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Author: search.filters.author.Camila AwadSubject: search.filters.subject.health care personnel

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    Arsenic Exposure During Pregnancy and Childhood: Factors Explaining Changes over a Decade
    (MDPI AG, 2025-03-16)
    RUBILAR RAMIREZ, PAOLA ANDREA  
    ;
    HIRMAS ADAUY, MACARENA SOLEDAD  
    ;
    APABLAZA SALINAS, MAURICIO IVÁN  
    ;
    Camila Awad
    ;
    Xaviera Molina
    Arsenic chronic exposure, particularly in its inorganic form, represents a significant public health concern. This study was conducted in Arica, the northernmost city in the country, whose inhabitants have been exposed to inorganic arsenic both naturally through drinking water and anthropogenically due to a toxic waste disposal site. We explored changes in inorganic arsenic levels in a cohort of pregnant women and their children over a decade, identifying exposure trends and their determinants. We used data on arsenic exposure through maternal urine samples during pregnancy, collected by the Health Authority between 2013 and 2016 (measurement 1), and followed up with assessments of their children in 2023 (measurement 2). Temporal changes in inorganic arsenic concentration were analyzed using the Wilcoxon Signed-Rank test, and a mixed linear regression model was employed to determine which factors contributed to urinary inorganic arsenic levels. We did not observe significant differences in mean arsenic concentrations between the two-time points (p = 0.4026). The mixed linear regression model revealed that children consuming bottled water had 8.3% lower urinary inorganic arsenic concentrations than those drinking tap water (95% CI: −15.36 to −0.54%). Additionally, children from ethnic groups had 8.64% higher inorganic arsenic concentrations (95% CI: 0.49 to 17.5%), while those with caregivers with higher education showed a 13.67% reduction (95% CI: −25.06 to −0.56%). Despite mitigation efforts, these findings underscore the ongoing risk of inorganic arsenic exposure among vulnerable populations. They further emphasize the importance of addressing natural arsenic contamination in water and implementing targeted interventions to reduce disparities associated with socioeconomic and demographic factors.</jats:p>
    Scopus© Citations 1  6
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    Barriers and Facilitators in Access to Diabetes, Hypertension, and Dyslipidemia Medicines: A Scoping Review
    (2022)
    CASTILLO LABORDE, CARLA CECILIA  
    ;
    Macarena Hirmas-Adauy  
    ;
    MATUTE WILLEMSEM, MARIA ISABEL  
    ;
    Anita Jasmen
    ;
    Oscar Urrejola
    <jats:p><jats:bold>Objective:</jats:bold> Identify barriers and facilitators in access to medicines for diabetes, hypertension, and dyslipidemia, considering patient, health provider, and health system perspectives.</jats:p><jats:p><jats:bold>Methods:</jats:bold> Scoping review based on Joanna Briggs methodology. The search considered PubMed, Cochrane Library, CINAHL, Academic Search Ultimate, Web of Science, SciELO Citation Index, and grey literature. Two researchers conducted screening and eligibility phases. Data were thematically analyzed.</jats:p><jats:p><jats:bold>Results:</jats:bold> The review included 219 documents. Diabetes was the most studied condition; most of the evidence comes from patients and the United States. Affordability and availability of medicines were the most reported dimension and specific barrier respectively, both cross-cutting concerns. Among high- and middle-income countries, identified barriers were cost of medicines, accompaniment by professionals, long distances to facilities, and cultural aspects; cost of transportation emerges in low-income settings. Facilitators reported were financial accessibility, trained health workers, medicines closer to communities, and patients’ education.</jats:p><jats:p><jats:bold>Conclusion:</jats:bold> Barriers and facilitators are determined by socioeconomic and cultural conditions, highlighting the role of health systems in regulatory and policy context (assuring financial coverage and free medicines); providers’ role bringing medicines closer; and patients’ health education and disease management.</jats:p>
    Scopus© Citations 12  1