Substantial data suggest that flavonoid-rich food could help prevent cardiovascular disease and cancer. Cocoa is the richest source of flavonoids, but current processing reduces the content substantially. The Kuna living in the San Blas drink a flavanol-rich cocoa as their main beverage, contributing more than 900 mg/day and thus probably have the most flavonoid-rich diet of any population. We used diagnosis on death certificates to compare cause-specific death rates from year 2000 to 2004 in mainland and the San Blas islands where only Kuna live. Our hypothesis was that if the high flavanoid intake and consequent nitric oxide system activation were important the result would be a reduction in the frequency of ischemic heart disease, stroke, diabetes mellitus, and cancer -all nitric oxide sensitive processes. There were 77,375 deaths in mainland Panama and 558 deaths in the San Blas. In mainland Panama, as anticipated, cardiovascular disease was the leading cause of death (83.4 ± 0.70 age adjusted deaths/100,000) and cancer was second (68.4 ± 1.6). In contrast, the rate of CVD and cancer among island-dwelling Kuna was much lower (9.2 ± 3.1) and (4.4 ± 4.4) respectively. Similarly deaths due to diabetes mellitus were much more common in the mainland (24.1 ± 0.74) than in the San Blas (6.6 ± 1.94). This comparatively lower risk among Kuna in the San Blas from the most common causes of morbidity and mortality in much of the world, possibly reflects a very high flavanol intake and sustained nitric oxide synthesis activation. However, there are many risk factors and an observational study cannot provide definitive evidence.
Background We aimed to investigate the prevalence of violence against women (VAW) in Panama and its association with social determinants of health (SDH) and to estimate the femicide rates from 2014 to 2017. Methods Data were derived from three cross-sectional population-based studies. Logistic regression models were used to estimate the association between SDH and VAW, expressed as odds ratios (ORs) and 95% confidence intervals (CIs). Age-standardized femicide rates were estimated using data from the Public Ministry. Results Compared to the reference categories, women in the lowest quintile (Q) of income distribution (Q1: OR 4.0 [95% CI 1.4–11.7], Q2: OR 3.0 [95% CI 1.1–7.9]), divorced/separated women (OR 1.5 [95% CI 1.0–2.1]) and those in the age categories 25–33 y and 34–49 y (OR 1.9 [95% CI 1.2–3.1]) were more likely to have experienced violence in the past year. Indigenous ethnicity (OR 2.3 [95% CI 1.3–4.1]), age 15–19 y (OR 1.8 [95% CI 1.1–2.9]) and lowest education levels (very low: OR 4.7 [95% CI 1.4–15.5]; low: OR 4.5 [95% CI 1.4–14.6]) were associated with permissive attitudes towards violence. Indigenous (OR 2.7 [95% CI 1.3–6.1]), Afro-Panamanians (OR 3.1 [95% CI 1.3–7.6]) and education level (low: OR 2.5 [95% CI 1.2–4.9]; medium: OR 3.0 [95% CI 1.4–6.6]) were associated with physical/sexual intimate partner violence. Standardized adjusted femicide rates (×100 000) from 2015 to 2017 were 1.5, 0.9 and 0.8, respectively. Conclusions Our findings highlight the importance of prevention programmes.
There were other significant positive findings that demonstrate the efficacy of this peer-to-peer model educating high school students about lowering the risks of contracting HIV/AIDS. This model could also be used to prevent or mitigate other risky behaviors.
Objetivo. Identificar la prevalencia y factores asociados al uso del condón en la última relación sexual con una pareja no conyugal no conviviente (PNCC) entre aquellos que mantuvieron relaciones con este tipo de parejas en los últimos 12 meses. Métodos. Análisis secundario de 3261 entrevistados con PNCC de la Encuesta Nacional de Salud Sexual y Reproductiva (ENASSER) 2015, utilizando regresión logística multivariada para identificar asociaciones entre características sociodemográficas, acceso a servicios, comportamiento, y violencia de pareja con el uso del condón. Resultados. El 54% de los entrevistados usó condón en la última relación sexual. El análisis ajustado muestra que los hombres (aOR=2.89; p<0.001) tienen mayores oportunidades de usar condón. Estas oportunidades disminuyen con la edad y aumentan con el bienestar: menor en el grupo de 25-49 (aOR=0.47; p<0.001) y 20-24 (aOR=0.51; p=0.019) en comparación con el grupo de 15-19 años, mayor en hogares con bienestar alto (aOR=2.48; p<0.001) y medio (aOR=1.83; p=0.034), viviendo en áreas no comarcales (aOR=1.74; p=0.026), con trabajadora sexual/casual/conocido (aOR=6.82; p<0.001), novio/novia (aOR=3.41; p<0.001) como última pareja sexual. En las mujeres, las oportunidades eran mayores si vivían en áreas no comarcales (aOR=2.95; p=0.021), con trabajadora sexual/casual/conocido como última pareja sexual (aOR=3.99; p=0.001); y baja con menor educación (noveno grado o menos) (aOR=0.55; p=0.031), y si sufrió violencia por parte de una pareja en los últimos 12 meses (aOR=0.43; p=0.027). Conclusiones. La prevalencia de uso del condón con PNCC fue baja. Los factores asociados fueron sexo, edad, residencia, bienestar, tipo de pareja y violencia reciente en las mujeres.
<p>Introducción: Los derechos a la salud sexual y reproductiva (DSSR) son básicos, y la capacidad de las mujeres para ejercerlos influye en lograr objetivos de desarrollo. Objetivos: Estimar indicadores de DSSR en mujeres de 2029 años identificando factores asociados. Métodos: Con datos de 20142015 de la Encuesta Nacional de Salud Sexual y Reproductiva (ENASSER) se analizaron 1206 casadas/unidas (982 con demanda de planificación familiar, 1082 con hijos, y 978 usuarias de anticonceptivos), midiéndose la violencia conyugal en el último año, conocimiento sobre prevención del VIH, demanda satisfecha con anticonceptivos modernos, atención profesional al parto y autonomía. Se utilizó la regresión logística multivariada para probar asociaciones. Resultados: Padeció violencia conyugal 13.0%, tenía conocimiento sobre prevención del VIH 38.8%, satisfacía su demanda de planificación familiar con métodos modernos 62.0%; recibió atención profesional al parto 81.1%; y mostró autonomía 10.3%. Las oportunidades relativas ajustadas (ORa) de violencia conyugal eran mayores en mujeres que la justificaban ORa=1.92;IC95%:1.093.39) ; el conocimiento sobre prevención del VIH aumentaba con la escolaridad (ORa=1.13;IC95%:1.041.22) ; la satisfacción de la demanda con métodos modernos era menor si justificaban la violencia conyugal (ORa=0.42; IC95%:0.200.85) y mayor en aquellas con una mayor percepción de empoderamiento (ORa=2.33;IC95%:1.155.00). Las ORa de atención profesional en el último parto disminuyen cuando aumentaba la edad (ORa=0.72; IC95%:0.620.84), y era menor si experimentaron matrimonio infantil (ORa=0.43; IC 95%:0.190.95). Las ORa de mayor autonomía resultaron menores en casadas (ORa=0.22; IC 95%:0.100.47) y amas de casa (ORa=0.53; IC 95%:0.280.98). Conclusiones: El ejercicio de DSSR y sus factores asociados constituyen desafíos al diseño de políticas públicas.</p><p>ABSTRACT</p><p>Introduction: Sexual and reproductive health rights (SRHR) are basic, and women capacity to exert them influence achieving development goals. Objectives: Estimate indicators of SRHR in women aged 2029 years, identifying associated factors. Methods: A total of 1206 married/ cohabitant women (908 with need for family planning, 1082 with children and 978 contraceptive users) were analyzed with data from National Sexual and Reproductive Health Survey 20142015. It was obtained the proportion of conjugal violence victims in the last year, with knowledge about VIH prevention, family planning needs satisfied by modern contraceptive methods, with professional care at delivery and with autonomy. Multivariate logistic regression was used to test associations. Results: The 13.0% of women suffered conjugal violence, 38.8% had knowledge about HIV prevention, 62.0% used modern contraceptives for satisfying family planning needs, 81.1% received professional care at delivery, and 30.7% made informed decisions about SRH. Adjusted odds ratio (AOR) for conjugal violence were greater when women justified violence (AOR=1.92;95%CI:1.093.39) ; knowledge about HIV prevention increases with schooling (AOR=1.13;95%CI:1.041.22) ; family planning met with modern contraceptives methods was lower, if they justified violence (AOR=0.42;95%CI 0.200.85) and higher in women with a higher empowerment perception (AOR=2.33;95%CI: 1.155.00). The AOR for professional care at last delivery decrease with increasing age (AOR=0.72; 95%CI: 0.620.84) and was lower if they experienced child marriage (AOR=0.43; 95%CI: 0.190.95). The AOR for autonomy was lower in married women (AOR=0.22; 95%CI: 0.100.47) and housewives (AOR=0.53; 95%CI: 0.280.98). Conclusions: The exert of SRHR and its associated factors challenge public policies design.<br /><br /></p>
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