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Carpio-Arias TV, Guijarro-Garvi M, Ruiz-Cantero MT. [Effect of gender equality on mortality from non-communicable diseases]. Gac Sanit 2024; 38:102369. [PMID: 38377629 DOI: 10.1016/j.gaceta.2024.102369] [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] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 12/12/2023] [Accepted: 12/13/2023] [Indexed: 02/22/2024]
Abstract
OBJECTIVE Relate gender inequalities with the probability of mortality from non-communicable diseases (NCD), in the countries of the world from the year 2000 to 2019, to detect the progress of Target 3.4 of the Sustainable Development Goal 3, to reduce NCD by one third between the ages of 30 and 70 by 2030. METHOD Exploratory ecological study on the association between the probability of death from NCD and the gender inequality index (GII) at the global level in 2000, 2015 and 2019. Logistic regression estimation of the risk of not being on track to meet Target 3.4 by 2019 by gender inequality. RESULTS The mean probability of death from NCD decreased progressively in all countries. Median 2000/2015/2019: women 20.20/16.58/16; men 26.59/22.45/21.88; total 23.14/20.10/19.23. The risk of not achieving the goal in 2019 is greater in countries with a lower GII than in countries with a higher GII (OR: 2.13; 95% CI: 1.14-3.99; p=0.018), being the higher risk in women (OR: 2.64; 95% CI: 1.40-5.06; p=0.003) than in men (OR: 2.12; 95% CI: 1.44-3.98; p=0.017). CONCLUSIONS The risk of deaths from NCD has decreased in both sexes in all countries of the world since the year 2000; but progress is slow, so the greater gender inequality in the countries, there is a greater risk of not achieving the reduction needed to comply with the agreement to reduce mortality from NCD by one third in 2030; this risk being greater in women than in men.
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Affiliation(s)
- Tannia Valeria Carpio-Arias
- Escuela Superior Politécnica de Chimborazo, Facultad de Salud Pública, Grupo de Investigación en Alimentación y Nutrición Humana, Riobamba, Chimborazo, Ecuador.
| | | | - María Teresa Ruiz-Cantero
- Grupo de Investigación en Salud Pública, Universidad de Alicante, San Vicente del Raspeig, Alicante, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España
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Pinchas-Mizrachi R, Shapiro E, Romem A, Zalcman BG. Predictors of respiratory cancer-related mortality for Jews and Arabs in Israel. SSM Popul Health 2021; 14:100783. [PMID: 33898728 PMCID: PMC8056258 DOI: 10.1016/j.ssmph.2021.100783] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 03/21/2021] [Accepted: 03/23/2021] [Indexed: 01/30/2023] Open
Abstract
Background Respiratory cancers, including lung, tracheal and bronchus cancers, are a leading cause of cancer-related mortality in Israel; however, incidence can differ among demographic groups. Despite the importance of sociodemographic characteristics and the interactions between them to incidence and mortality, this topic is understudied. This study analyzes sociodemographic disparities by sex and ethnicity among Jews and Arabs to understand cancer outcome differences stratified by SES, marital status, and number of children as potential contextual factors. Methods This retrospective cohort study analyzed respiratory cancer-related mortality rates among Israelis born between 1940 and 1960 over 21-years. The follow up period was between January 1, 1996 and 12.31.2016. Mortality rates for Jews and Arabs were calculated. Using a Cox Regression, a multivariate model was constructed to determine the association between ethnicity and respiratory cancer mortality. The study population was then divided into four groups, by sex and ethnicity, to determine the association between marital status, number of children, and SES with respiratory cancer mortality for each subgroup. Results The overall mortality rate was 0.6%. Arabs had higher mortality rates compared to Jews, even after adjusting for demographic factors including age, sex and SES (Adjusted Hazard Ratio (AHR) = 1.442, 99% confidence intervals (CI) = 1.354,1.546). Among men, a higher mortality rate was found among Arabs (AHR = 1.383, 99%CI = 1.295,1.477), while among women, Arabs had lower mortality rates (AHR = 0.469, 99%CI = 0.398,0.552). Significant mortality rate differences were observed by ethnicity and sex for each sociodemographic variable. Conclusions This study highlights the importance and implications of understanding differences in respiratory cancer mortality between Jews and Arabs, a minority group in Israel, and is relevant for minority groups in general. There is a need to tailor interventions for these groups, based on differing underlying causes and contextual factors for these cancers. Cancer outcomes among these groups should also be studied separately, by sex, to better understand them. This retrospective multivariable cohort study analyzed respiratory cancer mortality. Data was collected for 26 years for 196,974 Arabs and 1,470,676 Jews in Israel. A higher mortality rate was found among Arab men compared to Jewish men. A lower mortality rate was found among Arab women compared to Jewish women. Implications for predictive factors found for respiratory cancer-related mortality.
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Affiliation(s)
- Ronit Pinchas-Mizrachi
- Jerusalem College of Technology, Jerusalem, Israel.,The Israel Academic College, Ramat Gan, Israel
| | - Ephraim Shapiro
- Department of Health Systems Management, Ariel University, Ariel, Israel
| | - Ayal Romem
- Pulmonary Division, Head of IP Service, Meir Medical Center, Kfar Saba, Israel
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Vidal-Cevallos P, Higuera-De-La-Tijera F, Chávez-Tapia NC, Sanchez-Giron F, Cerda-Reyes E, Rosales-Salyano VH, Servin-Caamaño A, Vázquez-Medina MU, Méndez-Sánchez N. Lactate-dehydrogenase associated with mortality in hospitalized patients with COVID-19 in Mexico: a multi-centre retrospective cohort study. Ann Hepatol 2021; 24:100338. [PMID: 33647501 PMCID: PMC7908830 DOI: 10.1016/j.aohep.2021.100338] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 02/15/2021] [Accepted: 02/18/2021] [Indexed: 02/08/2023]
Abstract
INTRODUCTION AND OBJECTIVES As of January 2021, over 88 million people have been infected with COVID-19. Almost two million people have died of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). A high SOFA score and a D-Dimer >1 µg/mL identifies patients with high risk of mortality. High lactate dehydrogenase (LDH) levels on admission are associated with severity and mortality. Different degrees of alanine aminotransferase (ALT) and/or aspartate aminotransferase (AST) abnormalities have been reported in these patients, its association with a mortality risk remains controversial. The aim of this study was to explore the correlation between LDH and in-hospital mortality in Mexican patients admitted with COVID-19. MATERIALS & METHODS We performed a retrospective multi-centre cohort study with 377 hospitalized patients with confirmed SARS-CoV-2 in three centres in Mexico City, Mexico, who were ≥18 years old and died or were discharged between April 1 and May 31, 2020. RESULTS A total of 377 patients were evaluated, 298 (79.1%) patients were discharged, and 79 (20.9%) patients died during hospitalization. Non-survivors were older, with a median age of 46.7 ± 25.7 years old, most patients were male. An ALT > 61 U/l (OR 3.45, 95% CI 1.27-9.37; p = 0.015), C-reactive protein (CRP) > 231 mg/l (OR 4.71, 95% CI 2.35-9.46; p = 0.000), LDH > 561 U/l (OR 3.03, 95% CI 1.40-6.55; p = 0.005) were associated with higher odds for in-hospital death. CONCLUSIONS Our results indicate that higher levels of LDH, CRP, and ALT are associated with higher in-hospital mortality risk in Mexican patients admitted with COVID-19.
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Affiliation(s)
- Paulina Vidal-Cevallos
- Liver Research Unit, Medica Sur Clinic & Foundation and Faculty of Medicine. National Autonomous University of Mexico, Mexico City, Mexico,National Autonomous University of Mexico. Mexico City, Mexico, 14050, Mexico
| | - Fatima Higuera-De-La-Tijera
- Gastroenterology and Hepatology Department, Mexico’s General Hospital “Dr. Eduardo Liceaga”. Dr. Balmis 148, col. Doctores, C.P. 06720, Mexico City, Mexico
| | - Norberto C. Chávez-Tapia
- Obesity and Digestive Disease Unit, Medica Sur Clinic and Foundation. Puente de Piedra 150, col. Toriello Guerra, C.P. 14050, Mexico City, Mexico
| | - Francisco Sanchez-Giron
- Director of the Clinical Pathology Laboratory, Medica Sur Clinic and Foundation. Puente de Piedra 150, col. Toriello Guerra, C.P. 14050, Mexico City, Mexico
| | - Eira Cerda-Reyes
- Academic Coordinator, Central Military Hospital, Periférico Blvrd Manuel Ávila Camacho s/n, col. Militar, C.P. 11200, Mexico City, Mexico
| | - Victor Hugo Rosales-Salyano
- Internal Medicine Department, Mexico’s General Hospital “Dr. Eduardo Liceaga”. Dr. Balmis 148, col. Doctores, C.P. 06720, Mexico City, Mexico
| | - Alfredo Servin-Caamaño
- Internal Medicine Department, Mexico’s General Hospital “Dr. Eduardo Liceaga”. Dr. Balmis 148, col. Doctores, C.P. 06720, Mexico City, Mexico
| | - Martín Uriel Vázquez-Medina
- Superior School of Medicine, National Polytechnic Institute Salvador Díaz Mirón S/N, Miguel Hidalgo, Casco de Santo Tomas, C.P. 11340, Mexico City, Mexico
| | - Nahum Méndez-Sánchez
- Liver Research Unit, Medica Sur Clinic & Foundation and Faculty of Medicine. National Autonomous University of Mexico, Mexico City, Mexico; National Autonomous University of Mexico. Mexico City, Mexico, 14050, Mexico.
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McElvenny DM, Miller BG, MacCalman LA, Sleeuwenhoek A, van Tongeren M, Shepherd K, Darnton AJ, Cherrie JW. Mortality of a cohort of workers in Great Britain with blood lead measurements. Occup Environ Med 2015; 72:625-32. [PMID: 25872777 DOI: 10.1136/oemed-2014-102637] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2014] [Accepted: 03/19/2015] [Indexed: 01/28/2023]
Abstract
OBJECTIVES We examined the mortality of a historic cohort of workers in Great Britain with measured blood lead levels (BLLs). METHODS SMRs were calculated with the population of Great Britain as the external comparator. Trends in mortality with mean and maximum BLLs and assessed lead exposure were examined using Cox regression. RESULTS Mean follow-up length among the 9122 study participants was 29.2 years and 3466 deaths occurred. For all causes and all malignant neoplasms, the SMRs were statistically significantly raised. For disease groups of a priori interest, the SMR was significantly raised for lung cancer but not for stomach, brain, kidney, bladder or oesophageal cancers. The SMR was not increased for non-malignant kidney disease but was borderline significantly increased for circulatory diseases, for ischaemic heart disease (IHD) and cerebrovascular disease (CVD). No significant trends with exposure were observed for the cancers of interest, but for circulatory diseases and IHD, there was a statistically significant trend for increasing HR with mean and maximum BLLs. CONCLUSIONS This study found an excess of lung cancer, although the risk was not clearly associated with increasing BLLs. It also found marginally significant excesses of IHD and CVD, the former being related to mean and maximum BLLs. The finding for IHD may have been due to lead, but could also have been due to other dust exposure associated with lead exposure and possibly tobacco smoking. Further work is required to clarify this and the carcinogenicity of lead.
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Affiliation(s)
| | | | | | | | | | | | | | - John W Cherrie
- Institute of Occupational Medicine, Edinburgh, UK Heriot Watt University, Edinburgh, UK
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Brusse-Keizer M, Zuur-Telgen M, van der Palen J, VanderValk P, Kerstjens H, Boersma W, Blasi F, Kostikas K, Milenkovic B, Tamm M, Stolz D. Adrenomedullin optimises mortality prediction in COPD patients. Respir Med 2015; 109:734-42. [PMID: 25937049 DOI: 10.1016/j.rmed.2015.02.013] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Revised: 02/23/2015] [Accepted: 02/24/2015] [Indexed: 11/27/2022]
Abstract
BACKGROUND Current multicomponent scores that predict mortality in COPD patients might underestimate the systemic component of COPD. Therefore, we evaluated the accuracy of circulating levels of proadrenomedullin (MR-proADM) alone or combined with the ADO (Age, Dyspnoea, airflow Obstruction), updated ADO or BOD (Body mass index, airflow Obstruction, Dyspnoea) index to predict all-cause mortality in stable COPD patients. METHODS This study pooled data of 1285 patients from the COMIC and PROMISE-COPD study. RESULTS Patients with high MR-proADM levels (≥0.87 nmol/l) had a 2.1 fold higher risk of dying than those with lower levels (p < 0.001). Based on the C-statistic, the ADOA index (ADO plus MR-proADM) (C = 0.72) was the most accurate predictor followed by the BODA (BOD plus MR-proADM) (C = 0.71) and the updated ADOA index (updated ADO plus MR-proADM) (C = 0.70). Adding MR-proADM to ADO and BOD was superior in forecasting 1- and 2-year mortality. The net percentages of persons with events correctly reclassified (NRI+) within respectively 1-year and 2-year was 31% and 20% for ADO, 31% and 20% for updated ADO and 25% and 19% for BOD. The net percentages of persons without events correctly reclassified (NRI-) within respectively 1-year and 2-year was 26% and 27% for ADO, 27% and 28% for updated ADO and 34% and 34% for BOD. CONCLUSIONS Adding MR-proADM increased the predictive power of BOD, ADO and updated ADO index.
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Affiliation(s)
| | - Maaike Zuur-Telgen
- Department of Pulmonary Medicine, Medisch Spectrum Twente, Enschede, The Netherlands
| | - Job van der Palen
- Medical School Twente, Medisch Spectrum Twente, Enschede, The Netherlands; Department of Research Methodology, Measurement, and Data Analysis, University of Twente, Enschede, The Netherlands
| | - Paul VanderValk
- Department of Pulmonary Medicine, Medisch Spectrum Twente, Enschede, The Netherlands
| | - Huib Kerstjens
- University Of Groningen, University Medical Centre Groningen, Department of Pulmonary Medicine, and Groningen Research Institute for Asthma and COPD (GRIAC), Groningen, The Netherlands
| | - Wim Boersma
- Department of Pneumology, Medisch Centrum Alkmaar, Alkmaar, The Netherlands
| | - Francesco Blasi
- Department of Pathophysiology and Transplantation, University of Milan, IRCCS Fondazione Cà Granda Milan, Italy
| | | | - Branislava Milenkovic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Clinic for Pulmonary Diseases, Clinical Center of Serbia, Belgrade, Serbia
| | - Michael Tamm
- Clinic of Pneumology and Respiratory Cell Research, University Hospital Basel, Basel, Switzerland
| | - Daiana Stolz
- Clinic of Pneumology and Respiratory Cell Research, University Hospital Basel, Basel, Switzerland
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Tanuseputro P, Perez R, Rosella L, Wilson K, Bennett C, Tuna M, Hennessy D, Manson H, Manuel D. Improving the estimation of the burden of risk factors: an illustrative comparison of methods to measure smoking-attributable mortality. Popul Health Metr 2015; 13:5. [PMID: 25717287 PMCID: PMC4339639 DOI: 10.1186/s12963-015-0039-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Accepted: 02/05/2015] [Indexed: 02/02/2023] Open
Abstract
Background Prevention efforts are informed by the numbers of deaths or cases of disease caused by specific risk factors, but these are challenging to estimate in a population. Fortunately, an increasing number of jurisdictions have increasingly rich individual-level, population-based data linking exposures and outcomes. These linkages enable multivariable approaches to risk assessment. We demonstrate how this approach can estimate the population burden of risk factors and illustrate its advantages over often-used population-attributable fraction methods. Methods We obtained risk factor information for 78,597 individuals from a series of population-based health surveys. Each respondent was linked to death registry (568,997 person-years of follow-up, 6,399 deaths).Two methods were used to obtain population-attributable fractions. First, the mortality rate difference between the entire population and the population of non-smokers was divided by the total mortality rate. Second, often-used attributable fraction formulas were used to combine summary measures of smoking prevalence with relative risks of death for select diseases. The respective fractions were then multiplied to summary measures of mortality to obtain smoking-attributable mortality. Alternatively, for our multivariable approach, we created algorithms for risk of death, predicted by health behaviors and various covariates (age, sex, socioeconomic position, etc.). The burden of smoking was determined by comparing the predicted mortality of the current population with that of a counterfactual population where smoking is eliminated. Results Our multivariable algorithms accurately predicted an individual’s risk of death based on their health behaviors and other variables in the models. These algorithms estimated that 23.7% of all deaths can be attributed to smoking in Ontario. This is higher than the 20.0% estimated using population-attributable risk methods that considered only select diseases and lower than the 35.4% estimated from population-attributable risk methods that examine the excess burden of all deaths due to smoking. Conclusions The multivariable algorithms presented have several advantages, including: controlling for confounders, accounting for complexities in the relationship between multiple exposures and covariates, using consistent definitions of exposure, and using specific measures of risk derived internally from the study population. We propose the wider use of multivariable risk assessment approach as an alternative to population-attributable fraction methods.
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Affiliation(s)
- Peter Tanuseputro
- Bruyère Research Institute, Bruyère Centre of Learning, Research and Innovation in Long-Term Care, Ottawa, Ontario Canada ; Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa, Ontario Canada ; Institute for Clinical Evaluative Sciences, Population Health and Primary Care, Ottawa, Ontario Canada
| | - Richard Perez
- Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa, Ontario Canada ; Institute for Clinical Evaluative Sciences, Population Health and Primary Care, Ottawa, Ontario Canada
| | - Laura Rosella
- Public Health Ontario, Toronto, Ontario Canada ; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario Canada
| | - Kumanan Wilson
- Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa, Ontario Canada ; Institute for Clinical Evaluative Sciences, Population Health and Primary Care, Ottawa, Ontario Canada ; Department of Medicine, University of Ottawa, Ottawa, Ontario Canada
| | - Carol Bennett
- Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa, Ontario Canada ; Institute for Clinical Evaluative Sciences, Population Health and Primary Care, Ottawa, Ontario Canada
| | - Meltem Tuna
- Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa, Ontario Canada ; Institute for Clinical Evaluative Sciences, Population Health and Primary Care, Ottawa, Ontario Canada
| | - Deirdre Hennessy
- Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa, Ontario Canada ; Health Analysis Division, Statistics Canada, Ottawa, Ontario Canada
| | | | - Douglas Manuel
- Bruyère Research Institute, Bruyère Centre of Learning, Research and Innovation in Long-Term Care, Ottawa, Ontario Canada ; Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa, Ontario Canada ; Institute for Clinical Evaluative Sciences, Population Health and Primary Care, Ottawa, Ontario Canada ; Health Analysis Division, Statistics Canada, Ottawa, Ontario Canada ; Department of Family Medicine, University of Ottawa, Ottawa, Ontario Canada
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Arroyave I, Burdorf A, Cardona D, Avendano M. Socioeconomic inequalities in premature mortality in Colombia, 1998-2007: the double burden of non-communicable diseases and injuries. Prev Med 2014; 64:41-7. [PMID: 24674854 PMCID: PMC4067972 DOI: 10.1016/j.ypmed.2014.03.018] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2013] [Revised: 01/16/2014] [Accepted: 03/11/2014] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Non-communicable diseases have become the leading cause of death in middle-income countries, but mortality from injuries and infections remains high. We examined the contribution of specific causes to disparities in adult premature mortality (ages 25-64) by educational level from 1998 to 2007 in Colombia. METHODS Data from mortality registries were linked to population censuses to obtain mortality rates by educational attainment. We used Poisson regression to model trends in mortality by educational attainment and estimated the contribution of specific causes to the Slope Index of Inequality. RESULTS Men and women with only primary education had higher premature mortality than men and women with post-secondary education (RRmen=2.60, 95% confidence interval [CI]: 2.56, 2.64; RRwomen=2.36, CI: 2.31, 2.42). Mortality declined in all educational groups, but declines were significantly larger for higher-educated men and women. Homicide explained 55.1% of male inequalities while non-communicable diseases explained 62.5% of female inequalities and 27.1% of male inequalities. Infections explained a small proportion of inequalities in mortality. CONCLUSION Injuries and non-communicable diseases contribute considerably to disparities in premature mortality in Colombia. Multi-sector policies to reduce both interpersonal violence and non-communicable disease risk factors are required to curb mortality disparities.
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Affiliation(s)
- Ivan Arroyave
- Department of Public Health, Erasmus University Medical Center, Dr. Molewaterplein 50, 3015 GE Rotterdam, The Netherlands; Faculty of Medicine, Universidad CES, Calle 10A #22-04, Medellin, Colombia.
| | - Alex Burdorf
- Department of Public Health, Erasmus University Medical Center, Dr. Molewaterplein 50, 3015 GE Rotterdam, The Netherlands.
| | - Doris Cardona
- Faculty of Medicine, Universidad CES, Calle 10A #22-04, Medellin, Colombia.
| | - Mauricio Avendano
- Department of Public Health, Erasmus University Medical Center, Dr. Molewaterplein 50, 3015 GE Rotterdam, The Netherlands; London School of Economics and Political Science, LSE Health and Social Care, Cowdray House, Houghton Street, London WC2A 2AE, UK; Department of Social and Behavioral Sciences, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA.
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