6,275 results on '"POVERTY"'
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2. Associations between type of childhood adversities and labour market participation and employment conditions in young adults
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Tjeerd Rudmer de Vries, Iris Arends, Albertine J. Oldehinkel, Ute Bültmann, Interdisciplinary Centre Psychopathology and Emotion regulation (ICPE), and Public Health Research (PHR)
- Subjects
Adult ,Employment ,Young Adult ,Adolescent ,Social Problems ,Epidemiology ,Public Health, Environmental and Occupational Health ,Humans ,Prospective Studies ,Occupations ,Poverty - Abstract
BackgroundCumulative exposure to childhood adversity is associated with a variety of labour market outcomes in young adulthood. It remains largely unclear whether the type of adversity matters in this association. This prospective study examined the differences in exposure to 14 adverse experiences among groups of young adults aged 22 characterised by distinct labour market participation states and employment conditions.MethodsWe used data from the TRacking Adolescents’ Individual Lives Survey, a Dutch prospective cohort study with 15 years of follow-up (N=1524). We included 14 adverse experiences (ages 0–16) across five domains: peer influences, loss or threat of loss, material deprivation, family dynamics and maltreatment. Labour market participation states and employment conditions were assessed at age 22. We used latent class analysis to derive labour market outcome groups, which we subsequently compared on exposure to adverse experiences using pairwise comparisons.ResultsInactive individuals (n=85, 5.6%), often neither in education (77.4%) nor employment (98.6%) and on benefits (94.4%), were more likely to be exposed to many distinct types of adverse experiences (eg, parental addiction, bullying victimisation) as compared with all other groups. Early workers (n=413, 27.1%), often on temporary contracts and low monthly incomes, were more likely to be exposed to parental divorce (22.7%) compared with students with side jobs (12.9%).ConclusionsDifferent adverse experiences are not equally associated with labour market outcomes. Researchers and stakeholders in policy and practice should be aware of the differences between adverse experiences in their importance for labour market outcomes in young adults.
- Published
- 2023
3. Facilitators and barriers to the implementation of improved solid fuel cookstoves and clean fuels in low-income and middle-income countries
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Air Pollution ,Income ,Humans ,Cooking ,Developing Countries ,Poverty ,Indoor/analysis - Abstract
2·6 billion people rely on solid fuels for cooking or heating. Accelerating access to cleaner solutions is crucial to reduce the negative effects of solid fuel use. Despite abundant evidence on how to implement these solutions, previous attempts have been disappointing. An overview of the evidence is missing and the translation of the evidence into practice is poor. We conducted an umbrella review using eight databases to: consolidate evidence on the factors that influence the implementation of improved solid fuel cookstoves and clean fuels in low-income and middle-income countries; weigh the level of confidence in existing evidence; and develop two practical implementation strategy tools. We identified 31 relevant reviews (13 systematic reviews and 18 narrative reviews) that covered over 479 primary studies. We found 15 implementation factors supported by the highest level of evidence. Regarding improved solid fuel cookstoves, these factors included: cost; knowledge and beliefs about the innovation; and compatibility. For clean fuels these factors included: cost; knowledge and beliefs about the innovation; and external policy and incentives. The factors were synthesised into the Cleaner Cookstove Implementation Tool and the Clean Fuel Implementation Tool. These tools can be used to optimise the implementation of cleaner cooking solutions, thereby improving health, environmental, climate, and gender equity outcomes.
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- 2022
4. Effects of hospital facilities on patient outcomes after cancer surgery
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Knight, Sr, Chu, K, Lapitan, Mc, Dare, Aj, Pius, R, Shaw, Ca, Drake, Tm, Norman, L, Ademuyiwa, Ao, Adisa, Ao, Aguilera, Ml, Al-Saqqa, Sw, Al-Slaibi, I, Bhangu, A, Biccard, Bm, Brocklehurst, P, Costas-Chavarri, A, Elhadi, M, Fairfield, Cj, Fitzgerald, Je, Ghosh, D, Glasbey, J, Henegouwen, Miv, Ingabire, Jca, Kingham, Tp, Lawani, I, Lieske, B, Lilford, R, Martin, J, Mclean, Ka, Moore, R, Morton, D, Nepogodiev, D, Ntirenganya, F, Pata, F, Pinkney, T, Stephen, R Knight, Catherine, A Shaw, Riinu, Pius, Thomas, M Drake, Lisa, Norman, Adesoji, O Ademuyiwa, Adewale, O Adisa, Maria Lorena Aguilera, Sara, W Al-Saqqa, Ibrahim, Al-Slaibi, Aneel, Bhangu, Bruce, M Biccard, Peter, Brocklehurst, Ainhoa, Costas-Chavarri, Kathryn, Chu, Anna, Dare, Muhammed, Elhadi, Cameron, J Fairfield, J Edward Fitzgerald, Dhruv, Ghosh, James, Glasbey, Mark, I van Berge Henegouwen, C Allen Ingabire, J, T Peter Kingham, Marie Carmela Lapitan, Ismaïl, Lawani, Bettina, Lieske, Richard, Lilford, Janet, Martin, Kenneth, A McLean, Rachel, Moore, Dion, Morton, Dmitri, Nepogodiev, Faustin, Ntirenganya, Francesco, Pata, Thomas, Pinkney, Ahmad Uzair Qureshi, Antonio Ramos-De la Medina, Aya, Riad, Hosni Khairy Salem, Joana, Simões, Richard, Spence, Neil, Smart, Stephen, Tabiri, Hannah, Thomas, Thomas, G Weiser, Malcolm, West, John, Whitaker, Ewen, M Harrison, Arben, Gjata, Maria Marta Modolo, Sebastian, King, Erick, Chan, Sayeda Nazmun Nahar, Ade, Waterman, Dominique, Vervoort, Alemayehu Ginbo Bedada, Bernardo De Azevedo, Ana Gabriela Figueiredo, Manol, Sokolov, Venerand, Barendegere, Gerald, Ekwen, Arnav, Agarwal, Qinyang, Liu, Juan Camilo Correa, Kalisya Luc Malemo, Jacques, Bake, Jakov, Mihanovic, Kamila, Kunčarová, Julius, Orhalmi, Hosni, Salem, Jyri, Teras, Aristotelis, Kechagias, Alexis, P Arnaud, Judith, Lindert, Vasileios, Kalles, Maria-Lorena, Aguilera-Arevalo, Gustavo, Recinos, Zsolt, Baranyai, Basant, Kumar, Harish Neelamraju Lakshmi, Sanoop Koshy Zachariah, Philip, Alexander, Sunil Kumar Venkatappa, Pramesh, C, Radhian, Amandito, Christina, Fleming, Luca, Ansaloni, Gianluca, Pellino, Ahmed, M Altibi, Ibrahim, Nour, Intisar, Hamdun, Ali, M Ghellai, Donatas, Venskutonis, Tomas, Poskus, Justas, Zilinskas, Precious, Malemia, Yong Yong Tew, Elaine, Borg, Sarah, Ellul, Fatima Zahraa Wafqui, David, W Borowski, Anne Sophie van Dalen, Cameron, Wells, Harissou, Adamou, Adesoji, Ademuyiwa, Adewale, Adisa, Kjetil, Søreide, Sara Al Saqqa, Osaid, Alser, Haya, Tahboub, Helmut Alfredo Segovia Lohse, Sebastian Shu Yip, Piotr, Major, António Sampaio Soares, Matei Razvan Bratu, Andrey, Litvin, Armen, Vardanyan, Ahmad, Gudal, Naif, Albati, Jovan, Juloski, Miran, Rems, Sarah, Rayne, Stephanie Van Straten, Yoshan, Moodley, Irene Ortega Vázquez, Jaime, Ruiz-Tovar, Kithsiri Janakantha Senanayake, Sujeewa Priyantha Bandara Thalgaspitiya, Omer Abdelbagi Omer, Anmar, Homeida, Yucel, Cengiz, Daniel, Clerc, Muhammad, Alshaar, Hanen, Bouaziz, Yuksel, Altinel, Matthew, Doe, Maryna, Freigofer, Ella, Teasdale, Rakan, Kabariti, Joshua Michael Clements, Stephen Richard Knight, Ahsan, Ashfaq, Ijeoma, Azodo, Gabriela, Wagner, Ivan, Trostchansky, Mayaba, Maimbo, David, Linyama, Helidon, Nina, Amanda, Zeko, Claudio Gabriel Fermani, Santiago, Villalobos, Federico, Carballo, Pablo, Farina, Sebastian, Guckenheimer, Marilla, Dickfos, Ankit, Ajmera, Chester, Chong, Ralph, Gourlay, Sikandar, Hussaini, Yi Jia Lee, Adeeb, Majid, Peter, Martin, Rebecca, Miles, Owen James Morris, Jamie, Phua, William, Ridley, Tarunpreet, Saluja, Ryan Renxin Tan, Jen, Teh, Anna, Wells, Bharti, Arora, Qaasim, Dollie, Debbie, Ho, Yanru, Ma, Omattage Mahasha Perera, Anthony, Truong, Amanda Caroline Dawson, Bryan, Lim, Upuli, Pahalawatta, Jacqueline, Phan, Xiao-Ming Sarah Woon-Shoo-Tong, Andrea, Yeoh, Lillian, Charman, Andrew, Drane, Sharon, Laura, Charmaine Chu Wen Lo, Amy, Mozes, Rita, Poon, Hao Han Tan, Ellen, Wall, Prakshi, Chopra, Jasmine De Giovanni, Bal, Dhital, Brian, Draganic, Alexander, Duller, Jonathan, Gani, Yao Kuan Goh, Jun Young Jeong, Brendan, Mcmanus, Prakash, Nagappan, Peter, Pockney, Anya, Rugendyke, Mahsa, Sarrami, Stephen, Smith, Vanessa, Wills, Hsu Ven Wong, Geoffrey, Ye, Geoffrey, Zhang, Ethan, Brooker, Daniel, Feng, Bonnie, Lau, Carlin, Ngai, Sarah, Birks, David, Gyorki, Jaime Otero de Pablos, Ali, Abbosh, Chris, Gillespie, Ahmed, Mahmoud, Bianca, Kwan, Joshua, Lawson, Andrea, Warwick, Janne, Bingham, Andrew, J Cockbain, Nagendra Naidu Dudi-Venkata, Jordan, Ellaby-Hall, Ben, Finlay, Emily, Humphries, Jade, Pisaniello, Monique, Pisaniello, Salma, Salih, Tarik, Sammour, Haidar Hadri Abd Wahab, April De Silva, Nicola, Hayward, Kartik, Iyer, Guy, Maddern, Gian Andrea Prevost, Naga, Annapureddy, Krishna Pranathi Settipalli, Jeremy, Yeo, Lucy, Hempenstall, Lily, Pham, Shaun, Purcell, Cherry, Talavera, Ashish, I Vaska, Gurpreet, Chaggar, Phillip, Chrapko, Annelise, Cocco, Sarah Michelle Crystal Jade Coulter-Nile, Grahame, Ctercteko, James, French, Houchen, Gong, Martijn, Gosselink, Thuvarahan, Jegathees, Ivan, Jin, Michelle, Kalachov, Kathryn, Kiefhaber, Katherine, Lee, Jason, Luong, Steven, Phan, Henry, Pleass, Kelly, Veale, Zhi, Zeng, Angela, Au, Ashe, Debiasio, Idy, Deng, Jananee, Myooran, Amrita, Nair, Peter, Stewart, Anton, Stift, Lukas Walter Unger, Kerstin, Wimmer, Nabila, Ahmed, Syed, Hasan, Saber, Rahman, Margaret, O'Shea, Greg, Padmore, Adrian, Peters, Pietro, Perduca, Guenda, Pulcina, Nicolas, Tinton, Frederic, Buxant, Elsa, Dabin, Giulia, Garofalo, Francis, Dossou, Freddy Houehanou Rodrigue Gnangnon, Yacoubou Imorou Souaibou, Pako, Motlaleselelo, Omphile, Tlhomelang, Igor Lima Buarque, Gustavo Mendonça Ataíde Gomes, Aldo Vieira Barros, Ilia, Batashki, Nikolai, Damianov, Vladislav, Stoyanov, Dragomir, Dardanov, Svilen, Maslyankov, Plamen, Petkov, George, Todorov, Evgeni, Zhivkov, Aygulya, Akisheva, Miguel Angel Castilla Moreno, Geno, Genov, Ivelina, Ilieva, Tsvetomir, Ivanov, Martin, Karamanliev, Azhar, Khan, Emil, Mitkov, Tsanko, Yotsov, Boyko, Atanasov, Nikolay, Belev, Mihail, Slavchev, Carlos, Nsengiyumva, Elgan, Jones, Simon, Stock, Steve, Kyota, James, Brown, Tresor Mabanza, K, Lemery Nigo Samuel, Chidi, Otuneme, Ngwang, Prosper, Franklin, Umenze, Marylise, Boutros, Natasha, Caminsky, Sinziana, Dumitra, Richard, Garfinkle, Dominique, Morency, Ebram, Salama, Alexander, Banks, Lorenzo, Ferri, Haitian, He, Amit, Katz, Alexander Sender Liberman, Sarkis, Meterissian, Allison, Pang, Elena, Parvez, Usmaan, Hameed, Fahima, Osman, Sangita, Sequeira, Natalie, Coburn, Alisha, Jaffer, Paul, Karanicolas, Matthew, Mosseler, Reilly, Musselman, Xinyuan, Liu, Ching Wan Yip, Juan Sebastian Garces-Otero, Carolina, Guzman, Sebastian, Sierra, Andres Uribe Valencia, Paulo Andrés Cabrera Rivera, Saul, Camelo, Andrea, Gonzalez, Alejandro, González-Orozco, Manuel Santiago Mosquera Paz, Carlos J- Perez Rivera, Felipe, Gonzalez, Andres, Isaza-Restrepo, Laura, Nino-Torres, Natalia Arias Madrid, Maria Clara Mendoza Arango, Justin, Tsandiraki, Damir, Jemendžić, Branislav, Kocman, Oliver, Šuman, Renata, Canic, Darko, Jurišić, Ivana, Karakas, Ana Krizanovic Rupcic, Vlatka, Pitlovic, Josip, Samardžić, Mario, Kopljar, Ivan, Bacic, Edgar, Domini, Robert, Karlo, Danijela, Miljanić, Andrea, Simic, Mariam, Ahmed, Majdi Al Nassrallah, Rabiya, Altaf, Talal, Amjad, Ruba, Eltoum, Heba, Haidar, Alhassan, Hassan, Omar, Khalil, Marwan, Qasem, Rommel, Ramesh, Gautham, Sajith, Maham, Wisal, Jan, Žatecký, Michele, Bujda, Katerina, Jirankova, Ales, Paclik, Aya, Abdallah, Mariam Abdulgawad Almogy, Esraa Ayman El-Sawy, Ahmed Moustafa ElFayoumy, Nourhan, Elghareeb, Nourhan Ahmed Esmat, Ahmed, Fadel, Abdullah, Habater, Heba, Hamdy, Amr, Hefni, Marwa, Kamal, Norhan Mohamed Abobakr, Ahmed, Sayed, Nancy, Shaker, Ehab, Taha, Hoda, Tharwat, Omar, Zakaria, Ibrahem, Abdelmotaleb, Ali, Al-Dhufri, Hamza, S Al-Himyari, Enas El Sheikh, Asmaa, Eldmaty, Aya, Elkhalawy, Ahmed, M Elkhashen, Kithara, Magdy, Safa, Mostafa, Habib Doutoum Sadia, Mohamed Mahmoud Saleh, Dina, Samir, Mohamed Yahia Mohamed Ali, Mahmoud, A Nassar, Samar, Abdelhady, Aly, Abdelrazek, Israa, Abdelsalam, Aya, El-Sawy, Eman, Essam, Mohamed, Gadelkarim, Khaled, Ghaly, Mohamed, Hassabalnaby, Rana, Masarani, Nourhan Mohamed Shaaban, Ahmed, Sabry, Menatalla, Salem, Nourhan Akram Soliman, Diaaaldin, Zahran, Moustafa Ramadan Abou El Soud, Esraa Tarek Badr, Hala, Borham, Nehal, Elmeslemany, Mohammad, Elsayed, Fawzia, Elsherif, Sara, Eslam, Gehad, Gaber, Sondos, Ibrahim, Yara, Kamh, Abdelrahman, Mahmoud, Shimaa Gamal Mohamed, Eman, Morshedy, Cinderella, Omar, Fatima Salem Soliman, Shaza, Abdelkawy, Naglaa, Abdelmohsen, Mahmoud, Abdelshakour, Ahmed, Dahy, Norhan, Gamal, Mohammed, Gamal, Ahmad, Hasan, Helal, Hetta, Nehad, Mousa, Mohamed, Omar, Somia, Rabie, Mahmoud, Saad, Bakeer, Saleh, Marwa Sayed Mohamed, Muhammad, Shawqi, Heba Abdelhady Mousa, Mostafa, Alnoury, Mohamed, Elbealawy, Ahmed, Elshafey, Muhammad Essam Ibrahim El Desouki Muhammad Ahmed, Mennatullah, Ghonaim, Fawzy, Hgag, Mohamed, Ibrahim, Mahmoud, Morsy, Mohamed Reda Loaloa, Ahmed, Refaat, Hadeer, Samir, Fatma, Shahien, Mohamed, Sobhy, Fathy, Sroor, Esraa, Abdellatif, Marina, Adel, Amr Abdelghani Afifi, Eman, Afifi, Marco, Antaky, Amr, Dawoud, Naira El Zoghby, Amira, El-Remaily, Ali Abdelazez Elzanfaly, Ahmed, Gadallah, Fatma Alzahraa Gamal, Omar, Hashem, Shrouk Medhat Youssef, Aliaa Muhammad Attyah, Malak, Munir, Omar, Shazly, Esraa, Taha, Karim, Wilson, Sawsan, Adel, Asmaa, Ali, Esraa, Eid, Esraa, Elhelow, Marwa, Elmahdy, Bassant, Elshatby, Amany Hossam El-Din Zakaria, Ahmad, Hossny, Eman, Ibrahim, Ahmed, M Yonis, Maram, Metwalli, Basant, Yousry, Esraa, Zid, Mina, A Yacoub, Ahmed, Abdelhakim, Nervana, Abouelsoad, Mo'Min, Alkhatib, Ahmed, Ashraf, Alaa, Ashraf, Yasmin, Elazab, Mahmoud, Elfanty, Osama, Elkabir, Mai, Elsayed, Ahmed, Elshimy, Hager, Elsobky, John, Eskander, Ahmed, Gad, Ward, Hamsho, Noura Khaled Abdelwahed, Menna, Magdy, Dalia, Moharam, Abeer, Osama, Shereen, Ramadan, Radwa, Roum, Taqwa, Sayed, Tarneem, Shehada, Ahmed Mohy Zidan, Khalid, Abbas, Amr, Ali, Mohamed, Attia, Mohamed, Balata, Ayman El Nakeeb, Mohamed Ibrahim Elsayed Elewaily, Ahmed, Elfallal, Hossam, Elfeki, Ahmed, Elkhadragy, Sameh, Emile, Helmy, Ezzat, Hasnaa, Hosni, Islam, Mansour, Waleed, Omar, Gehad, Othman, Kareem, Sadek, Mostafa, Shalaby, Noura, Shehab-Eldeen, Rawda Anas Khalifa, Helmy, Badr, Mostafa, Eldeep, Ahmed, Eldeep, Amany Eldoseuky Mohammed, Salwa, Khallaf, Eman Magdy Hegazy, Rokia, Mahmoud, Pola, Mikhail, Mahmoud, Morsi, Sara, Mowafy, Dina, Raafat, Amina, Safy, Marwa, Sera, Ahmed Shible Sera, Mostafa Salim Mohamed AbdAllah, Muhammad, Abdelkader, Abdulrahman Osama Abdou, Ahmedgaber, Ahmed, Shireen, Gaafar, Fatma Ibrahim Negm, Mina, Lapic, Ahmed, Maher, Hagar, Mahmoud, Ahmed, Mostafa, Mohamed, Samir, Fatma, Samy, Nourhan, Semeda, Hind, I Shalaby, Alaa, El-Taweel, Ahmed Galal Elnagar, Ahmed Gamal Hemidan, Mohamed, Hussein, Ahmed, A Kandil, Moawad, Mf, Ayat Allah Nasser Hamamah, Mostafa, Soliman, Mohamed, Abdelkhalek, Noura Abdelmaksoud Tawakel, Ahmed Mohamed Abdelwahed, Alrawy, Abdou, Khalid, Atallah, Mohammed Yasser Elsherbeny, Eman, Emara, Mohamed, Hamdy, Omar, Hamdy, Amira, Haron, Salma, Ismail, Islam Hany Metwally, Nihal Mohamed Hamed Elgaml, Ahmed, Nassar, Basel, Refky, Mirna, Sadek, Mahmoud, Saleh, Asmaa, Yunes, Mai, Zakaria, Mohammed, Zuhdy, Notila, Fayed, Mohammed Mustafa Hassan Mohammed, Sander, Kütner, Priit, Melnik, Indrek, Seire, Toomas, Ümarik, Eppu, Ainoa, Verner, Eerola, Hanna, Koppatz, Laura, Koskenvuo, Ville, Sallinen, Sini, Takala, Jevgeni, Katunin, Arto, Turunen, Niki, Christou, Muriel, Mathonnet, Vincent, Lavoue, Krystel Nyangoh Timoh, Lucie, Soulabaille, Romain, Lesourd, Aude, Merdrignac, Laurent, Sulpice, Benoît, André, Elodie, Chantalat, Charlotte, Vaysse, Bertrand, Dousset, Sebastien, Gaujoux, Gregory, Martin, Octavian, Clonda, Domantas, Juodis, Klaus, Kienle, Andras, Mravik, Samuel, Palmer, Gabor, Szabadhegyi, Anita Eseenam Agbeko, Solomon, Gyabaah, Frank Enoch Gyamfi, Nuhu, Naabo, Atta Owusu Senior, Joseph, Yorke, Frank, Owusu, Francis, Abantanga, Theophilus Teddy Kojo Anyomih, Abdul-Jalilu Mohammed Muntaka, Emmanuel Owusu Abem, Mohammed, Sheriff, Paul, M Wondoh, Dimitrios, Balalis, Dimitrios, Korkolis, Georgios, Gkiokas, Eirini, Pantiora, Theodosios, Theodosopoulos, Argyrios, Ioannidis, Konstantinos, Konstantinidis, Sofia, Konstantinidou, Nikolaos, Machairas, Anna, Paspala, Anastasia, Prodromidou, Christos, Chouliaras, Konstantinos, Papadopoulos, Ioannis, Baloyiannis, Ioannis, Mamaloudis, George, Tzovaras, Ioanna, Akrida, Maria-Ioanna, Argentou, Stylianos, Germanos, Evangelos, Iliopoulos, Ioannis, Maroulis, George, Skroubis, George, Theofanis, Christos, Chatzakis, Orestis, Ioannidis, Lydia, Loutzidou, Panagiotis, Karathanasis, Nikolaos, Michalopoulos, Charalampos, Theodoropoulos, Dimitrios, Theodorou, Tania, Triantafyllou, Zoe, Garoufalia, Natasha, Hasemaki, Michalis, Kontos, Gregory, Kouraklis, Stylianos, Kykalos, Theodore, Liakakos, Eustratia, Mpaili, Alexandros, Papalampros, Dimitrios, Schizas, Athanasios, Syllaios, Ekaterini Christina Tampaki, Antonios, Tsimpoukelis, Maria Ioanna Antonopoulou, Eirini, Deskou, Dimitrios, K Manatakis, Dimitrios, Papageorgiou, Menelaos, Zoulamoglou, Christos, Anthoulakis, Michalis, Margaritis, Nikolaos, Nikoloudis, Veronica, Campo, André, Ceballos, Mario-Andrés, Flores, Waleska, Giron, Donghyun, Ko, Gabriel, Martinez, Verónica Rivera Lara, Nataly, Rueda, Andres, Sanchez, Jorge Carlos Guillermo Tejeda Garrido, Alvaro Eduardo Alvarez Rivera, Elvis Benjamin Bamaca Ixcajoc, Lilian Elizabeth Barreda Zelaya, Patricia, Chacòn-Herrera, Ligia Margarita Corea Ruiz, Guillermo, Echeverria-Davila, Mario, Garcia, Danilo, García, Edgar Fernando Gutiérrez Mayen, Noriega, José, Nery, Mazariegos, Diego, Méndez, Michael Paniagua Espinoza, David, Bardos, Marton, Benke, Kristof, Illes, Balint András Kokas, Réka, Szabó, Akhila, Appukuttan, Anjitha, Asok, D K, Vijaykumar, Kapil, Malik, Praveen, Ravishankaran, Ritesh, Tapkire, Guru, Moorthy, Joyner, Abraham, Ramesh, Muthuvel, John, Alapatt, Abhay, Kattepur, Nizamudheen, Pareekutty, Mebanshanbor, Garod, Caleb, Harris, Cliff, Wanniang, Ashish, Gupta, Deepak, Nehra, Sanjeev, Parshad, Rajgopal, Acharya, Rajendra, Badwe, Manish, Bhandare, Urvashi, Jain, Karishma, Kirti, Nita, Nair, Shailesh, Shrikhande, Purvi, Thakkar, Premkumar, Anandan, C S, Archana, Arun Holenarasipur Narasannaiah, Tejaswi, Jagarlamudi, M R, Rashmi, Mallikarjuna, Manangi, Abhishek, Raghavendra, K Seshagiri Rao, Vinay, S, Vinay, Sajjan, Aneesh, Shenoy, Santhosh Shivashankar Chikkanayakanahalli, Kavya, Tharanath, Sushmita, V, Peter, Adidharma, Raksheeth, Agarwal, Phebe Anggita Gultom, Ghafur Rasyid Arifin, Matthew, Billy, Zatira, Elfizri, Alessa, Fahira, Devi, Felicia, Triana Hardianti Gunardi, Nadya, Johanna, Nadia Rahmadiani Nugrahadi, Sonar Soni Panigoro, Siti, Rahmayanti, Retta Catherina Sihotang, Santi Yuanita Brata, Hadi, Winoto, Nastaran, Barati, Manoochehr, Karami, Hamidreza, Khorshidi, Homa, Naderifar, Mazin, A Abdulla, Maggie, Coleman, Ronan, J Doherty, Rob, Hannon, Brenda, Murphy, Aine, Stakelum, Des, Winter, Lylas, Aljohmani, Richard, Farnan, Yeshey, Seldon, Tanna, Tan, Shriya, Varghese, Mohammad, Alherz, Muaaz, Ather, Mohammad, Bajilan, Vivien, Graziadei, Isobel, Pilkington, Omar, Quidwai, Paul, Ridgway, Haaris, Shiwani, Abd Al-Rahman Tahir, Eimear, Blunnie, Daniel, Burke, Niall, Kennedy, Kate, Macdonagh, Maeve, O'Neill, Siobhan, Rooney, Giuseppe, Falco, Guglielmo, Ferrari, Simone, Mele, Gabriela Elisa Nita, Lara, Ugoletti, Maurizio, Zizzo, Gianmaria, Confalonieri, Giovanni, Pesenti, Fulvio, Tagliabue, Gianluca, Baronio, Deborah, Ongaro, Giacomo, Pata, Bruno, Compagnoni, Renato, Salvadori, Lucio, Taglietti, Nicola, D'Alessandro, Pierpaolo Di Lascio, Giovanni, Pascale, Luca, Bortolasi, Tommaso, Campagnaro, Massimo, Carlini, Giorgio, Lisi, Davide, Lombardi, Corrado, Pedrazzani, Domenico, Spoletini, Giulia, Turri, Paola, Violi, Donato Francesco Altomare, Fabrizio, Aquilino, Nicola, Musa, Vincenzo, Papagni, Arcangelo, Picciariello, Leonardo, Vincenti, Dario, Andreotti, Savino, Occhionorelli, Matteo, Tondo, Stefano Maria Massimiliano Basso, Paolo, Ubiali, Riccardo, Cirelli, Marco Enrico Mario Maino, Guglielmo Niccolò Piozzi, Emanuele, Picone, Rosa, Scaramuzzo, Giovanni, Sinibaldi, Alfonso, Amendola, Lorenzo, Anastasio, Luigi, Bucci, Emanuele, Caruso, Antonio, Castaldi, Sara Di Maso, Vincenza Paola Dinuzzi, Giovanni, Esposito, Maria, Gaudiello, Mariano Cesare Giglio, Paola Antonella Greco, Gaetano, Luglio, Andrea, Manfreda, Ester, Marra, Federica, Mastella, Gianluca, Pagano, Roberto, Peltrini, Vincenzo, Pepe, Michele, Sacco, Viviana, Sollazzo, Giovanni, Spiezio, Ettore, Cianchetti, Nunzia, Menduni, Michele Maria Carvello, Francesca Di Candido, Antonino, Spinelli, Fabio, Corsi, Luca, Sorrentino, Fabio, Marino, Emanuele Luigi Giuseppe Asti, Luigi, Bonavina, Emanuele, Rausa, Martina, Asta, Andrea, Belli, Francesco, Bianco, Carmela, Cervone, Paolo, Delrio, Armando, Falato, Andrea Fares Bucci, Rita, Guarino, Ugo, Pace, Daniela, Rega, Emilia De Luca, Gaetano, Gallo, Giuseppe, Sammarco, Giuseppe, Sena, Giuseppina, Vescio, Letizia, Santandrea, Giampaolo, Ugolini, Davide, Zattoni, Nicola, Chetta, Gaetano, Logrieco, Serafino, Vanella, Gianluca, Garulli, Nicola, Zanini, Andrea, Bondurri, Francesco, Cammarata, Francesco, Colombo, Diego, Foschi, Giulia Maria Beatrice Lamperti, Anna, Maffioli, Gianluca Matteo Sampietro, Al'Ona, Yakushkina, Gloria, Zaffaroni, Enrico, Cicuttin, Maria Grazia Sibilla, Harmony, Impellizzeri, Marco, Inama, Gianluigi, Moretto, Sylvie, Mochet, Elisa, Ponte, Antonella, Usai, Stefano, Mancini, Andrea, Sagnotta, Luigi, Solinas, Elisa, Bolzonaro, Nicolò, Tamini, Gianluca, Curletti, Raffaele, Galleano, Michele, Malerba, Sofia, Campanella, Gianfranco, Cocorullo, Francesco, Colli, Paolino De Marco, Nicolò, Falco, Tommaso, Fontana, Leonel Jospin Kamdem Mambou, Antonella 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Orozco, Alejandro Gonzalez Ojeda, Samantha Corro Díaz González, Laura Martinez, Antonio Ramos-De la Medina, Bonifacio Mosqueda Amador, Armando Novoa, Dennet Arturo Olazo Espejo, Alejandro Jimenez, Federico Lopez Rosales, Elva Gabriela Vanoye, Luis Alberto Garcia Gonzalez, Roberto Carlos Miranda-Ackerman, Manuel Solano-Genesta, Alethia Alvarez-Cano, Hector Hugo Romero-Garza, Heriberto Medina-Franco, Lorelí Mejía-Fernández, Noel Salgado-Nesme, Omar Vergara-Fernandez, Guadalupe Montserrat Gutiérrez-Mota, Francisco Xavier Hernandez Vera, Anabella Llantada Lopez, Gilberto Morgan Villela, Felipe de Jesus Ramirez Padilla, Walezka Tapia Marin, Mónica Martínez Maldonado, Ramses Sánchez Suárez, José Manuel Troche, Chaymae Benyaiche, Oumaima Outani, Souadka Amine, Amine Benkabbou, Anass Mohammed Majbar, Raouf Mohsine, Ali Rafik, Thida Oung, Moe Moe Tin, David W Borowski, Philipp Plarre, David W Borowski, Philipp Plarre, Anna Alberga, Nina Sluiter, Jurriaan Tuynman, Robin Blok, Didem Cömert, Roel Hompes, Marianne Kalff, Merel Elisabeth Stellingwerf, Pieter Tanis, Mark van Berge Henegouwen, Elise Maria van Praag, Daan Wisselink, Michael Gerhards, Josephine Lopes Cardozo, Emma Westerduin, Joske de Jonge, Aaw van Geloven, Kaz van Schilt, Frank den Boer, Simone Stoots, Stijn Vlek, Jamie Adams, Ibrahim S Al-Busaidi, Gabrielle Budd, Seung Il Choi, Michael Jen Jie Chu, Anurag Ganugapati, Lucy McKinstry, Rebecca Pascoe, Simon Richards, Kenrick Rosser, Annie Stevenson, Rebecca White, Shebani Farik, Jin Kwun, Ahmed Murad, Sarah Cowan, Timothy Hall, Michael Hayton, Laminou Malam Sani, Souleymane Oumarou Garba, Harissou Adamou, Ibrahim Amadou Magagi, Oumarou Habou, Halima Aliyu, Muhammad Daniyan, Tunde T Sholadoye, Lawal Abdullahi, Lofty-John Anyanwu, Aminu Mohammad Mohammad, Abubakar Bala Muhammad, Abdurrahman Abba Sheshe, Ibrahim Suleiman, Alaba Adesina, Ajibola Awolowo, Clement Onuoha, Omotayo Salami, Ogechukwu Taiwo, Agboola Taiwo, Stephen Kache, Jerry Godfrey Makama, Danjuma Sale, Olajide Abiola, Akinlabi Ajao, Anthony Ajiboye, Amarachukwu Etonyeaku, Julius Olaogun, Ademola Adebanjo, Opeoluwa Adesanya, Michael Olatunji Afolayan, Olanrewaju Balogun, Ayomide Makanjuola, Samuel Nwokocha, Rufus Wale Ojewola, Thomas Olagboyega Olajide, Adewale Aderounmu, Abdul-Rashid Adesunkanmi, Adewale Adisa, Augustine Agbakwuru, Adeleke Akeem Aderogba, Olusegun Isaac Alatise, Olukayode Arowolo, Oladejo Lawal, Tajudeen Mohammed, Chinedu Ndegbu, Olalekan Olasehinde, Funmilola Wuraola, Akinbolaji Akinkuolie, Amarachukwu Etonyeaku, Arinzechukwu Mosanya, Omobolaji Ayandipo, Peter Elemile, Taiwo Akeem Lawal, Samuel Ali Sani, Stephen Garba, Rebecca Hauwa Sani, Samson Olori, Henry Onyebuashi, Ifeanyi Umoke, Adedire Adenuga, Ademola Adeyeye, Olufemi Habeeb, Bashir Lawal, Abdulrasheed Nasir, Eirik Kjus Aahlin, Didrik Kjønås, Elisabeth Myrseth, Jibran Abbasy, Abdul Alvi, Omair Saleem, Asma Afzal, Anam Nazir, Muhammad Farooq, Ayesha Liaqat, Syed Asghar Naqi, Ali Raza, Muzna Sarfraz, Muhammad Sarwar, Muntaha Banglani, Ambreen Munir, Rahmat Sehrish, Bushra Ayub, Raza Sayyed, Amna Altaf, Saima Ayub, Ahmad Uzair Qureshi, Komal Saeed, Bilal Syed, Sana Amir Akbar, Abdul Wahid Anwer, Ruqayya Naheed Khan, Amina Iqbal Khan, Shahid Khattak, Sameen Mohtasham, Muhammad Asad Parvaiz, Aamir Ali Syed, Abdul Basit Ansari, Noman Shahzad, Tanwir Khaliq, Isbah Rashid, Shahzad Hussain Waqar, Hasan Abu Al-Saleem, Amjad Abu Alqumboz, Mohammad Alqadi, Adham Amro, Rawan Assa, Eman Awesat, Rawan Ayyad, Mohammed Hammad, Ayat Haymony, Bassel Hijazi, Bara Hmeidat, Rowaa Lahaseh, Aseel Qawasmi, Alaa Rajabi, Mohammed Shehada, Sundus Shkokani, Yasmine Yaghi, Nadine Yaghi, Mohammad AlZohour, Mohammad Farid, Yousef Mahmoud Habes, Wesam Juba, Yanal Nubani, Abdelrahman Rabee, Mohammad Sa'deh, Saeed Abed, Iyad Al Basos, Mohammad Alswerki, Dina Ashour, Israa Awad, Samar Diab, Alaa El Jamassi, Sahar El-Kahlout, Somaya Elhout, Ahmed N K Hajjaj, Doaa Hasanain, Baraa Nabil Hajjaj, Mohammed Obaid, Eman Saikaly, Ahmed Salhi, Hiba Al-Tammam, Murad Almasri, Muath Baniowda, Doha Beshtawi, Ali Horoub, Rami Misk, Bayan Mohammad, Rami Qasrawi, Tasnim Sholi, Samar Abu-Nimeh, Abrar Abu-Srour, Sadi A Abukhalaf, Samer Adawi, Barah Alsalameh, Kholoud Ayesh, Muawiyah Elqadi, Ahmad Hammouri, Fatima Karim Mustafa, Natalie Marzouqa, Shatha Melhem, Dima Miqdad, Balqees Mohamad, Mhammed Rawhi, Ayman B Abu Ahammala, Ahmed Abu Ataya, Israa Abu Jayyab, Samar Al-Shwaikh, Othman Alagha, Mohammed Alasttal, Haneen Awadallah, Mahmood Elblbessy, Jehad Fares, Akram Jarbou, Ibtisam Mahfouz, Moath A Albahnasawi, Asmaa' Abo Mahadi, Hasan Abuelhatal, Ayham Abuelqomboz, Abdelrahman Almoqayyad, Abdallah Alwali, Reem Balaawi, Mahmoud Hamouda, Mohammed Humeid, Abdullah Jedyan, Tasneem Mahmoud Abu Hamam, Ghadeer Matar, Ali Salem, Tahani Samra, Nureddin Shaheen, Karam Shihada, Ayoob A Nemer, Mahmoud Abu Al Amrain, Abdulwhhab Abu Alamrain, Najlaa Abu Jamie, Mohammed R Abu-Rous, Nada Alfarra, Mohammed AlTaweel, Noor Alwhaidi, Ramadan Hamed, Bader Saqqa, Ahmad Shaheen, Dana Aljaber, Loay Aljaberi, Malak Alwaheidi, Assef Jawaada, Hani Khaldi, Rami Qahoush, Jalil Qari, Rana Saadeh, Ahlam Salim, Aseel Yacoub, Abbas Abbas, Rana Abu Shua'ib, Baraa Abu Zainah, Mahmoud AbuSirrees, Basheer Babaa, Ola Barhoush, Asef Belal Qadomi, Laith Daraghmeh, Reema Haji, Alaa Khatatbeh, Lana Khatib, Salsabeel Qarariah, Yara Quzmar, Khalil Safadi, Roqaya Salameh, Mohammad Hassan, Shifaa Herzallah, Loai Massad, Ahmed Nazzal, Ranin Nazzal, Dennis Escobar, Gustavo Miguel Machain V, Agustin Rodriguez Gonzalez, Jorge Emerson Chachaima Mar, Nathaly Olga Chinchihualpa Paredes, Vicente Cuba, Walter Lopez, Maria Milagros Niquen Jimenez, Nestor Alberto Sanchez Bartra, Olenka Sapallanay Ojeda, Diego Sequeiros, Andrea Toscano Pacheco, María Vergara, Sol Abarca, Rodrigo Alcorta, Giuliano Borda-Luque, Ivan Edward Eusebio Zegarra, Claudia Luján López, Mirella Marrufo, Cinthya Mogrovejo, Andrea Nomura, Yamile Rodríguez Angeles, Maitza Rosario Vidal Meza, Gabriela Zavala, José Neiser Castillo Arrascue, Jomara Caroline Hidrogo Cabrera, José Julio Mariano Larrea Vera, Miguel Osorio, Edgar Alcides Ylatoma Díaz, Mark Anthony Fontanilla, Joseph Roy Fuentes, Anna Leah Salazar, Genieve Dominguez, Marc Paul Lopez, Shiela Macalindong, Mark Augustine Onglao, Arjel Ramirez, Marie Dione Sacdalan, Mayou Martin Tampo, Gemma Leonora Uy, Jeremiah Mangahas, Kenneth Yabut, Joannes Paul Cañete, Bernalynn Eris Cansana, Ernes John Castro, Maria Kaiserin Lipana, Manuel Francisco Roxas, Vlu Jean Zara, Maciej Chroł, Paula Franczak, Michał Orłowski, Piotr Budzyński, Andrzej Budzyński, Pawel Bury, Agata Czerwińska, Jadwiga Dworak, Jacek Dziedzic, Michał Kisielewski, Jan Kulawik, Anna Lasek, Piotr Major, Piotr Małczak, Marcin Migaczewski, Michał Pędziwiatr, Magdalena Pisarska, Dorota Radkowiak, Mateusz Rubinkiewicz, Anna Rzepa, Tomasz Skoczylas, Maciej Stanek, Katarzyna Truszkiewicz, Mateusz Wierdak, Marek Winiarski, Piotr Zarzycki, Anna Zub-Pokrowiecka, Piotr Kowalewski, Rafał Roszkowski, Maciej Walędziak, Miguel Tomé, Sara Patrocinio, Ines Guerreiro, Filipe Almeida, Xavier de Sousa, Nuno Monteiro, Maria Teresa Costa Santos, Daniela de Oliveira, Marta Lopes Serra, Daniela Morgado, Christian Neves, Ana Carolina Oliveira, Alice Pimentel, Sofia Silva, Márcia Carvalho, Lúcia Carvalho, Joana Magalhães, Leonor Matos, Tânia Monteiro, Carlota Ramos, Vanessa Santos, José Barbosa, Jose Costa-Maia, Vítor Devezas, Ana Fareleira, Cristina Fernandes, Diana Gonçalves, Henrique Mora, Marina Morais, Fabiana Silva de Sousa, Sara Catarino Santos, Ana Logrado, André Tojal, Edgar Amorim, Miguel F Cunha, Ana Fazenda, João Pedro Melo Neves, Inês Isabel Sampaio da Nóvoa Gomes Miguel, Diogo Veiga, José Azevedo, Hugo Cardoso Louro, Mariana Leite, José Azevedo, Maria Bairos Menezes, Bárbara Gama, Diana Brito, Marta Cristina Cruz Martins, André Graça E Magalhães, Ana Catarina Longras, Rita Lourenço, Diana Matos, Luis Castro, Filipa Policarpo, Joana Romano, Mariana Leite, Cristina Monteiro, Diogo Pinto, Marina Duarte, Sónia Fortuna Martins, Mariline Oliveira, Diogo Galvão, Lisandra Martins, Anaisa Silva, Viorel Taranu, Bárbara Vieira, Jessica Neves, Simone Oliveira, Hugo Ribeiro, Margarida Cinza, Rosa Felix, Arnaldo Machado, Joana Oliveira, Joana Patrício, Rita Pedroso de Lima, Mário Pereira, Miguel Rocha Melo, Cristina Velez, Alberto Abreu da Silva, Mariana Claro, Daniel Costa Santos, Andreia Ferreira, Hugo Capote, Daniela Rosado, Filipa Taré, Oriana Nogueira, Miguel Ângelo, José Miguel Baiao, Andreia Guimarães, João Marques, Miguel Nico Albano, Marta Silva, Ana Valente da Costa, Teresa Vieira Caroço, Sara Almeida Braga, Ines Capunge, Marta Fragoso, João Guimarães, Bruno Pinto, João Ribeiro, Miguel Angel, Guilherme Fialho, Monica Guerrero, Filipa Campos Costa, Diogo Cardoso, Vasco Cardoso, Magda Alves, Inês Estalagem, Tiago Louro, Cláudia Marques, Rita Martelo, Miguel Morgado, Rita Canotilho, Ana Margarida Correia, Pedro 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Maghrabi, Nadim Malibary, Mohammed Nassif, Abdulaziz Saleem, Abdullah Sultan, Wail Tashkandi, Hanaa Tashkandi, Nora Trabulsi, Mouhamadou Bachir Ba, Adja Coumba Diallo, Abdourahmane Ndong, Vladica Cuk, Uroš Janković, Jovan Juloski, Sharon Zhiling Koh, Frederick Koh, Kuok Chung Lee, Kai Yin Lee, Sean Lee, Wei Qi Leong, Bettina Lieske, Su Ann Lui, Prajwala Prakash, Jan Grosek, Gregor Norcic, Ales Tomazic, Nicolas Fitchat, Robert Jaich, Devorah Wineberg, Modise Zacharia Koto, Daniella Baiocchi, Damian Clarke, Christina Johanna Steenkamp, Stephanie Van Straten, Sharon Bannister, Adam Boutall, Galya Chinnery, Anna Coccia, Angela Dell, Parveen Karjiker, Christo Kloppers, Nicholas Loxton, Tumi Mabogoane, Francois Malherbe, Eugenio Panieri, Shreya Rayamajhi, Richard Spence, Tirsa van Wyngaard, Claire Warden, T E Madiba, Yoshan Moodley, Nivashen Pillay, Savannah Brooks, Charlise Kruger, Lisa Hannah Van Der Merwe, Ferhana Gool, Maahir Kariem, Heather Bougard, Kathryn Chu, Nazmie Kariem, Fazlin Noor, Reantha Pillay, Leandi Steynfaardt, Lucía González González, José Miguel Marín Santos, Paula Martín-Borregón, Javier Martínez Caballero, Cristina Nevado García, Pastora Rodriguez Fraga, Gonzalo De Castro Parga, Maria Pilar Fernández Veiga, Lucía Garrido López, Hugo Infante Pino, Irene Lages Cal, Marta López Otero, Manuel Nogueira Sixto, Marta Paniagua García Señorans, Laura Rodríguez Fernández, Alejandro Ruano Poblador, Erika Rufo Crespo, Raquel Sanchez-Santos, Vincenzo Vigorita, Ester Alonso Batanero, Dorisme Asnel, Isabel Cifrian Canales, Elisa Contreras Saiz, Irene De Santiago Alvarez, Tamara Díaz Vico, Sebastian Fernandez Arias, Daniel Fernández Martínez, Carmen García Bernardo, Luis Joaquín García Flórez, Carmen Garcia Gutierrez, Manuel García Munar, Carlos Alberto Márquez Zorrilla Molina, Marta Merayo, José Luis Michi Campos, Maria Moreno Gijon, Jorge L Otero-Diez, Jose Luis Rodicio Miravalles, Lorena Solar-Garcia, Aida Suárez Sánchez, Nuria Truan, Cristina Alejandre Villalobos, Yurena Caballero Díaz, Marta Jimenez, Dacil Montesdeoca, Antonio Navarro-Sánchez, Victor Vega, Juan Beltrán de Heredia, Zahira Gómez, Carlos Jezieniecki, Ana Patricia Legido Morán, Mario Montes-Manrique, Mario Rodriguez-Lopez, María Ruiz Soriano, Jeancarlos Trujillo Díaz, Andrea Vazquez Fernandez, Nuria Argudo, Miguel Pera, Laia Torrent Jansà, Melody García Domínguez, Ignacio Goded, Marta Roldón Golet, Issa Talal El-Abur, Alejandra Utrilla Fornals, Vanesa Zambrana Campos, Maria Del Mar Aguilar Martinez, Marina Bosch, Luis García-Catalá, Luis Sánchez-Guillén, Eva Artigau, Nuria Gomez Romeu, David Julià Bergkvist, Beatriz Espina Perez, Olga Morató, Carles Olona, Beatriz Diéguez, Alexander Forero-Torres, Manuel Losada, Segundo Gomez-Abril, Paula Gonzálvez, Rosario Martinez, Sergio Navarro Martínez, Carmen Payá-Llorente, Álvaro Pérez Rubio, Sandra Santarrufina Martinez, Juan Carlos Sebastián Tomás, Ramon Trullenque Juan, Alberto Gegúndez Simón, Paloma Maté, Maria Isabel Prieto-Nieto, Ines Rubio-Perez, Aitor Urbieta, Marina Vicario Bravo, David Abelló, Matteo Frasson, Alvaro Garcia-Granero, Alfredo Abad Gurumeta, Ane Abad-Motos, Elena Lucena-de Pablo, Beatriz Nozal, Javier Ripollés-Melchor, Rut Salvachúa, Esther Ferrero, Luis Garcia-Sancho Tellez, Irene Ortega Vázquez, Antonio L Picardo, Jose Alberto Rojo López, Laura Patricia Zorrilla Matilla, Carmen Cagigas Fernandez, Sonia Castanedo Bezanilla, José Estevez Tesouro, Maria Jose Fernandez-Diaz, Juan García Cardo, Marcos Gomez Ruiz, Erik Gonzalez-Tolaretxipi, Jaime Jimeno Fraile, Cristobal Poch, Montserrat Rodriguez-Aguirre, Noemí Troche Pesqueira, Maria Soledad Trugeda-Carrera, Javier de la Torre, Ruth Blanco-Colino, Eloy Espin-Basany, Martin Espinosa-Bravo, Clara Morales Comas, Eduardo Reyes Afonso, Joaquín Rivero Déniz, Christian Siso Raber, Mireia Verdaguer Tremolosa, Pramodh Chandrasinghe, Sumudu Kumarage, Nimeshi Wijekoon Arachchilage, Kithsiri Janakantha Senanayake, Ahmed Abdalla Ahmed Elkamel, 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M., Guimaraes, A., Marques, J., Nico Albano, M., Silva, M., Valente da Costa, A., Vieira Caroco, T., Almeida Braga, S., Capunge, I., Fragoso, M., Guimaraes, J., Pinto, B., Ribeiro, J., Angel, M., Fialho, G., Guerrero, M., Campos Costa, F., Cardoso, D., Cardoso, V., Alves, M., Estalagem, I., Louro, T., Marques, C., Martelo, R., Morgado, M., Canotilho, R., Correia, A. M., Martins, P., Peyroteo, M., Gomes, J., Monteiro, R., Romano, M., Alves, D. M., Peixoto, R., Quintela, C., Jervis, M. J., Melo, D., Pacheco, A., Paixao, V., Pedro, V., Pimenta, J., Pimenta de Castro, J., Rocha, A., Beuran, M., Ciubotaru, C., Diaconescu, B., Hostiuc, S., Negoi, I., Stoica, B., Anokhin, E., Kuznetsov, G., Oganezov, G., Paramzin, F., Romanova, E., Rutkovskii, V., Shushval, M., Zabiyaka, M., Dzhumabaev, K., Ivanov, V., Mamedli, Z., Achkasov, S., Balkarov, A., Nabiev, E., Nagudov, M., Rybakov, E., Saifutdinova, K., Sushkov, O., Joseph, L., Ndayishimiye, I., Faustin, N., Mutabazi, A. Z., Mvukiyehe, J. P., Nsengimana, V. J. P., Uwakunda, C., Abbas, M. M., Akeel, N., Aljiffry, M., Awaji, K., Farsi, A., Jamjoum, G., Khoja, A., Maghrabi, A., Malibary, N., Nassif, M., Saleem, A., Sultan, A., Tashkandi, W., Tashkandi, H., Trabulsi, N., Ba, M. B., Diallo, A. C., Ndong, A., Cuk, V., Jankovic, U., Koh, S. Z., Koh, F., Lee, K. C., Lee, K. Y., Lee, S., Leong, W. Q., Lui, S. A., Prakash, P., Grosek, J., Norcic, G., Tomazic, A., Fitchat, N., Jaich, R., Wineberg, D., Koto, M. Z., Baiocchi, D., Clarke, D., Steenkamp, C. J., Bannister, S., Boutall, A., Chinnery, G., Coccia, A., Dell, A., Karjiker, P., Kloppers, C., Loxton, N., Mabogoane, T., Malherbe, F., Panieri, E., Rayamajhi, S., van Wyngaard, T., Warden, C., Madiba, T. E., Pillay, N., Brooks, S., Kruger, C., Van Der Merwe, L. H., Gool, F., Kariem, M., Bougard, H., Kariem, N., Noor, F., Pillay, R., Steynfaardt, L., Gonzalez Gonzalez, L., Marin Santos, J. M., Martin-Borregon, P., Martinez Caballero, J., Nevado Garcia, C., Rodriguez Fraga, P., De Castro Parga, G., Fernandez Veiga, M. P., Garrido Lopez, L., Infante Pino, H., Lages Cal, I., Lopez Otero, M., Nogueira Sixto, M., Paniagua Garcia Senorans, M., Rodriguez Fernandez, L., Ruano Poblador, A., Rufo Crespo, E., Sanchez-Santos, R., Vigorita, V., Alonso Batanero, E., Asnel, D., Cifrian Canales, I., Contreras Saiz, E., De Santiago Alvarez, I., Diaz Vico, T., Fernandez Arias, S., Fernandez Martinez, D., Garcia Bernardo, C., Garcia Florez, L. J., Garcia Gutierrez, C., Garcia Munar, M., Marquez Zorrilla Molina, C. A., Merayo, M., Michi Campos, J. L., Moreno Gijon, M., Otero-Diez, J. L., Rodicio Miravalles, J. L., Solar-Garcia, L., Suarez Sanchez, A., Truan, N., Alejandre Villalobos, C., Caballero Diaz, Y., Jimenez, M., Montesdeoca, D., Navarro-Sanchez, A., Vega, V., Beltran de Heredia, J., Gomez, Z., Jezieniecki, C., Legido Moran, A. P., Montes-Manrique, M., Rodriguez-Lopez, M., Ruiz Soriano, M., Trujillo Diaz, J., Vazquez Fernandez, A., Argudo, N., Pera, M., Torrent Jansa, L., Garcia Dominguez, M., Goded, I., Roldon Golet, M., Talal El-Abur, I., Utrilla Fornals, A., Zambrana Campos, V., Aguilar Martinez, M. D. M., Bosch, M., Garcia-Catala, L., Sanchez-Guillen, L., Artigau, E., Gomez Romeu, N., Julia Bergkvist, D., Espina Perez, B., Morato, O., Olona, C., Dieguez, B., Forero-Torres, A., Losada, M., Gomez-Abril, S., Gonzalvez, P., Martinez, R., Navarro Martinez, S., Paya-Llorente, C., Perez Rubio, A., Santarrufina Martinez, S., Sebastian Tomas, J. C., Trullenque Juan, R., Gegundez Simon, A., Mate, P., Prieto-Nieto, M. I., Rubio-Perez, I., Urbieta, A., Vicario Bravo, M., Abello, D., Frasson, M., Garcia-Granero, A., Abad Gurumeta, A., Abad-Motos, A., Lucena-de Pablo, E., Nozal, B., Ripolles-Melchor, J., Salvachua, R., Ferrero, E., Garcia-Sancho Tellez, L., Picardo, A. L., Rojo Lopez, J. A., Zorrilla Matilla, L. P., Cagigas Fernandez, C., Castanedo Bezanilla, S., Estevez Tesouro, J., Fernandez-Diaz, M. J., Garcia Cardo, J., Gomez Ruiz, M., Gonzalez-Tolaretxipi, E., Jimeno Fraile, J., Poch, C., Rodriguez-Aguirre, M., Troche Pesqueira, N., Trugeda-Carrera, M. S., de la Torre, J., Blanco-Colino, R., Espin-Basany, E., Espinosa-Bravo, M., Morales Comas, C., Reyes Afonso, E., Rivero Deniz, J., Siso Raber, C., Verdaguer Tremolosa, M., Chandrasinghe, P., Kumarage, S., Wijekoon Arachchilage, N., Abdalla Ahmed Elkamel, A., A. Adam, M., Blomme, N., Thorell, A., Wogensen, F., Alga, A., Ansarei, D., Celebioglu, F., Heinius, G., Nigard, L., Pieniowski, E., Ahlqvist, S., Bjorklund, I., Franberg, A., Hakansson, M., Adamo, K., Franklin, O., Sund, M., Wiberg, R., Andersson, Y., Chabok, A., Nikberg, M., Kugelberg, A., Canonica, C., Christoforidis, D., Fasolini, F., Gaffuri, P., Giuliani, M., Meani, F., Popeskou, S. G., Pozza, S., Wandschneider, W., Peterer, L., Widmer, L. W., Zimmermann, B., Bakoleas, P., Chanousi, I., Charalampidou, L., Grochola, L. F., Heid, F., Ntaoulas, S., Outos, M., Peros, G., Podolska-Skoczek, H., Reinisch, K. B., Zielasek, C., Demartines, N., Gilgien, J., Kefleyesus, A., St-Amour, P., Toussaint, A., Alhimyar, M., Alsaid, B., Alyafi, A., Alkhaledi, A., Kouz, B., Omarain, A., Al-Sabbagh, Y., Alkhatib, H., Sara, S., Alhaj, A., Danial, A., Kadoura, L., Maa Albared, S., Monawar, Y., Nahas, L., Abd, B., Saad, A., Wakkaf, H., Bouzaiene, H., Ghalleb, M., Akaydin, E., Akbaba, A. C., Atakul, O., Baltaci, E., Besli, S., Burgu, G., Cenal, U., de Muijnck, C., Demirkaya, H. C., Dogruoz, A., Gezer, Z. I., Gundogdu, Y., Kara, M., Korkmaz, H. K., Kurtoglu, G. K., Ozben, V., Ozmen, B. B., Pektas, A. M., Sel, E. K., Yenidunya, N., Bengur, F. B., Oral, B. M., Yozgatli, T. K., Abdullayev, S., Gunes, M. E., Sahbaz, N. A., Banaz, T., Kargici, K., Kuyumcu, O. F., Yanikoglu, E., Yesilsancak, M., Yilmaz, D., Aktas, M. K., Rencuzogullari, A., Isik, A., Leventoglu, S., Yalcinkaya, A., Yuksel, O., Kalayci, M. U., Kara, Y., Sarici, I. S., Akin, A., Alemdag, G. N., Arslan, E., Baki, B. E., Bodur, M. S., Calik, A., Candas Altinbas, B., Cihanyurdu, I., Erkul, O., Gul, B., Guner, A., Kose, B., Semiz, A., Sevim, Tayar, S., Tomas, K., Tufek, O. Y., Turkyilmaz, S., Ulusahin, M., Usta, A., Yildirim, R., Guler, S. A., Tatar, O. C., Varol, E., Kirimtay, B., Uysal, M., Yildiz, A., Kose, E., Ciftci, A. B., Colak, E., Eraslan, H., Kucuk, G. O., Yemez, K., Lule, H., Bienfait, M., Bua, E., Okalany, N., Basarab, M., Bielosludtsev, O., Kolhanova, K., Perepelytsia, K., Romanukha, K., Savenkov, D., Siryi, S., Tereshchenko, M., Viacheslav, N., Volovetskyi, A., Kebkalo, A., Tryliskyy, Y., Tyselskiy, V., Bruce, E., Chow, B. L., Iddles, E., Mcguckin, S., Newall, N., Ramsay, G., Sharma, P., Stewart, C., Wong, J., Badran, A., Bath, M., Belais, F., Butt, E., Joshi, K., Kapur, M., Shaw, M., Townson, A., Williams, C. Y. K., Gray, T., Greig, R., Husain, M., Murray, E., Mustafa, A., Asif, A., Gokul, A., Shah, M., Akitikori, M. T., Charalabopoulos, A., Davidson, S., Mcnally, S., Rupani, S., Juma, F., Mills, S. C., Muirhead, L., Sellars, K., Walsh, U., Warren, O., Chambers, A., Hunt, R., Boyce, S., Cornwall, H., Tol, I., Argyriou, E. O., Eardley, N., Povey, M., Aithie, J. M. S., Irfan, A., Mcguigan, M. -C., Starr, R., Warren, C. R., Archibald, J., Kirby, G., Kisyov, I., Khoo, C. K., Lee, R., Photiou, D., Davis, R., Prasad, U., Yang, P. Z., Bird, J., Leung, E., Summerour, V., Currow, C., Kiam, J., Tan, G. J. S., Muthusami, A., Pegba-Otemolu, I., Urbonas, T., Nunoo-Mensah, J., Smolskas, E., Boddy, A., Gravante, G., Hunter, D., Andrew, D., Koh, A., Thompson, A., Adams, L., Clements, H. A., De Silva, K., Ekpete, O., Haque, S., Henderson, S., Ibrahim, B., Jayasinghe, T., Livie, J., Mailley, K., Nair, G., Tan, D., Baggaley, C., Dawidziuk, A., Szyszka, B., Barter, C., Gandhi, N., Hassell, K., Hitchin, S., Kelsall, J., Nagy, E., Nessa, A., Whisker, L., Yanni, F., Ali, M., Arora, D., Hediwattege, S., Kumarasinghe, N., Rathore, M., Tennakoon, A., Ali Ahmad, S. M., Bajomo, O., Nadira, F., Celentano, V., Griffiths, E., Karri, R. S., Mak, J. K. C., Pipe, M., Bhatti, M. I., Rabie, M., Boyle, C., Hamilton, D., Mihuna, A., Ng, J. C. K., Nicholson, G., Oliwa, A., Pearson, R., Rose, A., Yong, S. Q., Boereboom, C., Hanna, M., Walter, C., Greensmith, T. S., Mitchell, R., Monaghan, E., Crawford, J., Moug, S., Blackwell, J., Boyd-Carson, H., Herrod, P., Al-Allaf, O., Beattie, M., Bullock, C., Burman, S., Clark, G., Flamey, N., Flannery, O., Harding, A., Kodiatt, B., Lawday, S., Mahapatra, S., Mukundu Nagesh, N., Ng, M., Rye, D., Yoong, A., Clark, L., Deans, C., Edirisooriya, M., Carrington, E. V., Wong, T. L. E., Yusuf, B., Chamberlain, C., Duke, K., Kmiotek, E., Botes, A., Condie, N., Schrire, T., Shah, R., Thomas-Jones, I., Yates, C., Anthony, N., Matthews, E., Sahnan, K., Tankel, J., Tucker, S., Winter Beatty, J., Ziprin, P., Duggan, W., Kantartzi, A., Sridhar, S., Khaw, R. A., Srivastava, P., Underwood, C., Alves do Canto Brum, H., Chopra, S., Davis, L., Hughes, R., Tulley, J., Alberts, J., Athisayaraj, T., Olugbemi, M., Ahmad, K., Chan, C., Chapman, G., Fleming, H., Fox, B., Grewar, J., Hulse, K., Rutherford, D., Sinead, M., Speake, D., Vaughan-Shaw, P. G., Christodoulides, N., Kudhail, S., Welch, M., Husaini, S. M., Lambracos, S., Anyanwu, C., Suresh, R., Thomas, J. S., Gleeson, E., Platoff, R., Saif, A., Enumah, Z., Etchill, E., Gabre-Kidan, A., Bernstein, M., Carrano, F. M., Connors, J., Lynn, P., Melis, M., Newman, E., Foster, D. S., Perrone, K., Titan, A., Ahmad, S., Bafford, A. C. M. D., Dal Molin, M., Hanna, N., Zafar, S. N., Hemmila, M., Napolitano, L., Wong, J. J., Chandler, J., Wood, L., Wren, S., Ottesen, T., You, L., Yu, K., Arcienega Yanez, M. D. P., Ferreira Fernandes, M., Gonzalez, D., Cubas, S., Gonzalez, M. C., Zubiaurre, V., Demolin, R., Giroff, N., Sciuto, P., Campos, M., Rodriguez Cantera, G., Deepika, G., Simuchimba, E., Bulaya, A., Chibuye, C., Chirengendure, B., Kabale, M. -R., Kabongo, K., Munthali, J., Mweso, O., Pikiti, F., Otieno, J., Lai, L. T., Blackman, B., Subramaniam, S., Karim, R., Kok, N., Lee, Y. D., Ali, S., Sinha, A., Corrigan, R., Barnes, N., Wong, F., Dennis, G., Jedamzik, J., Phillips, E., Piette, W., Van hentenryck, M., Koco, H., Lawani, S., Kassa, M. W., Santos Bezerra, T., Gribnev, P., Dimitrov, D., Krastev, P., Oum, S., Bonghaseh, D. T., Al Farsi, M., Alsharqawi, N., Acevedo, V., Castillo Barbosa, A. C., Giron, F., Leon Rodriguez, J. P., Kucan, D., Rosko, D., Barsic, N., Zupan, D., Hegazi, A., Truncikova, V., Fryba, V., Mohamed, M., Nagi, A., Rashad Temerik, A., Elshawy, M. E., Mahmoud, M. I., Anwar, M., Rageh, T., Elmokadem, A., Gaballa, K., Teppo, S., Pengerma, P., Ballouhey, Q., Bergeat, D., Weyl, A., Hain, E., Gyedu, A., Yenli, E., Osei-Poku, D., Rompou, V. -A., Zoikas, A., Gaitanidis, A., Koukis, G., Perivoliotis, K., Tavlas, P., Galanos-Demiris, K., Zografos, G., Karavokyros, I., Xanthopoulou, G., Iordanidou, E., Ayau, F., Garcia, A., Damjan, P., Wason, D., B L, A., Rangganata, E., Kamath, P., O'Connor, D. B., Pinto, M., Perrone, F., Tropeano, F. P., Troilo, F., Bossi, D., Scala, D., Pulitano, L., Carella, M., Pietrabissa, A., Gori, A., Giraudo, G., De Simone, V., Russo, A. A., Braccio, B., Al-Taher, R., Athamneh, S., Parker, A., Sawiee, A., Kattia, A., Tababa, O., Shaeeb, Z., Syminas, V., Jurgaitis, J., Damuleviciene, G., Svagzdys, S., Razafimanjato, N. N. M., Chieng Loo, L., Tiong, I. C., Wan Muhmad, W. F., Vijeyan, H., Li Ying, T., Grech, G., Arrangoiz, R., Jimenez Ley, V. B., Arizpe, D., Lagunes Lara, E., Castro Lopez, E. V., Eaazim, J., Gordinou de Gouberville, M., Bastiaenen, V., Rottier, S., Nahab, F., Ji, M. Y., Seyoji, M., Nwachukwu, C., Emeghara, O., Muhammed, S. E., Idowu, A., Sowemimo, O., Ogundoyin, O., Akande, O., Lott, A., Nadeem, M., Laghari, A. A., Loya, A., Mushtaq, H., Abdullah, M. T., Abuhilal, B., Atawneh, M., Hamdan, H., Alhabil, B., Srour, A., Mousa, I., Da Silva Medina, L., Bartosiak, K., Ferreira, P., Francisco, V., Lemos, R., Frutuoso, L., Fernandes, S., Fonseca, T., Pereira, J., Rachadell, J., Torre, A., Madeira Martins, F., Carvalho, A. C., Rodrigues Ferreira, J., Ribeiro da Silva, B., Devesa, H., Vieira, A., Monica, I., Amaro, M., Sousa, D., Reia, M., Louro, J., Martins, A., Dominguez, J., Santos, I., Freitas Oliveira, N. M., Pereira, J. C., Silva-Vaz, P., Freire, L., Escrevente, R., Negoita, V. M., Shakhmatov, D., Nezerwa, Y., Radulovic, R., Obery, G., Viljoen, F., Mendes, T., Suarez, A., Moncada, E., Fernandez-Hevia, M., Curtis Martinez, C., Gil Garcia, J. M., Gonzalez Zunzarren, M., Idris, T., Eklov, K., Grahn, O., Amin, L., Blomqvist, M., Ajani, C., Kraus, R., Seeger, N., Willemin, M., Rayya, F., Ayash, M., Msouti, R., Kannas, I., Abazid, E., Esper, A., Slim, S., Kavcar, A. S., Aytac, E., Dural, A. C., Ilker, A., Eray, I. C., Kurnaz, E., Altiner, S., Tepe, M. D., Sahin, C., Savli, E., Innocent, A., Babirye, L., Diachenko, A., Hordoskiy, V., Curry, H., Chau, C. Y. C., Robertson, H., Lennon, H., Loi, L., Kirkham, E., Mccann, C., Watts, D., Gurung, B., Wilson, M., Tribedi, T., Garofalo, E., Zahra, B., Macdonald, S., Daniels, I., Ng, N., Khosla, S., Olivier, J., Yue, S. Y. P., Suresh, G., Wellington, J., Lorejo, E., Mossaad, M., Crutcher, M., Alimi, M., Baiu, I., Abdou, H., Conway, A., Peck, C., Perdomo Perez, M. A., Zulu, S., Nakazwe, M., Burger, S., Davies, J., Donaldson, R., Ede, C., Garden, O. J., Lesetedi, C., Mabedi, C., Magill, L., Makinde Alakaloko, F., Makupe, A., Monahan, M., Mulira, S., Muller, E., Musowoyo, J., Olory-Togbe, J. L., Roberts, T., Smith, M., Tayler, V., Windsor, J., Yepez, R., Sundar, S., Runigamugabo, E., Verjee, A., Chen, J., Daya, L., El Aroussi, N., Farina, V., Gnintedeme Olivier, T., Gonzales Nacarino, M., Hammani, A., Honjo, S., Jacobs, R., Kimura, H., Nkoronko, M., Oscullo Yepez, J. J., Pin Hung, W., Raj, A., Romani Pozo, A., Rommaneh, M., Sassamela Fabiano, S. C., Shiroma Gago, C. M., Srinivas, A., Sung, C. -Y., Tai, A., Valle Aranda, Y. C., Venturini, S., Wilguens Lartigue, J., Public and occupational health, AMS - Sports, APH - Health Behaviors & Chronic Diseases, CCA - Cancer Treatment and quality of life, Amsterdam Gastroenterology Endocrinology Metabolism, Cancer Center Amsterdam, and Albarella, Sara
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global surgery ,hospitals ,humans ,income ,neoplasms ,postoperative period ,poverty ,prospective studies ,no keywords listed ,General Medicine ,Prospective Studie ,Hospital ,Settore MED/18 - Chirurgia Generale ,outcome ,Hospitals, Humans, Income, Neoplasms, surgery, Postoperative Period, Poverty, Prospective Studies ,cancer surgery ,Human ,hospital facilities - Abstract
© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide. Methods: A multimethods analysis was performed as part of the GlobalSurg 3 study—a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital. Findings: Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3·85 [95% CI 2·58–5·75]; p
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- 2022
5. Substandard and falsified antibiotics: neglected drivers of antimicrobial resistance?
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Guillermo A Zabala, Khonsavath Bellingham, Vayouly Vidhamaly, Phonepasith Boupha, Kem Boutsamay, Paul N Newton, and Céline Caillet
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Surveys and Questionnaires ,Health Policy ,Drug Resistance, Bacterial ,Public Health, Environmental and Occupational Health ,Humans ,Global Health ,Poverty ,Anti-Bacterial Agents - Abstract
ObjectivesAntimicrobial resistance (AMR) is a significant global health threat with substandard and falsified (SF) antibiotics being neglected contributing factors. With their relationships poorly understood, more research is needed in order to determine how interventions to reduce SF antibiotics should be ranked as priorities in national AMR action plans. We assessed the evidence available on the global prevalence of SF antibiotics, examined the quality of the evidence and discussed public health impact.Materials/MethodsWe searched PubMed, Embase, Google and Google Scholar for publications on antibiotic quality up to 31 December 2020. Publications reporting on the prevalence of SF antibiotics were evaluated for quantitative analysis and assessed using the Medicines Quality Assessment Reporting Guidelines.ResultsOf the 10 137 screened publications, 648 were relevant to antibiotic quality. One hundred and six (16.4%) surveys, published between 1992 and 2020 and conducted mainly in low-income and middle-income countries (LMICs) (89.9% (480/534) of the data points), qualified for quantitative analysis. The total number of samples tested for quality in prevalence surveys was 13 555, with a median (Q1–Q3) number of samples per survey of 47 (21–135). Of the 13 555 samples, 2357 (17.4%) failed at least one quality test and the median failure frequency (FF) per survey was 19.6% (7.6%–35.0%). Amoxicillin, sulfamethoxazole-trimethoprim and ciprofloxacin were the most surveyed antibiotics, with FF of 16.1% (355/2208), 26.2% (329/1255) and 10.4% (366/3511), respectively. We identified no SF survey data for antibiotics in the WHO ‘Reserve’ group. The mean Medicine Quality Assessment Reporting Guidelines score was 11 (95% CI 10.1 to 12.2) out of 26.ConclusionsSF antibiotics are widely spread with higher prevalence in LMICs. The quality of the evidence is poor, and these data are not generalisable that 17.4% of global antibiotic supply is SF. However, the evidence we have suggests that interventions to enhance regulatory, purchasing and financial mechanisms to improve the global antibiotic supply are needed.PROSPERO registration numberCRD42019124988.
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- 2023
6. The quality of veterinary medicines and their implications for One Health
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Vayouly Vidhamaly, Konnie Bellingham, Paul N Newton, and Céline Caillet
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Counterfeit Drugs ,Health Policy ,Income ,Public Health, Environmental and Occupational Health ,Humans ,One Health ,Public Health ,Poverty - Abstract
ObjectiveSubstandard and falsified (SF) veterinary medicines affect animal health, agricultural production and food security and will influence antimicrobial resistance (AMR) in both animals and humans. Yet, our understanding of their extent and impact is poor. We assess the available public domain evidence on the epidemiology of SF veterinary medicines, to better understand their prevalence and distribution and their public health impact on animals and humans.MethodsSearches were conducted in Embase, PubMed, MEDLINE, Global Health, Web of Science, CAB Abstracts, Scopus, Google Scholar, Google and websites with interest in veterinary medicines quality up to 28 February 2021. Identified articles in English and French were screened for eligibility. The Medicine Quality Assessment Reporting Guidelines were used to assess the quality of prevalence surveys.ResultsThree hundred and fourteen publications were included with a failure frequency (the percentage of samples that failed at least one quality test) of 6.5% (2335/35 733). The majority of samples were from post-marketing surveillance by medicines regulatory authorities of the Republic of Korea and China. A small proportion (3.5%) of samples, all anti-infectives, were from 20 prevalence surveys, with more than half (53.1%, 662/1246) collected in low-income and lower middle-income countries in Africa and Asia. The prevalence survey sample size ranged from 4 to 310 samples (median (Q1–Q3): 50 (27–80)); 55.0% of surveys used convenience outlet sampling methods. In 20 prevalence surveys more than half of the samples (52.0%, 648/1246) failed at least one quality test. The most common defects reported were out-of-specification active pharmaceutical ingredient(s) (API) content, failure of uniformity of units and disintegration tests. Almost half of samples (49.7%, 239/481) that failed API content tests contained at least one of the stated APIs below pharmacopoeial limits. Fifty-two samples (4.2% of all samples) contained one or more incorrect API. One hundred and twenty-three publications described incidents (recalls/seizures/case reports) of SF veterinary medicines in 29 countries.ConclusionThe data suggest that SF veterinary products are likely to be a serious animal and public health problem that has received limited attention. However, few studies of SF veterinary medicines are available and are geographically restricted. Lower API content and disintegration/dissolution than recommended by pharmacopoeial standards risks treatment failure, animal suffering and contribute to AMR. Our findings highlight the need of more research, with robust methodology, to better inform policy and implement measures to assure the quality of veterinary medicines within supply chains. The mechanism and impact of SF veterinary products on animal and human health, agricultural production, their economy and AMR need more transdisciplinary research.
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- 2023
7. Identifying context-specific domains for assessing antimicrobial stewardship programmes in Asia: protocol for a scoping review
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Vu, HTL, Hamers, RL, Limato, R, Limmathurotsakul, D, Karkey, A, Dodds Ashley, E, Anderson, D, Patel, PK, Patel, TS, Lessa, FC, and van Doorn, HR
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Antimicrobial Stewardship ,Review Literature as Topic ,Asia ,Anti-Infective Agents ,health services administration & management ,public health ,Humans ,General Medicine ,Centers for Disease Control and Prevention, U.S ,infectious diseases ,Poverty ,United States ,quality in health care - Abstract
IntroductionAntimicrobial stewardship (AMS) is an important strategy to control antimicrobial resistance. Resources are available to provide guidance for design and implementation of AMS programmes, however these may have limited applicability in resource-limited settings including those in Asia. This scoping review aims to identify context-specific domains and items for the development of a healthcare facility (HCF)-level tool to guide AMS implementation in Asia.Methods and analysisThis review is the first step in a larger project to assess AMS implementation, needs and gaps in Asia. We will employ a deductive qualitative approach to identify locally appropriate domains and items of AMS implementation guided by Nilsen and Bernhardsson’s contextual dimensions. This process is also informed by discussions from a technical advisory group coordinated by the US Centers for Disease Control and Prevention to develop an AMS HCF-level assessment tool for low-income and middle-income countries. We will review English-language documents that discuss HCF-level implementation, including those describing frameworks, components/elements or recommendations for design, implementation or assessment globally and specific to Asia. We have performed the search in August–September 2021 including general electronic databases (MEDLINE, Embase, Web of Science and Google Scholar), region-specific databases, national action plans, grey literature sources and reference lists to identify eligible documents. Country-specific documents will be restricted to countries in three subregions: South Asia, East Asia and Southeast Asia. Codes and themes will be derived through a content analysis, classified following the predefined context dimensions and used for developing domains and items of the assessment tool.Ethics and disseminationResults from this review will feed into our stepwise process for developing a context-specific HCF-level assessment tool for AMS programmes to assess the implementation status, identify intervention opportunities and monitor progress over time. The process will be done in consultation with local stakeholders, the end-users of the generated knowledge.
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- 2023
8. Randomized Comparative Effectiveness Trial of 2 Federally Recommended Strategies to Reduce Excess Body Fat in Overweight, Low-Income Patients: MyPlate.gov vs Calorie Counting
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William J. McCarthy, Melvin Rico, Maria Chandler, Dena R. Herman, Cindy Chang, Thomas R. Belin, Stephanie Love, Evangelina Ramirez, and Lillian Gelberg
- Subjects
Adult ,Comparative Effectiveness Research ,and promotion of well-being ,Clinical Trials and Supportive Activities ,immigrant ,Cardiovascular ,Medical and Health Sciences ,Oral and gastrointestinal ,Clinical Research ,General & Internal Medicine ,Behavioral and Social Science ,Humans ,Obesity ,Poverty ,Latine ,Metabolic and endocrine ,Nutrition ,Cancer ,Original Research ,obesity treatment ,Prevention ,Diabetes ,clinical trial ,Overweight ,Health Services ,Prevention of disease and conditions ,nutrition intervention ,Stroke ,Quality Education ,Adipose Tissue ,Studies in Human Society ,Quality of Life ,3.1 Primary prevention interventions to modify behaviours or promote wellbeing ,Patient Safety ,Family Practice - Abstract
PURPOSE: Since 2011, US authorities have supported the following 2 approaches to healthier body fat composition: the Centers for Disease Control and Prevention National Diabetes Prevention Program’s calorie counting (CC) approach and the US Department of Agriculture’s MyPlate (adherence to federal nutrition guidelines). The purpose of this study was to compare the effect of CC vs MyPlate approaches on satiety/satiation and on achieving healthier body fat composition among primary care patients. METHODS: We conducted a randomized controlled trial comparing the CC and MyPlate approaches from 2015 to 2017. The adult participants were overweight, of low income, and were mostly Latine (n = 261). For both approaches, community health workers conducted 2 home education visits, 2 group education sessions, and 7 telephone coaching calls over a period of 6 months. Satiation and satiety were the primary patient-centered outcome measures. Waist circumference and body weight were the primary anthropometric measures. Measures were assessed at baseline, 6 months, and 12 months. RESULTS: Satiation and satiety scores increased for both groups. Waist circumference was significantly decreased in both groups. MyPlate, but not CC, resulted in lower systolic blood pressure at 6 months but not at 12 months. Participants for both MyPlate and CC reported greater quality of life and emotional well-being and high satisfaction with their assigned weight-loss program. The most acculturated participants showed the greatest decreases in waist circumference. CONCLUSIONS: A MyPlate-based intervention might be a practical alternative to the more traditional CC approach to promoting satiety and facilitating decreases in central adiposity among low-income, mostly Latine primary care patients.
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- 2023
9. Effects of the 2021 Expanded Child Tax Credit on Adults’ Mental Health: A Quasi-Experimental Study
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Batra, Akansha, Jackson, Kaitlyn, and Hamad, Rita
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Adult ,Pediatric ,COVID-19 ,Taxes ,Article ,Mental Health ,Good Health and Well Being ,Clinical Research ,Applied Economics ,Behavioral and Social Science ,Public Health and Health Services ,Health Policy & Services ,Humans ,Child ,Poverty ,Pandemics - Abstract
The US Congress temporarily expanded the Child Tax Credit (CTC) during the COVID-19 pandemic to provide economic assistance for families with children. Although formerly the CTC provided $2,000 per child for mostly middle-income parents, during July-December 2021 it provided up to $3,600 per child. Eligibility criteria were also expanded to reach more economically disadvantaged families. There has been little research evaluating the effect of the policy expansion on mental health. Using data from the Census Bureau's Household Pulse Survey and a quasi-experimental study design, we examined the effects of the expanded CTC on mental health and related outcomes among low-income adults with children, and by racial and ethnic subgroup. We found fewer depressive and anxiety symptoms among low-income adults. Adults of Black, Hispanic, and other racial and ethnic backgrounds demonstrated greater reductions in anxiety symptoms compared to non-Hispanic White adults with children. There were no changes in mental health care use. These findings are important for Congress and state legislators to weigh as they consider making the expanded CTC and other similar tax credits permanent to support economically disadvantaged families.
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- 2023
10. Conceptualisations of positive mental health and wellbeing among children and adolescents in low‐ and middle‐income countries: A systematic review and narrative synthesis
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Laoise Renwick, Rebecca Pedley, Isobel Johnson, Vicky Bell, Karina Lovell, Penny Bee, and Helen Brooks
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Medicine (General) ,Adolescent ,Concept Formation ,Mental Disorders ,Public Health, Environmental and Occupational Health ,children and young people ,perceptions ,wellbeing ,R5-920 ,low- and middle- income countries ,Humans ,Public aspects of medicine ,RA1-1270 ,Child ,Developing Countries ,Poverty ,mental health ,low‐ and middle‐ income countries - Abstract
Background: Mental illnesses are the leading causes of global disease burden. The impact is heightened in low- and middle-income countries (LMICs) due to embryonic care systems and extant barriers to healthcare access. Understanding children and adolescents' conceptualisations of mental health wellbeing in these settings is important to optimize health prevention and promotion initiatives. Objective: To systematically review and synthesize children and adolescents' conceptualisations and views of mental health and wellbeing in LMICs. Design: Ten databases were systematically searched from inception to July 2020 and findings from included studies were synthesized. Results: Twenty papers met eligibility criteria comprising qualitative, quantitative and mixed methods studies. Children and adolescents identified aspects of mental health and wellbeing, including positive affect and outlook and having sufficient personal resources to face daily challenges. Identified factors recognized the importance of activating both kin and lay networks in supporting and maintaining wellbeing. Conceptualisations of mental health and wellbeing were varied and influenced by culture, developmental stage and gender. Discussion and Conclusions: Irrespective of environmental and sociocultural influences on concepts of wellbeing and mental health, children and adolescents in LMICs can conceptualise these constructs and identify how they pursue positive mental health and wellbeing important for developing age and culture-appropriate community mental health strategies. Our review highlights the need to extend inquiry to wider developmental stages and both across and within specific populations in LMICs. Patient and Public Involvement: Initial results were presented at stakeholder workshops, which included children, adolescents, parents and health professionals held in Indonesia in January 2019 to allow the opportunity for feedback.
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- 2022
11. Sociodemographic and socioeconomic correlates of learning disability in preterm children in the United States
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Okoli, Menkeoma Laura, Ogbu, Chukwuemeka E., Enyi, Chioma O., Okoli, Ibuchim C., Wilson, Ronee E., and Kirby, Russell S.
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Special services ,Insurance, Health ,Learning Disabilities ,Research ,education ,Infant, Newborn ,Public Health, Environmental and Occupational Health ,Infant ,Preterm birth ,United States ,Cross-Sectional Studies ,Socioeconomic Factors ,Humans ,Public aspects of medicine ,RA1-1270 ,Child ,SES ,Poverty ,Learning disability ,CLWLD - Abstract
Background In 2019, 1 in every 10 infants born in the United States was preterm. Prematurity has life-threatening consequences and causes a range of developmental disabilities, of which learning disability is a prevalent complication. Despite the availability of special services for children living with learning disability, gaps still exist in terms of access due to socioeconomic factors. The aim of this study is to evaluate socioeconomic and sociodemographic correlates of learning disability in preterm children. Methods This cross-sectional study used data from the 2016–2018 National Survey of Children’s Health. Weighted multivariable analyses were conducted to ascertain the association of sociodemographic and socioeconomic factors on learning disability among preterm children. The main outcome variable was the presence of learning disability. Results Among 9555 preterm children in our study population, 1167 (12%) had learning disability. Learning disability was significantly associated with health insurance, food situation, and poverty level after adjustment for other variables. Children currently insured had lower odds of having learning disability compared to those without health insurance (OR = 0.79, 95% C.I. = 0.70–0.91). Also, children living in households that cannot afford nutritious meals are more likely to have learning disability compared to those that can afford nutritious meals at home (OR = 1.55, 95% C.I. = 1.22–1.97). Conclusion These findings highlight the need for intervention efforts to target these children living with a learning disability to achieve the 2004 Individuals with Disabilities Education Act of promoting educational equality and empowerment of children living with a learning disability.
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- 2022
12. Health Communication Patterns and Adherence to a Micronutrient Home Fortification Program in Rural China
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Hein Raat, Hannah Johnstone, Yuju Wu, Yuping Mao, Ruixue Ye, Scott Rozelle, Qingzhi Wang, Chang Sun, Huan Zhou, and Public Health
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Rural Population ,China ,Nutrition and Dietetics ,Poverty ,business.industry ,Ethnic group ,Medicine (miscellaneous) ,Odds ratio ,Micronutrient ,Logistic regression ,Confidence interval ,Cross-Sectional Studies ,Health Communication ,Environmental health ,Humans ,Medicine ,Micronutrients ,business ,Health communication - Abstract
Objectives Examine the association between ethnic health communication patterns and adherence to a micronutrient home fortification program in rural China among 3 distinct ethnic groups. Design Cross-sectional survey conducted in rural western China. Setting Enrolled 283 villages across 6 national poverty counties in rural western China. Participants A total of 1,358 caregiver–children pairs with Han, Tibetan, or Yi ethnic backgrounds. Variables Measured A structured questionnaire was used to collect information on caregiver demographics, program adherence, and health communication about the program. Analysis Logistic regression model was used to examine the associations between health communication patterns and adherence to the program. Results Adherence rates across all ethnic groups were low, 55.5% (229/413) of Han, 55.0% (186/338) of Tibetan, and 47.2% (178/377) of Yi caregivers adhered to the program. Increased adherence was correlated with how each ethnic group received health information. Han caregivers were most influenced by mass media (odds ratio [OR], 1.87; 95% confidence interval [CI], 1.05–3.31), Tibetan caregivers by family (OR, 4.86; 95% CI, 1.45–16.29), and Yi caregivers by village doctors (OR, 6.63; 95% CI, 3.46–12.73). Conclusions and Implications Implementing culturally sensitive health communication strategies will likely improve adherence to home fortification programs among caregivers with distinct ethnic backgrounds.
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- 2022
13. Effect of a pediatric fruit and vegetable prescription program on child dietary patterns, food security, and weight status: a study protocol
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Amy Saxe-Custack, David Todem, James C. Anthony, Jean M. Kerver, Jenny LaChance, and Mona Hanna-Attisha
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Adolescent ,Public Health, Environmental and Occupational Health ,Diet ,Food Supply ,Study Protocol ,Prescriptions ,Food Security ,Fruit ,Vegetables ,Humans ,Public aspects of medicine ,RA1-1270 ,Child ,Poverty ,Fruit and vegetable prescription ,Nutrition - Abstract
Background Although nutrients in fruits and vegetables are necessary for proper development and disease prevention, most US children consume fewer servings than recommended. Prescriptions for fruits and vegetables, written by physicians to exchange for fresh produce, address access and affordability challenges while emphasizing the vital role of diet in health promotion and disease prevention. Michigan’s first fruit and vegetable prescription program (FVPP) exclusively for children was introduced in 2016 at one large pediatric clinic in Flint and expanded to a second clinic in 2018. The program provides one $15 prescription for fresh produce to all pediatric patients at every office visit. Prescriptions are redeemable at a year-round farmers’ market or a local mobile market. The current study will assess the impact of this FVPP on diet, food security, and weight status of youth. Methods Demographically similar pediatric patient groups with varying levels of exposure to the FVPP at baseline will be compared: high exposure (> 24 months), moderate exposure (12–24 months), and no previous exposure. Data collection will focus on youth ages 8–16 years. A total of 700 caregiver-child dyads (one caregiver and one child per household) will be enrolled in the study, with approximately 200 dyads at clinic 1 (high exposure); 200 dyads at clinic 2 (moderate exposure), and 300 dyads at clinic 3 (no previous exposure). Children with no previous exposure will be introduced to the FVPP, and changes in diet, food security, and weight status will be tracked over two years. Specific aims are to (1) compare baseline diet, food security, and weight status between pediatric patients with varying levels of exposure to the FVPP; (2) measure changes in diet, food security, and weight status before and after never-before-exposed children are introduced to the FVPP; and (3) compare mean 12- and 24-month follow-up measures of diet, food security, and weight status in the initial no exposure group to baseline measures in the high exposure group. Discussion Completion of study aims will provide evidence for the effectiveness of pediatric FVPPs and insights regarding the duration and intensity of exposure necessary to influence change. Trial registration The study was registered through clinicaltrials.gov [ID: NCT04767282] on February 23, 2021.
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- 2022
14. Does disability increase households’ health financial risk: evidence from the Uganda demographic and health survey
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Wilfried GUETS and Deepak Kumar Behera
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Health financial risk ,Health (social science) ,Epidemiology ,Socio-Demographic ,Environmental health ,Humans ,Uganda ,I32 ,Poverty ,J71 ,J14 ,Family Characteristics ,Disability ,Research ,Health Policy ,Financial risk ,I14 ,Public Health, Environmental and Occupational Health ,Middle Aged ,C83 ,Cross-Sectional Studies ,J1 ,Household Survey ,Health survey ,Business ,Health Expenditures ,Public aspects of medicine ,RA1-1270 ,Healthcare Payment - Abstract
Background In the last few years, there has been a worldwide commitment to protect the vulnerable individuals from higher financial risk through out-of-pocket (OOP) health expenditure. This study examines the influence of disability and socio-demographic factors on households’ health financial risks in Uganda. Methods We used nationally representative cross-sectional data from the Uganda Demographic and Health Survey (UDHS) collected in 2016 by the Uganda Bureau of Statistics (UBOS) in Uganda. We measured financial risk (households’ health expenditure) by money paid for health care services. We estimated the “probit” model to investigate the effect of disability on health financial risk. Results A total of 19,305 households were included in this study. Almost 32% of households paid money for health care services access, among which 32% paid through out-of-pocket. Almost 41% of household heads were affected by disability. The majority (73%) of families went to the public sector for health care services. The mean age was 45 years (SD ± 15). We find that disability is significantly associated with the household financial risk (p p p Conclusion Our results indicated that disability and household socio-demographic characteristics were associated with health financial risk in Uganda. Identifying families with disability and experiencing difficult living conditions constitute an entry point for health authorities to enhance health coverage progress in low and middle-income countries.
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- 2022
15. The effectiveness of supervision strategies to improve health care provider practices in low- and middle-income countries: secondary analysis of a systematic review
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Rowe, Samantha Y., Ross-Degnan, Dennis, Peters, David H., Holloway, Kathleen A., and Rowe, Alexander K.
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Medicine (General) ,Public Administration ,Research ,Health Personnel ,Performance ,Public Health, Environmental and Occupational Health ,Interrupted Time Series Analysis ,Supervision ,Health workers ,Developing countries ,R5-920 ,Systematic review ,Humans ,Quality improvement ,Public aspects of medicine ,RA1-1270 ,Poverty - Abstract
Background Although supervision is a ubiquitous approach to support health programs and improve health care provider (HCP) performance in low- and middle-income countries (LMICs), quantitative evidence of its effects is unclear. The objectives of this study are to describe the effect of supervision strategies on HCP practices in LMICs and to identify attributes associated with greater effectiveness of routine supervision. Methods We performed a secondary analysis of data on HCP practice outcomes (e.g., percentage of patients correctly treated) from a systematic review on improving HCP performance. The review included controlled trials and interrupted time series studies. We described distributions of effect sizes (defined as percentage-point [%-point] changes) for each supervision strategy. To identify attributes associated with supervision effectiveness, we performed random-effects linear regression modeling and examined studies that directly compared different approaches of routine supervision. Results We analyzed data from 81 studies from 36 countries. For professional HCPs, such as nurses and physicians, primarily working at health facilities, routine supervision (median improvement when compared to controls: 10.7%-points; IQR: 9.9, 27.9) had similar effects on HCP practices as audit with feedback (median improvement: 10.1%-points; IQR: 6.2, 23.7). Two attributes were associated with greater mean effectiveness of routine supervision (p Conclusions Although evidence is limited, to promote more effective supervision, our study supports supervising supervisors and having supervisors engage in problem-solving with HCPs. Supervision’s integral role in health systems in LMICs justifies a more deliberate research agenda to identify how to deliver supervision to optimize its effect on HCP practices.
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- 2022
16. The FACAM study: protocol for a randomized controlled study of an early interdisciplinary intervention to support women in vulnerable positions through pregnancy and the first 5 years of motherhood
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Pontoppidan, Maiken, Nygaard, Lene, Thorsager, Mette, Friis-Hansen, Mette, Davis, Deborah, and Nohr, Ellen Aagaard
- Subjects
Parents ,Medicine (General) ,Medicine (miscellaneous) ,Mothers ,Substance use ,Pregnant ,Early intervention ,Study Protocol ,R5-920 ,Pregnancy ,Humans ,Pharmacology (medical) ,Prospective Studies ,Vulnerable families ,Poverty ,Randomized Controlled Trials as Topic ,Mother ,Multidisciplinary ,High risk ,Infant, Newborn ,Infant ,Disadvantaged populations ,Mother-Child Relations ,Mental Health ,Parent ,Randomized controlled trial ,Female ,Mental health ,Support ,Qualitative - Abstract
Background Inequality in health can have profound short- and long-term effects on a child’s life. Infants develop in a responsive environment, and the relationship between mother and infant begins to develop during pregnancy. The mother’s ability to bond with the fetus and newborn child may be challenged by mental health issues which can cause impaired functioning and poorer health outcomes. Families with complex problems need interdisciplinary interventions starting in early pregnancy to be prepared for motherhood and to ensure healthy child development. This study aims to examine the effects of an early and coordinated intervention (the Family Clinic and Municipality (FACAM) intervention) offered to vulnerable pregnant women during pregnancy and the child’s first year of life on the mother-child relationship, maternal social functioning, mental health, reflective functioning, well-being, parental stress, and the development and well-being of the child. Methods The study is a prospective randomized controlled trial where we will randomize 320 pregnant women enrolled to receive antenatal care at the family clinic at Odense University Hospital, to either FACAM intervention or usual care. The FACAM intervention consists of extra support by a health nurse or family therapist during pregnancy and until the child starts school. The intervention is most intensive in the first 12 months and also includes attachment-based support provided either individually or in groups. The participants are assessed at baseline, and when the infant is 3 and 12 months old. The primary outcome is maternal sensitivity measured by the Coding Interactive Behavior (CIB) instrument. Secondary outcomes include prenatal parental reflective functioning, mental well-being, depressive symptoms, breastfeeding duration, maternal satisfaction, child development, parent competence, parental stress, and activities with the child. Discussion The trial is expected to contribute knowledge about the effect of early coordinated support in antenatal and postnatal care for vulnerable pregnant women and their families. Trial registration ClinicalTrials.gov NCT03659721. Registered on September 6, 2018
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- 2022
17. Psychological patterns of poverty in Russia
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Olga Poluektova, Maria Efremova, Seger M. Breugelmans, and Department of Social Psychology
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VALUES ,Wellbeing ,MOTIVATION ,General Medicine ,Self-Control ,POVERTY ,Russia ,socioeconomic conditions ,SELF-REGULATION ,Arts and Humanities (miscellaneous) ,Social Class ,Socioeconomic Factors ,Humans ,Child ,General Psychology ,Network Analysis - Abstract
This article aims to extend our understanding of the link between socioeconomic conditions and psychological variables. It focuses on the effects of five distinct socioeconomic indicators on a range of psychological variables in samples of 162 individuals living below the poverty line and 188 of their more well-off counterparts in Russia. Participants completed a questionnaire containing measures of socioeconomic indicators (i.e., income, education, perceived deprivation, subjective socioeconomic status, and childhood socioeconomic status) and psychological variables representing self-regulation, motivation, and well-being. Our main findings include: (a) significant effects of socioeconomic status on all psychological variables, which are in line with other studies seeking to answer similar questions, (b) varying importance of different socioeconomic indicators for different psychological variables, and (c) centrality of all socioeconomic indicators except childhood socioeconomic status, and of values of openness to change and self-transcendence, satisfaction with life and self-esteem in the network of relationships between socioeconomic indicators and psychological variables.
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- 2022
18. Widening or narrowing income inequalities in myocardial infarction? Time trends in life years free of myocardial infarction and after incidence
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Juliane Tetzlaff, Fabian Tetzlaff, Siegfried Geyer, Stefanie Sperlich, and Jelena Epping
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Male ,Epidemiology ,Research ,Incidence ,Computer applications to medicine. Medical informatics ,Public Health, Environmental and Occupational Health ,R858-859.7 ,Income inequalities ,Health expectancies ,Middle Aged ,Myocardial infarction ,Socioeconomic Factors ,Germany ,Income ,Humans ,Female ,Mortality ,Public aspects of medicine ,RA1-1270 ,Poverty ,Aged - Abstract
Background Despite substantial improvements in prevention and therapy, myocardial infarction (MI) remains a frequent health event, causing high mortality and serious health impairments. Previous research lacks evidence on how social inequalities in incidence and mortality risks developed over time, and on how these developments affect the lifespan free of MI and after MI in different social subgroups. This study investigates income inequalities in MI-free life years and life years after MI and whether these inequalities widened or narrowed over time. Methods The analyses are based on claims data of a large German health insurance provider insuring approximately 2.8 million individuals in the federal state Lower Saxony. Trends in income inequalities in incidence and mortality were assessed for all subjects aged 60 years and older by comparing the time periods 2006–2008 and 2015–2017 using multistate survival models. Trends in the number of life years free of MI and after MI were calculated separately for income groups by applying multistate life table analyses. Results MI incidence and mortality risks decreased over time, but declines were strongest among men and women in the higher-income group. While life years free of MI increased in men and women with higher incomes, no MI-free life years were gained in the low-income group. Among men, life years after MI increased irrespective of income group. Conclusions Income inequalities in the lifespan spent free of MI and after MI widened over time. In particular, men with low incomes are disadvantaged, as life years spent after MI increased, but no life years free of MI were gained.
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- 2021
19. The impact of financial incentives and restrictions on cyclical food expenditures among low-income households receiving nutrition assistance: a randomized controlled trial
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Sruthi Valluri, Susan M. Mason, Hikaru Hanawa Peterson, Simone A. French, and Lisa J. Harnack
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Benefit cycle ,Motivation ,Nutrition and Dietetics ,RC620-627 ,Research ,Cyclical food expenditures ,Medicine (miscellaneous) ,Physical Therapy, Sports Therapy and Rehabilitation ,United States ,Supplemental nutrition assistance program ,Financial restrictions ,Vegetables ,Humans ,Financial incentives ,Food Assistance ,Health Expenditures ,Public aspects of medicine ,RA1-1270 ,Nutritional diseases. Deficiency diseases ,Poverty - Abstract
Background The Supplemental Nutrition Assistance Program (SNAP) is the largest anti-hunger program in the United States. Two proposed interventions to encourage healthier food expenditures among SNAP participants have generated significant debate: financial incentives for fruits and vegetables, and restrictions on foods high in added sugar. To date, however, no study has assessed the impact of these interventions on the benefit cycle, a pattern of rapid depletion of SNAP benefits that has been linked to worsening nutrition and health outcomes over the benefit month. Methods Low-income households not currently enrolled in SNAP (n = 249) received benefits every 4 weeks for 12 weeks on a study-specific benefit card. Households were randomized to one of four study arms: 1) incentive (30% incentive for fruits and vegetables purchased with study benefits), 2) restriction (not allowed to buy sugar-sweetened beverages, sweet baked goods, or candy using study benefits), 3) incentive plus restriction, or 4) control (no incentive or restriction). Weekly household food expenditures were evaluated using generalized estimating equations. Results Compared to the control group, financial incentives increased fruit and vegetable purchases, but only in the first 2 weeks after benefit disbursement. Restrictions decreased expenditures on foods high in added sugar throughout the benefit month, but the magnitude of the impact decreased as the month progressed. Notably, restrictions mitigated cyclical expenditures. Conclusions Policies to improve nutrition outcomes among SNAP participants should consider including targeted interventions in the second half of the month to address the benefit cycle and attendant nutrition outcomes. Trial registration ClinicalTrial.gov, NCT02643576. Retrospectively registered December 22, 2014.
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- 2021
20. Cost Evaluation of Minimally Invasive Tissue Sampling (MITS) Implementation in Low- and Middle-Income Countries
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Laura T R Morrison, Elizabeth G Brown, Christina R Paganelli, Suraj Bhattarai, Rahell Hailu, Gervais Ntakirutimana, Djibril Mbarushimana, Nuwadatta Subedi, and Norman Goco
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Microbiology (medical) ,mortality surveillance ,costs ,Supplement Articles ,LMICs ,Infectious Diseases ,AcademicSubjects/MED00290 ,MITS ,Cause of Death ,Income ,Humans ,Autopsy ,Developing Countries ,Poverty - Abstract
Background Low- and middle-income countries (LMICs) face disproportionately high mortality rates, yet the causes of death in LMICs are not robustly understood, limiting the effectiveness of interventions to reduce mortality. Minimally invasive tissue sampling (MITS) is a standardized postmortem examination method that holds promise for use in LMICs, where other approaches for determining cause of death are too costly or unacceptable. This study documents the costs associated with implementing the MITS procedure in LMICs from the healthcare provider perspective and aims to inform resource allocation decisions by public health decisionmakers. Methods We surveyed 4 sites in LMICs across Sub-Saharan Africa and South Asia with experience conducting MITS. Using a bottom-up costing approach, we collected direct costs of resources (labor and materials) to conduct MITS and the pre-implementation costs required to initiate MITS. Results Initial investments range widely yet represent a substantial cost to implement MITS and are determined by the existing infrastructure and needs of a site. The costs to conduct a single case range between $609 and $1028 per case and are driven by labor, sample testing, and MITS supplies costs. Conclusions Variation in each site’s use of staff roles and testing protocols suggests sites conducting MITS may adapt use of resources based on available expertise, equipment, and surveillance objectives. This study is a first step toward necessary examinations of cost-effectiveness, which may provide insight into cost optimization and economic justification for the expansion of MITS.
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- 2021
21. Chronic airflow obstruction and ambient particulate air pollution
- Author
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Hamid Hacene Cherkaski, Rain Jõgi, Peter Burney, Eric D. Bateman, Terence A. R. Seemungal, Rune Nielsen, Gregory E. Erhabor, Filip Mejza, Padukudru Anand Mahesh, David M. Mannino, Asaad Ahmed Nafees, Amund Gulsvik, Guy B. Marks, Cosetta Minelli, Louisa Gnatiuc, Cristina Bárbara, Thorarinn Gislason, Mohammed Al Ghobain, Althea Aquart-Stewart, Meriam Denguezli, Ali Kocabas, Tobias Welte, Christer Janson, Kevin Mortimer, Herve Lawin, Andre F.S. Amaral, Emiel F.M. Wouters, Imed Harrabi, A. Sonia Buist, Jaymini Patel, O.F. Awopeju, Michael Studnicka, Talant Sooronbaev, Li Cher Lo, Daniel O. Obaseki, Elaine Fuertes, Sanjay Juvekar, Bertrand Hugo Mbatchou Ngahane, Asma El Sony, Parvaiz A Koul, Wan C. Tan, RS: NUTRIM - R3 - Respiratory & Age-related Health, Pulmonologie, MUMC+: MA Longziekten (3), Repositório da Universidade de Lisboa, Group, The BOLD (Burden of Obstructive Lung Disease) Collaborative Research, and Wellcome Trust
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Pulmonary and Respiratory Medicine ,wa_754 ,Male ,Passive smoking ,Respiratory Medicine and Allergy ,Respiratory System ,wa_750a ,010501 environmental sciences ,Airflow obstruction ,medicine.disease_cause ,Brief Communication ,01 natural sciences ,03 medical and health sciences ,Arbetsmedicin och miljömedicin ,Pulmonary Disease, Chronic Obstructive ,0302 clinical medicine ,Environmental health ,BOLD (Burden of Obstructive Lung Disease) Collaborative Research Group members ,Air Pollution ,Medicine ,Humans ,0105 earth and related environmental sciences ,Lungmedicin och allergi ,Air Pollutants ,Science & Technology ,Poverty ,business.industry ,Tobacco control ,1103 Clinical Sciences ,Dust ,Occupational Health and Environmental Health ,Environmental Exposure ,Particulates ,Particulate air pollution ,medicine.disease ,Obstructive lung disease ,BOLD (Burden of Obstructive Lung Disease) Collaborative Research Group ,PREVALENCE ,Gross national income ,030228 respiratory system ,wf_140 ,Female ,Particulate Matter ,business ,COPD epidemiology ,Life Sciences & Biomedicine ,wf_600 - Abstract
© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/., Smoking is the most well-established cause of chronic airflow obstruction (CAO) but particulate air pollution and poverty have also been implicated. We regressed sex-specific prevalence of CAO from 41 Burden of Obstructive Lung Disease study sites against smoking prevalence from the same study, the gross national income per capita and the local annual mean level of ambient particulate matter (PM2.5) using negative binomial regression. The prevalence of CAO was not independently associated with PM2.5 but was strongly associated with smoking and was also associated with poverty. Strengthening tobacco control and improved understanding of the link between CAO and poverty should be prioritised., Supported by Wellcome Trust grant 085790/Z/08/Z for the BOLD (Burden of Obstructive Lung Disease) Study. The initial BOLD programprogramme was funded in part by unrestricted educational grants to the Operations CenterCentre in Portland, Oregon from Altana, Aventis, AstraZeneca, Boehringer Ingelheim, Chiesi, GlaxoSmithKline, Merck, Novartis, Pfizer, Schering-Plough, Sepracor, and the University of Kentucky (Lexington, KY). A full list of local funders can be found at https://www.boldstudy.org.
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- 2021
22. A multidimensional model of healthy ageing: proposal and evaluation of determinants based on a population survey in Ecuador
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Jessica Villavicencio, Patricio Buendía, José David Caicedo-Gallardo, María F. Rivadeneira, and María José Mendieta
- Subjects
Gerontology ,Aging ,Cross-sectional study ,Quantitative research methods ,medicine.medical_treatment ,Health Status ,Population ,Logistic regression ,Healthy Aging ,Healthy ageing ,Medicine ,Humans ,education ,Socioeconomic status ,Aged ,education.field_of_study ,Rehabilitation ,Poverty ,business.industry ,Research ,RC952-954.6 ,Life satisfaction ,Multidimensional approach ,Cross-Sectional Studies ,Ageing ,Geriatrics ,Female ,Ecuador ,Geriatrics and Gerontology ,business - Abstract
Background Healthy ageing is a complex construct which involves multiple dimensions. Previous studies of healthy ageing have focused only on measuring the intrinsic capacity of the older person. The objectives of this study were to design a multidimensional model of healthy ageing and to identify its determinants from national data in Ecuador. Methods A cross-sectional analytical study was carried out from the National Survey of Health and Well-being of the Older Adult, 2010. Sample was 1797 adults aged 65 years or more. A multidimensional model was designed based on the World Health Organization’s concept of healthy ageing. For the analysis, two groups were created: a healthy ageing and a less healthy ageing group. Bivariate and multivariate logistic regressions were performed to analyze the probability of belonging to the healthy group according to sex, age, area of residence, level of education, perceived health status, perceived life satisfaction, and poverty by income level. Results The 53.15% of the sample was classified in the healthy ageing group. Women and the poorest older adults were less likely to be in the healthy ageing group (OR 0.58; 95% CI 0.464–0.737; OR 0.44; 95% CI 0.343–0.564). Older adults with secondary education or higher, who considered their health as excellent and who were satisfied with their life, had a greater probability of being in healthy ageing group (OR 2.61; 95% CI 1.586–4.309; OR 28.49; 95% CI 3.623–224.02; OR 0.23; 95% CI 0.165–0.341). Conclusions This study contributes with a multidimensional approach to healthy ageing. It proposes to evaluate the intrinsic capacity of the individual, the social and political environment and the interaction with it, through indicators that discriminate who are ageing in a healthy way and who are not. By using this model, it was identified that gender and economic situation seem to play an important role on heathy ageing of the Ecuadorian population. Public policies are necessary to promote healthy ageing, especially focused on improving socioeconomic conditions and gender equity.
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- 2021
23. Food Security, Conflict, and COVID-19: Perspective from Afghanistan
- Author
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Sudhan Rackimuthu, Mohammad Yasir Essar, Mohammad Mehedi Hasan, Zarmina Islam, Arash Nemat, Utkarsha Uday, Maryam Salma Babar, and Diana Mutasem Kokash
- Subjects
Coronavirus disease 2019 (COVID-19) ,United Nations ,media_common.quotation_subject ,Recession ,Perspective Piece ,State (polity) ,Virology ,Political science ,Development economics ,Pandemic ,Humans ,media_common ,Food security ,Poverty ,Perspective (graphical) ,Afghanistan ,COVID-19 ,Armed Conflicts ,Dietary Requirements ,Infectious Diseases ,Economic Recession ,Socioeconomic Factors ,Food Security ,Unemployment ,Parasitology ,Food Assistance - Abstract
Afghanistan, a country challenged by war and conflicts, has been in a state of turmoil for several years. The prolonged suffering has brought many challenges to the country’s inhabitants. Among these, food security is one important cause for concern. Food security occurs when people continuously have physical and economic access to adequate, safe, and nutritious food to meet their dietary requirements and food preferences for a functional and healthy life. Amid the pandemic, Afghanistan has witnessed a large increase in food shortages due to its dependence on neighboring countries. In light of current circumstances, food insecurity, coupled with political instability and the third wave of the COVID-19, have made it extremely hard for people to access daily provisions. Hence, people are left to navigate the COVID-19 pandemic with economic recession and poverty as the backdrop of the other health crises. To mitigate food security, international attempts are the required at this critical juncture. The aim of this article is to understand the causes leading to food insecurity and its implications in Afghanistan and to propose solutions that will improve the overall food security at the policy and implementation levels.
- Published
- 2021
24. Understanding urban inequalities in children’s linear growth outcomes: a trend and decomposition analysis of 39,049 children in Bangladesh (2000-2018)
- Author
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Hayman Win, Nicole Probst-Hensch, Günther Fink, and Jordyn Wallenborn
- Subjects
medicine.medical_specialty ,Population ,Child Nutrition Disorders ,Thinness ,medicine ,Humans ,Child ,education ,Socioeconomic status ,Growth Disorders ,Health equity ,Child nutrition ,Linear growth ,education.field_of_study ,Stunting ,Bangladesh ,Poverty ,business.industry ,Research ,Public health ,Public Health, Environmental and Occupational Health ,Place of birth ,medicine.disease ,Malnutrition ,Socioeconomic Factors ,Female ,Underweight ,medicine.symptom ,Public aspects of medicine ,RA1-1270 ,business ,Urban health ,Demography - Abstract
Background Despite significant progress in reducing child undernutrition, Bangladesh remains among the top six countries globally with the largest burden of child stunting and has disproportionately high stunting prevalence among the urban poor. We use population representative data to identify key predictors of child stunting in Bangladesh and assess their contributions to linear growth differences observed between urban poor and non-poor children. Methods We combined six rounds of Demographic and Health Survey data spanning 2000-2018 and used official poverty rates to classify the urban population into poor and non-poor households. We identified key stunting determinants using stepwise selection method. Regression-decomposition was used to quantify contributions of these key determinants to poverty-based intra-urban differences in child linear growth status. Results Key stunting determinants identified in our study predicted 84% of the linear growth difference between urban poor and non-poor children. Child’s place of birth (27%), household wealth (22%), maternal education (18%), and maternal body mass index (11%) were the largest contributors to the intra-urban child linear growth gap. Difference in average height-for-age z score between urban poor and non-poor children declined by 0.31 standard deviations between 2000 and 2018. About one quarter of this observed decrease was explained by reduced differentials between urban poor and non-poor in levels of maternal education and maternal underweight status. Conclusions Although the intra-urban disparity in child linear growth status declined over the 2000-2018 period, socioeconomic gaps remain significant. Increased nutrition-sensitive programs and investments targeting the urban poor to improve girls’ education, household food security, and maternal and child health services could aid in further narrowing the remaining linear growth gap.
- Published
- 2021
25. Homeless encampments: connecting public health and human rights
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Bernadette Pauly and Nicholas Olson
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Economic growth ,medicine.medical_specialty ,logement ,Human Rights ,media_common.quotation_subject ,Public policy ,Health Promotion ,Special Section on COVID-19: Commentary ,Santé publique ,Criminalization ,Right to housing ,Political science ,Affordable housing ,Tent cities ,medicine ,Humans ,Social determinants of health ,sans-abrisme ,villages de tentes ,Pandemics ,media_common ,droits de l’homme ,Public health ,Poverty ,Human rights ,SARS-CoV-2 ,Encampments ,Public Health, Environmental and Occupational Health ,COVID-19 ,Homelessness ,campements ,General Medicine ,Ill-Housed Persons ,Housing - Abstract
The COVID-19 pandemic is exacerbating longstanding issues related to homelessness, including lack of affordable housing, unemployment, poverty, wealth inequality, and ongoing impacts of colonization. Homelessness is often accompanied by narratives rooted in individual blame, criminalization, and reinforcement of substance use and mental health-related stigma. Visible homelessness, in the form of encampments, is a manifestation of government policy failures that neglect to uphold the human right to housing, and demonstrate eroding investments in affordable housing, income and systemic supports. Encampments make visible that some in our community lack basic determinants of health such as food, water, sanitation, safety, and the right to self-determination. In order for public health to effectively and equitably promote health and enact commitments to social justice, we argue that public health must adopt a human rights approach to housing and to homeless encampments. Embracing a human rights perspective means public health would advocate first and foremost for adequate housing and other resources rooted in self-determination of encampment residents. In the absence of housing, public health would uphold human rights through the provision of public health resources and prohibition on evictions of encampments until adequate housing is available.RéSUMé: La pandémie de COVID-19 exacerbe des problèmes de longue date liés au sans-abrisme, dont le manque de logements abordables, le chômage, la pauvreté, l’inégalité de richesse et les impacts continus de la colonisation. Le sans-abrisme s’accompagne souvent de discours narratifs ancrés dans le blâme personnel, la criminalisation et le renforcement de la stigmatisation de l’usage de substances et des troubles de santé mentale. Le sans-abrisme visible, qui prend la forme des campements, est un constat d’échec des politiques gouvernementales qui négligent de faire respecter le droit fondamental au logement, et il démontre l’érosion des investissements dans les logements abordables, le soutien du revenu et le soutien systémique. Les campements rendent visible le fait qu’il manque à certains membres de la collectivité les déterminants de base de la santé, comme la nourriture, l’eau, les installations sanitaires, la sécurité et le droit à l’autodétermination. Pour que la santé publique fasse efficacement et équitablement la promotion de la santé et pour qu’elle donne suite à ses engagements envers la justice sociale, nous faisons valoir qu’elle doit aborder le logement et les campements de sans-abri selon une approche fondée sur les droits humains. L’adoption d’une perspective axée sur les droits humains signifie que la santé publique doit d’abord et avant tout plaider en faveur de ressources, dont des logements adéquats, ancrées dans l’autodétermination des résidents des campements. En l’absence de logements, la santé publique devrait faire respecter les droits humains par la mise à disposition de ses ressources et par l’interdiction des expulsions des campements jusqu’à ce que des logements adéquats deviennent disponibles.
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- 2021
26. Accelerating Sustainable Development Goals for South African adolescents from high HIV prevalence areas: a longitudinal path analysis
- Author
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Mark Orkin, Lucie Cluver, Franziska Meinck, Department of Psychiatry and Mental Health, and Faculty of Health Sciences
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Child abuse ,Cash transfers ,Adolescent ,child abuse ,Psychological intervention ,Sustainable Development Goals ,HIV Infections ,Violence prevention ,social protection ,Adolescents ,food sufficiency ,South Africa ,accelerators ,Acquired immunodeficiency syndrome (AIDS) ,parenting ,Environmental health ,Prevalence ,medicine ,Humans ,Measurement invariance ,adolescents ,Prospective Studies ,Path analysis (statistics) ,Poverty ,Parenting ,business.industry ,General Medicine ,Sustainable Development ,sustainable development goals ,medicine.disease ,Mental health ,Social protection ,Food sufficiency ,violence prevention ,HIV/AIDS ,Medicine ,Female ,business ,Goals ,mental health ,Accelerators ,Research Article - Abstract
Background Adolescents experience a multitude of vulnerabilities which need to be addressed in order to achieve the Sustainable Development Goals (SDGs). In sub-Saharan Africa, adolescents experience high burden of HIV, violence exposure, poverty, and poor mental and physical health. This study aimed to identify interventions and circumstances associated with three or more targets (“accelerators”) within multiple SDGs relating to HIV-affected adolescents and examine cumulative effects on outcomes. Methods Prospective longitudinal data from 3401 adolescents from randomly selected census enumeration areas in two provinces with > 30% HIV prevalence carried out in 2010/11 and 2011/12 were used to examine six hypothesized accelerators (positive parenting, parental monitoring, free schooling, teacher support, food sufficiency and HIV-negative/asymptomatic caregiver) targeting twelve outcomes across four SDGs, using a multivariate (multiple outcome) path model with correlated outcomes controlling for outcome at baseline and socio-demographics. The study corrected for multiple-hypothesis testing and tested measurement invariance across sex. Percentage predicted probabilities of occurrence of the outcome in the presence of the significant accelerators were also calculated. Results Sample mean age was 13.7 years at baseline, 56.6% were female. Positive parenting, parental monitoring, food sufficiency and AIDS-free caregiver were variously associated with reductions on ten outcomes. The model was gender invariant. AIDS-free caregiver was associated with the largest reductions. Combinations of accelerators resulted in a percentage reduction of risk of up to 40%. Conclusion Positive parenting, parental monitoring, food sufficiency and AIDS-free caregivers by themselves and in combination improve adolescent outcomes across ten SDG targets. These could translate to the corresponding real-world interventions parenting programmes, cash transfers and universal access to antiretroviral treatment, which when provided together, may help governments in sub-Saharan Africa more economically to reach their SDG targets.
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- 2021
27. Infectious Diseases of Poverty: 10 years’ commitment to One Health
- Author
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Xiao-Nong Zhou
- Subjects
medicine.medical_specialty ,Poverty ,Diseases of poverty ,Public health ,Public Health, Environmental and Occupational Health ,MEDLINE ,General Medicine ,Infectious and parasitic diseases ,RC109-216 ,Communicable Diseases ,Infectious Diseases ,One Health ,Editorial ,Political science ,Environmental health ,Tropical medicine ,medicine ,Humans ,Public aspects of medicine ,RA1-1270 - Published
- 2021
28. Geographical drivers and climate-linked dynamics of Lassa fever in Nigeria
- Author
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Kate E. Jones, Lauren A. Attfield, Rimamdeyati Yashe, Saliu Oladele, Akanimo Iniobong, Christl A. Donnelly, Chikwe Ihekweazu, Elsie Ilori, Chioma Dan-Nwafor, Michael Amedu, Rory Gibb, David W. Redding, Ibrahim Abubakar, Medical Research Council (MRC), and National Institute for Health Research
- Subjects
medicine.medical_specialty ,Epidemiology ,Climate ,viruses ,Science ,General Physics and Astronomy ,Nigeria ,Disease ,General Biochemistry, Genetics and Molecular Biology ,Article ,Lassa Fever ,Spatio-Temporal Analysis ,Urbanization ,Environmental health ,medicine ,Animals ,Humans ,Computational models ,Lassa fever ,Baseline (configuration management) ,Lassa virus ,Poverty ,Disease Reservoirs ,Retrospective Studies ,Ecological epidemiology ,Multidisciplinary ,Geography ,Incidence (epidemiology) ,Public health ,Incidence ,General Chemistry ,medicine.disease ,Viral infection ,Epidemiological Monitoring ,Murinae - Abstract
Lassa fever is a longstanding public health concern in West Africa. Recent molecular studies have confirmed the fundamental role of the rodent host (Mastomys natalensis) in driving human infections, but control and prevention efforts remain hampered by a limited baseline understanding of the disease’s true incidence, geographical distribution and underlying drivers. Here, we show that Lassa fever occurrence and incidence is influenced by climate, poverty, agriculture and urbanisation factors. However, heterogeneous reporting processes and diagnostic laboratory access also appear to be important drivers of the patchy distribution of observed disease incidence. Using spatiotemporal predictive models we show that including climatic variability added retrospective predictive value over a baseline model (11% decrease in out-of-sample predictive error). However, predictions for 2020 show that a climate-driven model performs similarly overall to the baseline model. Overall, with ongoing improvements in surveillance there may be potential for forecasting Lassa fever incidence to inform health planning., Lassa Fever is a rodent-borne viral haemorrhagic fever that is a public health problem in West Africa. Here, the authors develop a spatiotemporal model of the socioecological drivers of disease using surveillance data from Nigeria, and find evidence of climate sensitivity.
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- 2021
29. School Supports for Reintegration Following a Suicide-Related Crisis: A Mixed Methods Study Informing Hospital Recommendations for Schools During Discharge
- Author
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Megan Rauch Griffard, Emily N. Toole, Marisa E. Marraccini, and Cari Pittleman
- Subjects
medicine.medical_specialty ,Adolescent ,medicine.medical_treatment ,education ,Psychological intervention ,Ethnic group ,Stigma (botany) ,Adolescents ,Mental health policy ,medicine ,Psychoeducation ,Humans ,Students ,Original Paper ,Schools ,Poverty ,Public health ,Mental health ,Hospitals ,Patient Discharge ,United States ,Psychiatry and Mental health ,Suicide ,Family medicine ,School reintegration ,Rural area ,Psychology - Abstract
The immediate period following psychiatric hospitalization is marked by increased risk for suicide behavior and rehospitalization. Because adolescents commonly return to school settings following hospital discharge, school-related stressors and supports are important considerations for psychiatric treatment and discharge planning. The current study aimed to inform recommendations provided by hospitals to schools to improve school reintegration practices by employing a concurrent, mixed-methods design. Specifically, we: (1) surveyed school professionals (n = 133) in schools varying in resource availability and populations in one southeastern state of the United States about supports and services provided to returning students; and (2) conducted in-depth interviews with a subset of these professionals (n = 19) regarding their perceptions of the hospital to school transition for youth recovering from suicide-related crises. Findings from survey responses indicated that, compared to schools located in urban and suburban areas, schools in rural areas were less likely to have school reintegration protocols for returning students. More generally, however, available interventions and modifications were relatively consistent across rural and urban/suburban schools, schools serving high and low poverty communities, and schools with predominantly white and predominantly ethnic and racial minoritized student bodies. Key themes across interviews signify the importance of communication between stakeholders, the type of information used to develop re-entry plans, available school-based services for returning youth, and the need to mitigate stigma associated with mental health crises. Findings inform recommendations that can be provided by hospitals to schools to support adolescent recovery as they return to school following psychiatric hospitalization. Supplementary Information The online version contains supplementary material available at 10.1007/s11126-021-09942-7.
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- 2021
30. Empirical analysis of socio-economic determinants of maternal health services utilisation in Burundi
- Author
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Desire Habonimana and Neha Batura
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Postnatal Care ,Adult ,medicine.medical_specialty ,Burundi ,Reproductive medicine ,Antenatal care ,Young Adult ,Health facility ,Pregnancy ,Environmental health ,Health care ,medicine ,Childbirth ,Humans ,Maternal Health Services ,Socio-economic determinants ,reproductive and urinary physiology ,Demography ,Poverty ,Marital Status ,business.industry ,Research ,Obstetrics and Gynecology ,Prenatal Care ,Gynecology and obstetrics ,Middle Aged ,Patient Acceptance of Health Care ,Parity ,Socioeconomic Factors ,Income ,Neonatal health ,RG1-991 ,Marital status ,Educational Status ,Female ,Maternal health ,Live birth ,business ,Facilities and Services Utilization - Abstract
BackgroundTimely and appropriate health care during pregnancy and childbirth are the pillars of better maternal health outcomes. However, factors such as poverty and low education levels, long distances to a health facility, and high costs of health services may present barriers to timely access and utilisation of maternal health services. Despite antenatal care (ANC), delivery and postnatal care being free at the point of use in Burundi, utilisation of these services remains low: between 2011 and 2017, only 49% of pregnant women attended at least four ANC visits. This study explores the socio-economic determinants that affect utilisation of maternal health services in Burundi.MethodsWe use data from the 2016–2017 Burundi Demographic and Health Survey (DHS) collected from 8941 women who reported a live birth in the five years that preceded the survey. We use multivariate regression analysis to explore which individual-, household-, and community-level factors determine the likelihood that women will seek ANC services from a trained health professional, the number of ANC visits they make, and the choice of assisted childbirth.ResultsOccupation, marital status, and wealth increase the likelihood that women will seek ANC services from a trained health professional. The likelihood that a woman consults a trained health professional for ANC services is 18 times and 16 times more for married women and women living in partnership, respectively. More educated women and those who currently live a union or partnership attend more ANC visits than non-educated women and women not in union. At higher birth orders, women tend to not attend ANC visits. The more ANC visits attended, and the wealthier women are; the more likely they are to have assisted childbirth. Women who complete four or more ANC visits are 14 times more likely to have an assisted childbirth.ConclusionsIn Burundi, utilisation of maternal health services is low and is mainly driven by legal union and wealth status. To improve equitable access to maternal health services for vulnerable population groups such as those with lower wealth status and unmarried women, the government should consider certain demand stimulating policy packages targeted at these groups.
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- 2021
31. Mapping the health systems response to violence against women: key learnings from five LMIC settings (2015–2020)
- Author
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Rakhi Ghoshal, Chandni Jaishwal, Nobhojit Roy, Shegufta Shefa Sikder, and Padma Bhate-Deosthali
- Subjects
medicine.medical_specialty ,Reproductive medicine ,Staffing ,Violence ,Documentation ,Nursing ,Gender-based violence ,medicine ,Humans ,Developing Countries ,Poverty ,Health policy ,Data collection ,Sexual violence ,Medical Assistance ,Low- and middle-income countries ,business.industry ,Research ,Health Policy ,Obstetrics and Gynecology ,General Medicine ,Entry point ,Gynecology and obstetrics ,Health system response ,Violence against women ,Reproductive Medicine ,Scale (social sciences) ,RG1-991 ,Female ,Public aspects of medicine ,RA1-1270 ,business ,One-stop centers - Abstract
Background Violence against women (VAW) is a global challenge, and the health sector is a key entry point for survivors to receive care. The World Health Organization adopted an earlier framework for health systems response to survivors. However, documentation on the programmatic rollout of health system response to violence against women is lacking in low and middle-income countries. This paper studies the programmatic roll out of the health systems response across select five low- and middle-income countries (LMIC) and identifies key learnings. Methods We selected five LMIC settings with recent or active programming on national-level health system response to VAW from 2015 to 2020. We synthesized publicly available data and program reports according to the components of the WHO Health Systems Framework. The countries selected are Bangladesh, Brazil, Nepal, Rwanda, and Sri Lanka. Results One-stop centers were found to be the dominant model of care located in hospitals in four countries. Each setting has implemented in-service training as key to addressing provider knowledge, attitudes and practice; however, significant gaps remain in addressing frequent staff turnover, provision of training at scale, and documentation of the impact of training. The health system protocols for VAW address sexual violence but do not uniformly include clinical and health policy responses for emotional or economic violence. Providing privacy to survivors within health facilities was a universal challenge. Conclusion Significant efforts have been made to address provider attitudes towards provision of care and to protocolize delivery of care to survivors, primarily through one-stop centers. Further improvements can be made in data collection on training impact on provider attitudes and practices, in provider identification of VAW survivors, and in prioritization of VAW within health system budgeting, staffing, and political priorities. Primary health facilities need to provide first-line support for survivors to avoid delays in response to all forms of VAW as well as for secondary prevention.
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- 2021
32. Developing and Testing Strategies for Improving Cleanliness of Shared Sanitation in Low-Income Settlements of Kisumu, Kenya
- Author
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Kwaku Amaning Adjei, Prince Antwi-Agyei, Raphael Kweyu, and Sheillah Simiyu
- Subjects
Low income ,Male ,Sanitation ,Psychological intervention ,Collective action ,Behavior Therapy ,Stakeholder Participation ,Virology ,Human settlement ,Humans ,Toilet Facilities ,Environmental planning ,Poverty ,Monitoring Plan ,Community Participation ,Monitoring system ,Hygiene ,Articles ,Kenya ,Household Work ,Infectious Diseases ,Parasitology ,Female ,Business ,Social capital - Abstract
Sharing of sanitation is common in low-income settlements in Sub-Saharan Africa. However, shared (limited) sanitation facilities have been thought to pose health risks due to poor hygiene levels. Interventions to improve user behavior and cleanliness of shared sanitation are few, both in literature and in practice. This study details the codesign and testing of strategies to improve the cleanliness of shared sanitation facilities in low-income areas of Kisumu City in Kenya. The strategies included a cleaning plan, monitoring system, and discussions among users, and were codesigned through workshops with stakeholders and group discussions with landlords and tenants. These strategies were tested in 38 compound houses through the Trials of Improved Practices approach over a 5-month period. Field staff visited the compounds, observed the cleanliness of the shared toilets, and through discussions, encouraged users to develop a formal cleaning system and a monitoring plan. The discussions built social capital and collective action and facilitated uptake of the cleaning plan with notable improvements in cleanliness of shared toilets. The results support the acceptability of shared sanitation in low-income settlements, the importance of codesigning and coproducing solutions with users, and the need to evaluate the effects of these strategies on cleanliness of shared sanitation.
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- 2021
33. Community-based rehabilitation implementation for people with disabilities in South Africa: a protocol for a scoping review
- Author
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Saul Cobbing, Verusia Chetty, and Sithembiso B Blose
- Subjects
People with disabilities ,Human Rights ,Community-based rehabilitation ,media_common.quotation_subject ,Population ,Medicine (miscellaneous) ,Context (language use) ,South Africa ,Protocol ,Humans ,Mass Screening ,Medicine ,Disabled Persons ,education ,Empowerment ,Research question ,media_common ,education.field_of_study ,Poverty ,business.industry ,Public relations ,Review Literature as Topic ,Systematic review ,business ,Delivery of Health Care ,Inclusion (education) ,Systematic Reviews as Topic - Abstract
Background People with disabilities (PWDs) remain among the poorest and least empowered population. They experience limited access to basic services, especially in low- and middle-income countries (LMIC). The infringement of their human rights remains at an alarming level, despite the availability of the community-based rehabilitation (CBR) strategy and the United Nations Convention on the Rights of People with Disabilities (UNCRPD). CBR, as a strategy for poverty alleviation, social inclusion and equalisation of opportunity, has broadened its scope from a mere strategy for access to health and rehabilitation services to include education, livelihood, social inclusivity and empowerment. CBR is implemented across the world in the majority of LMIC signatories to the UNCRPD. South Africa is among the countries that are implementing CBR. However, the extent and the nature of implementation is not known. This study, therefore, aims to map out the empirical evidence of the implementation of CBR in South Africa. Method The study is a scoping review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extended for Scoping Review (PRISMA-ScR) methodology. The information will be extracted and captured on a data charting template that will be used through each phase of the study. The review will be guided by the following research question validated by the amended population-concept-context framework according to the Joanna Briggs Institute methodology for scoping reviews: ‘An investigation into CBR implementation in South Africa.’ The search will be conducted in the following electronic databases Google Scholar, PubMed, Medline, and Cochrane, etc, using Boolean logic. Restrictions will be set for years (Jan. 2009–Dec. 2019), English language peer-reviewed studies based on South Africa. The search output will be screened for primary studies on Community based rehabilitation in South Africa. Two independent reviewers will conduct title and abstract screening to identify potential eligible studies. After which full-text screening on the potential eligible studies and assessed for inclusion by the two independent reviewers. The Mixed Method Appraisal Tool will be applied to assess the quality of the studies included in the review. Discussion The gathered evidence from the selected studies will be discussed in relation to the research questions using a narrative to identify and explore emergent themes. The review will provide a baseline of evidence on the implementation of CBR and will highlight gaps regarding the implementation of CBR in a South African Context. The gaps identified will be used to develop a framework that will guide implementation of CBR in South Africa.
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- 2021
34. Social capital and maternal and child health services uptake in low- and middle-income countries: mixed methods systematic review
- Author
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Yibeltal Assefa, Desalegne Amare, Endalkachew Worku Mengesha, Getu Degu Alene, and Gizachew Assefa Tessema
- Subjects
Gerontology ,medicine.medical_specialty ,Child Health Services ,Maternal and child health services ,Health informatics ,LMICs ,Health administration ,Health facility ,Social capital ,Pregnancy ,Medicine ,Humans ,Child ,Developing Countries ,Poverty ,Qualitative Research ,Social network ,business.industry ,Health Policy ,Nursing research ,Public health ,Research ,Female ,Public aspects of medicine ,RA1-1270 ,business ,Qualitative research - Abstract
Background Social capital has become an important concept in the field of public health, and is associated with improved health services uptake. This study aimed to systematically review the available literature on the role of social capital on the utilization of maternal and child health services in low- and middle-income countries (LMICs). Methods Mixed-methods research review and synthesis using three databases PubMed, Scopus, and Science Direct for peer-reviewed literature and Google Scholar and Google search engines for gray literature were performed. Both quantitative and qualitative studies conducted in LMICs, published in English and in grey literature were considered. Prior to inclusion in the review methodological quality was assessed using a standardized critical appraisal instrument. Results A total of 1,545 studies were identified, of which 13 records were included after exclusions of studies due to duplicates, reading titles, abstracts, and full-text reviews. Of these eligible studies, six studies were included for quantitative synthesis, and seven were included for qualitative synthesis. Of the six quantitative studies, five of them addressed the association between social capital and health facility delivery. Women who lived in communities with higher membership in groups that helps to form intergroup bridging ties had higher odds of using antenatal care services. Synthesized qualitative findings revealed that women received some form of emotional, informational, and instrumental support from their network members. Receiving health information from trusted people and socio-cultural factors influenced the use of maternal and child health services. Conclusions Social capital has a great contribution to improve maternal and child health services. Countries aiming at improving maternal and child health services can be benefited from adapting existing context-specific social networks in the community. This review identified limited available evidence examining the role of social capital on maternal and child health services uptake and future studies may be required for an in-depth understanding of how social capital could improve maternal and child health services. Systematic review registration PROSPERO CRD42021226923.
- Published
- 2021
35. Community-based health financing: empirical evaluation of the socio-demographic factors determining its uptake in Awka, Anambra state, Nigeria
- Author
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Giuseppe T. Cirella, Felix O. Iyalomhe, and Paul Oluwatomipe Adekola
- Subjects
Male ,Community fund ,medicine.medical_specialty ,Adolescent ,Nigeria ,Developing country ,Prepayment of loan ,Health Services Accessibility ,Health care ,medicine ,Humans ,Community-Based Health Insurance ,Poverty ,Health policy ,Demography ,Social policy ,Finance ,Insurance, Health ,Descriptive statistics ,Sub-Saharan Africa ,business.industry ,Research ,Health Policy ,Public health ,Prevention ,Healthcare ,Public Health, Environmental and Occupational Health ,Health services research ,Middle Aged ,Cross-Sectional Studies ,Female ,Business ,Public aspects of medicine ,RA1-1270 ,Health schemes - Abstract
Background There is an increasing global concern of financing poor people who live in low- and middle-income countries. The burden of non-communicable diseases of these people is, by in large, connected to a lack of access to effective and affordable medical care, weak financing, and delivery of health services. Policymakers have assumed, until recently, that poor people in developing countries would not pay health insurance premiums for the cost of future hospitalization. The emergence of community-based health financing (CBHF) has brought forth a renewed and empowered alternative. CBHF schemes are designed to be sustainable, varying in size, and well organized. Developing countries, such as Nigeria, have been testing and finetuning such schemes in the hope that they may 1 day reciprocate high-income countries. Methods A sample size of 372 respondents was used to assess the slums of Awka, the capital city of Anambra State, Nigeria, and empirically evaluate the socio-demographic characteristics of those who uptake CBHF using the provider Jamii Bora Trust (JBT). Cross-sectional research used a quantitative research approach with the instrumentality of structured questionnaires. Descriptive analysis was adopted to determine the socio-demographic characteristics of those who have CBHF uptake in Awka and evaluate the presence and benefits of CBHF in the city’s slums. Results The results show that more youth and middle-aged persons from 18 to 50 years are more insured (i.e., 73.8% combined) than those who are over 50 years of age. Gender distribution confirm more females (i.e., 61.9%) to be health-insured than their male counterpart (i.e., 38.1%). This perhaps reflected the reproductive roles by women and the fact that women have better health-seeking behavioral attitude. Moreover, the results correlate with previous studies that confirm women are more involved in local sustainable associations in low-income settings, of this nature, in sub-Saharan Africa. Corroborating this further, married people are more insured (i.e., 73.8%) than those who are not married (i.e., 26.2%) and insured members report higher use of hospitalization care than the non-insured. Conclusion CBHF uptake favored members in the lower income quintiles who are more likely to use healthcare services covered by the JBT scheme. This confirmed that prepayment schemes and the pooling of risk could reduce financial barriers to healthcare among the urban poor. Recommendations are suggested to improve enrollment levels in the CBHF programs.
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- 2021
36. People to policy: The promise and challenges of big data for India
- Author
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Anthony Vipin Das
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Big Data ,Government ,Economic growth ,Poverty ,business.industry ,media_common.quotation_subject ,Big data ,India ,Digital health ,Gross domestic product ,Ophthalmology ,Policy ,Blueprint ,health care policy ,Health care ,Perspective ,electronic medical records ,Medicine ,Humans ,Health Expenditures ,business ,Welfare ,Delivery of Health Care ,media_common - Abstract
Big data holds great promise to help unravel insights to bridge the gap in human understanding. There has to be an emphasis on the quality of the data points being collected to ensure meaningful analysis. India has made significant strides to lay down a strong framework through the National Digital Health Blueprint and the National Health Stack for the future. There is a need to focus on the first important step of collection of a "good quality" data point through the implementation of electronic medical records by the health care providers. In India, 60 million individuals move below the poverty line every year because of the expenses related to unforeseen illness that adversely affects the individual's welfare and the nation's economic growth. With an out-of-pocket expense rate currently at 70% and the government's health budget at a mere 1.3% of its GDP (gross domestic product), data-driven decisions are the need of the hour for policy making and to ensure equitable, efficient, and excellent delivery of health care. There is a huge potential to harness the power of big data to generate insights to address the four big challenges of health care in India - availability, accessibility, affordability, and acceptability.
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- 2021
37. The associations of everyday and major discrimination exposure with violence and poor mental health outcomes during the COVID-19 pandemic
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Anita Raj, Sangeeta Chatterji, Nicole E. Johns, Jennifer Yore, Arnab K. Dey, and David R. Williams
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Adult ,Health (social science) ,Outcome Assessment ,Economics ,poverty ,sexual violence ,Violence ,Medical and Health Sciences ,History and Philosophy of Science ,2.3 Psychological ,gender-based violence ,Behavioral and Social Science ,Humans ,sexual harrassment ,Aetiology ,economic deprivation ,Pandemics ,Violence Research ,Peace ,COVID-19 ,Gender -based violence ,Gender Equality ,Justice and Strong Institutions ,Brain Disorders ,Health Care ,Cross-Sectional Studies ,Mental Health ,Good Health and Well Being ,Studies in Human Society ,Public Health ,social and economic factors ,Sexual harassment - Abstract
Research on discrimination and risks for violence and mental health issues under the pandemic is notably absent. We examined the relative effects of perceived everyday discrimination (e.g., poorer service, disrespectful treatment in a typical week) and major experiences of race-based discrimination (e.g., racial/ethnic discrimination in housing or employment at any point in the lifetime) on experiences of violence and the PHQ-4 assessment of symptoms of depression and anxiety under the pandemic. We analyzed state-representative cross-sectional survey data from California adults (N=2114) collected in March 2021. We conducted multivariate regression models adjusting for age, race/ethnicity, gender, sexual identity, income, and disability. One in four Californians (26.1%) experienced everyday discrimination in public spaces, due most often to race/ethnicity and gender. We found that everyday discrimination was significantly associated with past year physical violence (single form Adjusted Odds Ratio [AOR] 5.0, 95% CI 2.5-10.3; multiple forms AOR 2.6, 95% CI 1.1-5.8), past year sexual violence (multiple forms AOR 2.5, 95% CI 1.4-4.4), and mental health symptoms (e.g., severe symptoms, multiple forms AOR 3.3, 95% CI 1.6-6.7). Major experiences of race-based discrimination (reported by 10.0% of Californians) were associated with past year sexual violence (AOR 2.0, 95% CI 1.1-3.8) and severe mental health symptoms (AOR 2.7, 95% CI 1.2-6.2). Non-race-based major discrimination (reported by 23.9% of Californians) was also associated with violence and mental health outcomes Everyday discrimination, more than major experiences of discrimination, was associated with higher risk for violence and poor mental health outcomes during the pandemic. Non-race-based forms of major discrimination independently were also associated with these negative outcomes. Findings indicate that efforts to reduce and ultimately eliminate discrimination should be a focus of public health and COVID-19 rebuilding efforts.
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- 2022
38. Consumption of Vitamin-A-Rich Foods and Vitamin A Supplementation for Children under Two Years Old in 51 Low- and Middle-Income Countries
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Omar Karlsson, Rockli Kim, Andreas Hasman, and S. V. Subramanian
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Male ,Rural Population ,Urban Population ,Burundi ,dietary diversity ,Nutritional Status ,Article ,Humans ,TX341-641 ,low- and middle-income countries ,Vitamin A ,Poverty ,Nutrition and Dietetics ,Nutrition. Foods and food supply ,Infant ,child nutrition ,vitamin A supplements ,Health Surveys ,vitamin-A-rich foods ,Diet ,Cross-Sectional Studies ,Socioeconomic Factors ,Child, Preschool ,Dietary Supplements ,Income ,Female ,Child Nutritional Physiological Phenomena ,Food Science - Abstract
Vitamin A supplementation for children 6–59 months old is an important intervention that boosts immune function, especially where children do not consume enough vitamin-A-rich foods. However, the low coverage of vitamin A supplementation is a persistent problem in low- and middle-income countries. We first estimated the percentage of children 6–23 months old receiving the minimum dietary diversity, vitamin-A-rich foods, and vitamin A supplementation, and second, the difference in the percentage receiving vitamin A supplementation between children 6–23 months old and children 24–59 months old using nationally representative cross-sectional household surveys, namely, the Demographic and Health Surveys, conducted from 2010 to 2019 in 51 low- and middle-income countries. Overall, 22% (95% CI: 22, 23) of children received the minimum dietary diversity, 55% (95% CI: 54, 55) received vitamin-A-rich foods, 59% (95% CI: 58, 59) received vitamin A supplementation, and 78% (95% CI: 78, 79) received either vitamin-A-rich foods or supplementation. A wide variation across countries was observed; for example, the percentage of children that received either vitamin-A-rich foods or supplementation ranged from 53% (95% CI: 49, 57) in Guinea to 96% (95% CI: 95, 97) in Burundi. The coverage of vitamin A supplementation should be improved, especially for children 6–23 months old, in most countries, particularly where the consumption of vitamin-A-rich foods is inadequate.
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- 2022
39. The Role of Forestry-Based Policies in Alleviating Relative Poverty in the Rocky Desertification Area in Southwest China
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Yifan Wang, He Li, and Rong Zhao
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Rural Population ,China ,Family Characteristics ,forestry-based poverty alleviation policy ,relative poverty ,rural households ,Health, Toxicology and Mutagenesis ,Public Health, Environmental and Occupational Health ,Humans ,Forestry ,Poverty - Abstract
China has put forward a series of forestry-based poverty alleviation policies, aiming to alleviate poverty and improve the livelihoods of rural households, especially in backward and ecologically fragile areas with rich forest resources. Based on field survey data, we used an empirical analysis method to investigate the role of forestry-based policies in alleviating the relative poverty of rural households in the rocky desertification area in southwest China. The Logit regression results demonstrate that forestry-based poverty alleviation policies are significant at alleviating the relative poverty of rural households, and there are differences in the degree and significance of the impact of various forestry-based poverty alleviation policies. In particular, the forestry industry support (FIS) policy, the ecological forest rangers (EFRs) policy, and the Sloping Land Conversion Program (SLCP) can significantly decrease the incidence of relative poverty of rural households, while the effect of the Public Benefit Forest Compensation Program (PBFC) on decreasing the incidence of relative poverty is not significant. The findings contribute to a better understanding of the role and effectiveness of China’s forestry-based poverty alleviation policies, and can provide a reference for optimizing the forestry poverty alleviation policies for the specific area and even the whole nation, as well as provide experience for worldwide poverty alleviation by forestry.
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- 2022
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40. Implementing value-based healthcare using a digital health exchange platform to improve pregnancy and childbirth outcomes in urban and rural Kenya
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Peter Dohmen, Teresa De Sanctis, Emma Waiyaiya, Wendy Janssens, Tobias Rinke de Wit, Nicole Spieker, Mark Van der Graaf, Erik M. Van Raaij, Economics, Tinbergen Institute, Amsterdam Centre for World Food Studies, Department of Technology and Operations Management, Health Services Management & Organisation (HSMO), Global Health, APH - Personalized Medicine, and APH - Quality of Care
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Communication ,digital health ,Public Health, Environmental and Occupational Health ,Infant, Newborn ,Kenya ,cohort-based implementation ,LMIC ,SDG 17 - Partnerships for the Goals ,SDG 3 - Good Health and Well-being ,Pregnancy ,value-based healthcare ,Humans ,MNCH ,Female ,Maternal Health Services ,outcome measurement ,Child ,Poverty ,Delivery of Health Care - Abstract
Maternal and neonatal mortality rates in many low- and middle-income countries (LMICs) are still far above the targets of the United Nations Sustainable Development Goal 3. Value-based healthcare (VBHC) has the potential to outperform traditional supply-driven approaches in changing this dismal situation, and significantly improve maternal, neonatal and child health (MNCH) outcomes. We developed a theory of change and used a cohort-based implementation approach to create short and long learning cycles along which different components of the VBHC framework were introduced and evaluated in Kenya. At the core of the approach was a value-based care bundle for maternity care, with predefined cost and quality of care using WHO guidelines and adjusted to the risk profile of the pregnancy. The care bundle was implemented using a digital exchange platform that connects pregnant women, clinics and payers. The platform manages financial transactions, enables bi-directional communication with pregnant women via SMS, collects data from clinics and shares enriched information via dashboards with payers and clinics. While the evaluation of health outcomes is ongoing, first results show improved adherence to evidence-based care pathways at a predictable cost per enrolled person. This community case study shows that implementation of the VBHC framework in an LMIC setting is possible for MNCH. The incremental, cohort-based approach enabled iterative learning processes. This can support the restructuring of health systems in low resource settings from an output-driven model to a value based financing-driven model.
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- 2022
41. Social Determinants of the Non-Utilization of the Supplementary Feeding Program (PACAM) Aimed at Older Adults’ Nutritional Support
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Sandra Alvear-Vega and Héctor Vargas-Garrido
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Aged, 80 and over ,Social Determinants of Health ,Nutritional Support ,Health, Toxicology and Mutagenesis ,Malnutrition ,Public Health, Environmental and Occupational Health ,older people ,social determinants of health ,nutrition ,malnutrition ,frailty ,risk factors ,Humans ,Nutritional Status ,Poverty ,Aged - Abstract
Chile has implemented the PACAM program to support older people with nutrition and for the prevention of malnutrition and frailty. This work aims to identify the social determinants of older persons not withdrawing PACAM food in order to obtain helpful knowledge for improving the program. First, the CASEN Survey 2017 was used (960,498 observations); the inclusion criterion was PACAM recipients (Yes/No). Next, a probit model was performed with a dichotomous response to determine the marginal effects of each independent variable (e.g., demographic, health, and social). The model shows a good fit (64.4%) with an explained variance between 10.5% to 14.1%. Those variables with more significant marginal effects are people aged 70–75, having tertiary and secondary education, urban living, not participating in social organizations, immigrants, and living in the austral zone. On the other hand, a higher likelihood of consumption was found among people of greater vulnerability (lowest income, lowest education, low health insurance, and aged over 80) and, therefore, in greater fragility. To conclude, the program achieves effective targeting, although improvement actions are required to expand coverage in some groups (indigenous people, immigrants, and people with disabilities). Moreover, authorities should evaluate and reinforce the program with tailored strategies for the older adults who actually withdraw food.
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- 2022
- Full Text
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42. The Impact of Mobile Payment on Household Poverty Vulnerability: A Study Based on CHFS2017 in China
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Yuhua Li, Xiheng Gong, Jingyi Zhang, Ziwei Xiang, and Chengjun Liao
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Rural Population ,Family Characteristics ,China ,mobile payment ,household poverty vulnerability ,entrepreneurship ,risk management capability ,IVprobit model ,electronic communication technology ,inclusive finance ,Health, Toxicology and Mutagenesis ,Entrepreneurship ,Public Health, Environmental and Occupational Health ,Humans ,Poverty - Abstract
Changes in digital technology have brought about new opportunities in the field of financial poverty alleviation in China, and mobile payment as a new digital financial model is important in helping families to lift themselves out of poverty effectively and prevent a return to poverty. This paper examines the impact of mobile payment on household poverty vulnerability and the mechanism of action using the China Household Finance Survey (CHFS) 2017 microsurvey data. After adopting the IVprobit model and a series of robustness tests, we found: (1) mobile payment significantly negatively impacts household poverty vulnerability; (2) the mechanism analysis indicates that promoting entrepreneurship and improving risk management capabilities are the main channels through which mobile payment mitigates household poverty vulnerability; (3) household entrepreneurship and entrepreneurial survival significantly reduce the probability of poverty vulnerability; and (4) the probit regression analysis explores how mobile payment has a greater negative impact on poverty vulnerability among low-income, homeless, and relatively backward households in rural or western areas. This work contributes to the literature on the use of electronic communication technology to eradicate poverty and on inclusive finance, providing vital results for other countries to use as an example.
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- 2022
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43. Giving Families a Voice for Equitable Healthy Food Access in the Wake of Online Grocery Shopping
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ANGELA TRUDE, Caitlin Lowery, Gabriela Milhassi Vedovato, and Shahmir Ali
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Nutrition and Dietetics ,Humans ,COVID-19 ,healthy food access ,food insecurity ,health disparities ,food assistance ,grocery stores ,Food Assistance ,Child ,Pandemics ,Poverty ,Aged ,Food Supply ,Food Science - Abstract
Understanding the views of families from low-income backgrounds about inequities in healthy food access and grocery purchase is critical to food access policies. This study explored perspectives of families eligible for the Supplemental Nutrition Assistance Program (SNAP) on healthy food access in physical and online grocery environments. The qualitative design used purposive sampling of 44 primary household food purchasers with children (aged ≤ 8), between November 2020–March 2021, through 11 online focus groups and 5 in-depth interviews. Grounded theory was used to identify community-level perceived inequities, including influences of COVID-19 pandemic, SNAP and online grocery services. The most salient perceived causes of inequitable food access were neighborhood resource deficiencies and public transportation limitations. Rural communities, people with disabilities, older adults, racially and ethnically diverse groups were perceived to be disproportionately impacted by food inequities, which were exacerbated by the pandemic. The ability to use SNAP benefits to buy foods online facilitated healthy food access. Delivery fees and lack of control over food selection were barriers. Barriers to healthy food access aggravated by SNAP included social stigma, inability to acquire cooked meals, and inadequate amount of monthly funds. Findings provide a foundation for policy redesign to promote equitable healthy food systems.
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- 2022
- Full Text
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44. The Association between Ambient PM2.5 and Low Birth Weight in California
- Author
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Jasmine Lee, Sadie Costello, John R. Balmes, and Stephanie M. Holm
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Pediatric ,Air Pollutants ,Health, Toxicology and Mutagenesis ,air pollution ,low birth weight ,epidemiology ,ecologic study ,Low Birth Weight ,Public Health, Environmental and Occupational Health ,Infant ,Perinatal Period - Conditions Originating in Perinatal Period ,No Poverty ,Newborn ,Low Birth Weight and Health of the Newborn ,Toxicology ,California ,Racism ,Preterm ,Infant Mortality ,Humans ,Birth Weight ,Particulate Matter ,Climate-Related Exposures and Conditions ,Poverty - Abstract
Previous studies have shown associations between air pollutants and low birth weight. However, few studies assess whether poverty and race/ethnicity are effect modifiers for this relationship. We used publicly available data on 7785 California census tracts from the California Communities Environmental Health Screening Tool (CalEnviroScreen). Multivariable linear regression was used to examine the association between outdoor PM2.5 and low birth weight (LBW), including stratification by poverty and race/ethnicity (as a proxy for experienced racism). A 1 µg m−3 increase in PM2.5 was associated with a 0.03% (95% CI: 0.01, 0.04) increase in the percentage of LBW infants in a census tract. The association between PM2.5 and LBW was stronger in census tracts with the majority living in poverty (0.06% increase; 95% CI: 0.03, 0.08) compared to those with fewer people living in poverty (0.02% increase; 95% CI: 0.00, 0.03). Our results show that exposure to outdoor PM2.5 is associated with a small increase in the percentage of LBW infants in a census tract, with a further increase in tracts with high poverty. The results for effect modification by race/ethnicity were less conclusive.
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- 2022
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45. Increasing Access to Care for the Underserved: Voices of Riders, Drivers, & Staff of a Rural Transportation Program
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Abby J. Schwartz, Alice R. Richman, Mallary Scott, Haiyong Liu, Weyling White, and Caroline Doherty
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Rural Population ,transportation ,healthcare access ,health disparities ,social determinants of health ,Health, Toxicology and Mutagenesis ,Public Health, Environmental and Occupational Health ,Humans ,COVID-19 ,Middle Aged ,Pandemics ,Poverty ,Health Services Accessibility - Abstract
The qualitative data presented in this paper was part of a larger concurrent mixed methods study evaluating the effectiveness of a transportation program (Project TRIP) for low-income residents in rural eastern North Carolina. Twenty stakeholders involved in TRIP were interviewed, including riders (n = 12) of which 83% were over 50 years old, program staff including the program coordinator and 5 case managers (n = 6), and transportation providers (n = 2). Due to the COVID-19 pandemic, interviews were completed by phone with each participant. Themes from the qualitative data included the: (1) Emotional, health, & financial impacts of TRIP, (2) Changes that should be implemented into TRIP when replicating the program, and (3) Unique aspects of how TRIP operates that could inform other rural transportation programs. Thematic analysis was used to analyze the transcript data. The findings are couched in the context of how TRIP potentially defrays the impacts of cumulative disadvantage that residents experience over the life course by increasing access to healthcare.
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- 2022
- Full Text
- View/download PDF
46. Targeted Telehealth Education Increases Interest in Using Telehealth among a Diverse Group of Low-Income Older Adults
- Author
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Emily Jezewski, Abigale Miller, MaryAnn Eusebio, and Jane Potter
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Male ,Surveys and Questionnaires ,Health, Toxicology and Mutagenesis ,Public Health, Environmental and Occupational Health ,Humans ,COVID-19 ,Female ,Medicare ,Poverty ,United States ,Telemedicine ,Aged ,telehealth ,outreach ,health promotion ,older adults - Abstract
Telehealth allows older adults to take control over their health and preventive care; however, they are less likely to use telehealth. Minority older adults use telehealth services less than their White counterparts. During COVID-19, the U.S. Medicare system allowed for telehealth delivery of Annual Wellness Visits, which are known to improve use of preventive services. To increase telehealth use, we targeted vulnerable, low-income, minority older adults and provided education to improve knowledge of and identify barriers to telehealth use. Ultimately, this could serve as a means of improving health and preventive care services. Participants resided at independent living facilities, low-income housing, and elders of the Native American coalition; N = 257. Participants received written education materials; a subset attended a 20-min presentation. In this quasi-experimental study, participants completed a pre-post survey. Results were analyzed using Chi-Squared and Fisher’s Exact tests. Participants included 54 ‘in-person’ and 203 ‘at-home’ learners. Most were female (79%), single/widowed (51%), and white (65%). At baseline, 39% were familiar with telehealth; following education 73% stated understanding on accessing telehealth. Nearly 40% of participants said they would use telehealth in the future; a larger proportion of “in-person” (73%) learners were willing to use telehealth than “at-home” learners (41%) (p = 0.001). Divorced older adults and Blacks voiced greater likelihoods of using telehealth than their married/widowed and White counterparts, respectively (Χ2(3, N = 195) = 9.693, p = 0.02), (p = 0.01). This education program demonstrates an increase likelihood in health promotion among older adults by increasing confidence in accessing and future use of telehealth; therefore, we achieved our aim of promoting telehealth use and improving health promotion.
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- 2022
- Full Text
- View/download PDF
47. Measuring Asian hate: Discordant reporting of race-based hate incidents and unfair treatment and association with measures of wellbeing
- Author
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Ninez A. Ponce, Alexander C. Adia, Rachel A. Banawa, Sean Tan, and Melanie D. Sabado-Liwag
- Subjects
Asian People ,Residence Characteristics ,Hate ,Public Health, Environmental and Occupational Health ,Humans ,COVID-19 ,Poverty - Abstract
BackgroundDuring COVID-19, anti-Asian discrimination increased in attention. Hate and unfair treatment are related but do not completely overlap. We expect those who report a hate incident would also report race-based unfair treatment, yet feelings of social desirability or self-blame may lead to under-reporting of unfair treatment.ObjectivesTo describe reporting of an experience of race-based hate but not an experience of race-based unfair treatment among Asians in California and explore the association between this reporting discordance with (1) serious psychological distress, (2) forgoing needed medical care, (3) increased household interpersonal conflict, and (4) feeling unsafe in their neighborhood.MethodsWe used the 2020 California Health Interview Survey's AANHPI COVID Module, conducted weighted descriptive and multivariate analyses, and computed adjusted relative risks (RR). The multivariate models controlled for Asian subgroup, age, gender, immigrant status, education level, poverty, and English proficiency.ResultsAmong Asians who reported race-based hate (6.9% overall), 62.4% reported not experiencing race-based unfair treatment. Compared to Asians not reporting a hate incident, this “discordant” group was more likely to experience serious psychological distress (RR = 6.9), forgo necessary medical care (RR = 2.4), increased household interpersonal conflicts (RR = 2.7), and feel unsafe in their neighborhoods (RR = 3.0). The “concordant” group did not post significant effects for severe psychological distress nor forgoing necessary medical care.DiscussionMost Asians reporting hate did not report race-based unfair treatment, and this group is most affected by the consequences of a hate incident. We indicate future directions for research and policy.
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- 2022
- Full Text
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48. Cost of Illness Analysis of Type 2 Diabetes Mellitus: The Findings from a Lower-Middle Income Country
- Author
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Muhammad Daoud Butt, Siew Chin Ong, Muhammad Umar Wahab, Muhammad Fawad Rasool, Fahad Saleem, Adnan Hashmi, Ahsan Sajjad, Furqan Aslam Chaudhry, and Zaheer-Ud-Din Babar
- Subjects
Cost of Illness ,Diabetes Mellitus, Type 2 ,Health, Toxicology and Mutagenesis ,Public Health, Environmental and Occupational Health ,cost of illness ,diabetes mellitus ,direct cost ,indirect cost ,diabetes in Pakistan ,diabetes economic burden ,Humans ,Efficiency ,Health Care Costs ,Poverty - Abstract
Background: Diabetes is a major chronic illness that negatively influences individuals and society. Therefore, this research aimed to analyze and evaluate the cost associated with diabetes management, specific to the Pakistani Type 2 diabetes population. Research scheme and methods: A survey randomly collected information and data from diabetes patients throughout Pakistan out-patient clinics. Direct and indirect costs were evaluated, and data were analyzed with descriptive and inferential statistics. Results: An overall of 1839 diabetes patients participated in the study. The results have shown that direct and indirect costs are positively associated with the participants’ socio-demographic characteristics, except for household income and educational status. The annual total cost of diabetes care was USD 740.1, amongst which the share of the direct cost was USD 646.7, and the indirect cost was USD 93.65. Most direct costs comprised medicine (USD 274.5) and hospitalization (USD 319.7). In contrast, the productivity loss of the patients had the highest contribution to the indirect cost (USD 81.36). Conclusion: This study showed that direct costs significantly contributed to diabetes’s overall cost in Pakistan and overall diabetes management estimated to be 1.67% (USD 24.42 billion) of the country’s total gross domestic product. The expense of medications and hospitalization mostly drove the direct cost. Additionally, patients’ loss of productivity contributed significantly to the indirect cost. It is high time for healthcare policymakers to address this huge healthcare burden. It is time to develop a thorough diabetes management plan to be implemented nationwide.
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- 2022
- Full Text
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49. A school without railings: rural backgrounds, social medicine, and the circulation of public health material in Colombia, 1930-1946
- Author
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Natalia Botero-Tovar
- Subjects
Rural Population ,medicine.medical_specialty ,Clientelism ,Economic growth ,Latin Americans ,história ,Colombia ,Politics ,social medicine ,History and Philosophy of Science ,Social medicine ,saúde pública ,Political science ,medicine ,Political corruption ,Humans ,History of medicine. Medical expeditions ,R131-687 ,Schools ,Poverty ,Public health ,public health ,Historiography ,General Medicine ,medicina social ,history - Abstract
Ambitious state hygiene education projects designed during liberal governments in Colombia (1930-1946) faced not just the poverty of rural populations, but also the reluctance of local political forces. I analyze hygiene education programs during the first two liberal governments of the Liberal Republic. I argue that public health programs did not reach their audience due to local clientelism and political corruption. The sources of this article come mainly from Colombia’s Ministry of Education reports and cultural magazines. The education sector also had health-related responsibilities and developed assessments of local needs, which contributed to public health programs. Latin America’s public health historiography could be enriched by exploring failures in the implementation of projects in the history of social medicine. Resumo Projetos governamentais de educação em saúde propostos por governos liberais da Colômbia (1930-1946) enfrentaram não apenas a pobreza das populações rurais, mas também a relutância de forças políticas. Analiso os programas de educação em saúde durante os dois primeiros governos da República Liberal. Argumento que os programas de saúde pública não alcançaram o público alvo por causa de clientelismo local e corrupção política. As fontes deste artigo foram, principalmente, relatórios do Ministério da Educação da Colômbia e revistas culturais. O setor da edução teve responsabilidades relacionadas à saúde e desenvolveu avaliações das necessidades locais, que contribuíram para programas de saúde pública. A historiografia da saúde pública na América Latina poderia se beneficiar se explorasse as falhas na implementação de projetos de medicina social.
- Published
- 2021
50. Prediction of cardiovascular risk in patients with chronic obstructive pulmonary disease: a study of the National Health and Nutrition Examination Survey database
- Author
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Yingshuo Huang, Yun Shi, and Jing Zhang
- Subjects
Adult ,Male ,Time Factors ,Heart disease ,National Health and Nutrition Examination Survey ,Social Determinants of Health ,NHANES database ,Comorbidity ,computer.software_genre ,Logistic regression ,Risk Assessment ,Pulmonary Disease, Chronic Obstructive ,medicine ,Humans ,Diseases of the circulatory (Cardiovascular) system ,Life Style ,Poverty ,Aged ,COPD ,Receiver operating characteristic ,Database ,business.industry ,Research ,Chronic obstructive pulmonary disease ,Middle Aged ,Nutrition Surveys ,Prognosis ,medicine.disease ,Cardiovascular disease ,United States ,Cross-Sectional Studies ,Blood pressure ,Cardiovascular Diseases ,Heart Disease Risk Factors ,Predictive model ,RC666-701 ,Female ,Cardiology and Cardiovascular Medicine ,business ,computer ,Body mass index - Abstract
Background Cardiovascular disease (CVD) is a common comorbidity associated with chronic obstructive pulmonary disease (COPD), but few studies have been conducted to identify CVD risk in COPD patients. This study was to develop a predictive model of CVD in COPD patients based on the National Health and Nutrition Examination Survey (NHANES) database. Methods A total of 3,226 COPD patients were retrieved from NHANES 2007–2012, dividing into the training (n = 2351) and testing (n = 895) sets. The prediction models were conducted using the multivariable logistic regression and random forest analyses, respectively. Receiver operating characteristic (ROC) curves, area under the curves (AUC) and internal validation were used to assess the predictive performance of models. Results The logistic regression model for predicting the risk of CVD was developed regarding age, gender, body mass index (BMI), high-density lipoprotein (HDL), glycosylated hemoglobin (HbA1c), family history of heart disease, and stayed overnight in the hospital due to illness last year, which the AUC of the internal validation was 0.741. According to the random forest analysis, the important variables-associated with CVD risk were screened including smoking (NNAL and cotinine), HbA1c, HDL, age, gender, diastolic blood pressure, poverty income ratio, BMI, systolic blood pressure, and sedentary activity per day. The AUC of the internal validation was 0.984, indicating the random forest model for predicting the CVD risk in COPD cases was superior to the logistic regression model. Conclusion The random forest model performed better predictive effectiveness for the cardiovascular risk among COPD patients, which may be useful for clinicians to guide the clinical practice.
- Published
- 2021
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