stage, in Colombia, Brazil and Mexico; (2) longer, more participatory process, with multiple cycles of action/reflection and pilot tests, in Chile; (3) open-ended design for ongoing adaptation, in Argentina and Uruguay. Professionals' time and the political cycle were the main barriers to participation. The clinical coordination problem selected was limited communication between primary and secondary care doctors. To address it, through discussions guided by context and feasibility criteria, interventions based on mutual feedback were selected. Conclusions: As expected in a flexible PAR process, its rollout differed across countries in participation and PAR cycles. Results show that PAR can help to design interventions adapted to context and offers lessons that can be applied in other contexts. [ABSTRACT FROM AUTHOR]

This study considers the role that public service announcements (PSAs) play in addressing violence against women (VAW) in Latin America. Using content analysis, the study examines 407 PSAs about VAW from 20 Latin American countries. The results show that 62.3% of the PSAs encourage bystanders to denounce violence while portraying women as victims in 48.8% of the PSAs. However, 71.7% of PSAs did not include a helpline or how to report the crime, only 11.8% of the PSAs have non-narrative, or factual information, about VAW, and just 6.4% engage in compelling narrative messaging or storytelling. [ABSTRACT FROM AUTHOR]

Alopecia areata (AA) represents an underrecognized burden in Latin America (LA), severely impacting quality of life (QoL). This impact is exacerbated by limited access to specialized dermatologic care and therapies for AA within and among nations. Many of the unmet needs for AA globally also exist in LA. The region has geographic, ethnic, cultural, and economic conditions. With new AA medicines targeting immunologic pathways on the horizon, LA must prepare regarding regulatory issues, reimbursement, awareness, and education to give adequate and timely treatment for patients with AA. To address these issues, the Americas Health Foundation convened a panel of six dermatologists from Argentina, Brazil, Colombia, and Mexico who are experts in AA and its comorbidities for a 3-day virtual meeting to discuss AA diagnosis and treatment in LA and create a manuscript offering recommendations to address discussed barriers. This publication examines unmet AA needs in LA, treatment, and innovative therapies and recommends improving AA care. Access constraints to conventional and novel medicines hinder appropriate treatments for patients. Therapy initiation delays can affect QoL, mental health, and disease progression. People with AA face stigmas, discrimination, and misconceptions owing to a lack of disease awareness. With promising new treatments for AA on the horizon, all stakeholders must coordinate efforts to enhance LA's AA management landscape and improve patient outcomes. [ABSTRACT FROM AUTHOR]

Copyright of Tapuya: Latin American Science, Technology & Society is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The aim of this work is to study slow journalism audiences, with a particular interest in Latin America, specifically Argentina, Colombia, and Mexico. Five case studies were carried out, covering Anfibia (Argentina), Arcadia (Colombia), Gatopardo (Mexico), La silla vacía (Colombia), and Letras libres (Mexico), along with a Delphi study (double round with 27 participants) and a structured questionnaire (of 1,500 people between the ages of 18 and 65 years). The results indicate that 75% of the surveyed population obtain their information from all kinds of digital media, among whom 84% use social media for this purpose. Slow journalism is still mainly unknown to a large fraction (17%) of the population, although once given its definition and some named examples, 40% of those surveyed claimed to have read the slow press at some time. Quality is the main reason for its consumption (62%), followed by searching for specific subjects (46%), especially for young people (65%) and in Colombia (52%). Experts in slow journalism agree that the key to consolidating an audience involves listening to and interacting with its members, together with their active participation in the media. [ABSTRACT FROM AUTHOR]

Approximately one-third of patients with major depressive disorder (MDD) have treatment-resistant depression (TRD). The TRAL study will evaluate the prevalence and impact of TRD among patients with MDD in four Latin American countries. In this multicenter, prospective, observational study, patients with MDD were recruited from 33 reference sites in Mexico, Colombia, Brazil, and Argentina. Patients were assessed for TRD, defined as failure to respond to ≥ 2 antidepressant medications of adequate dose and duration. Demographics, previous/current treatments, depressive symptoms, functioning, healthcare resource utilization, and work impairment were also collected and evaluated using descriptive statistics, chi-square test, Fisher exact test, t-test for independent samples, or the Mann–Whitney nonparametric test, as appropriate. 1475 patients with MDD were included in the analysis (mean age, 45.6 years; 78% women); 89% were receiving relevant psychiatric treatment. 429 patients met criteria for TRD, and a numerically higher proportion of patients with TRD was present in public versus private sites of care (31% vs 27%). The mean Montgomery-Asberg Depression Rating Scale score was 25.0 among all MDD patients and was significantly higher for patients with TRD versus non-TRD (29.4 vs 23.3; P < 0.0001). Patients with TRD, versus those with non-TRD, were significantly more likely to be older, have a longer disease duration, have more comorbidities, be symptomatic, have a higher median number of psychiatric consultations, and report greater work impairment. Patients with TRD have a disproportionate burden of disease compared to those with non-TRD. Appropriate treatment for TRD is a substantial unmet need in Latin America. https://www.ClinicalTrials.gov identifier NCT03207282, 07/02/2017. [ABSTRACT FROM AUTHOR]