Search

Background: The five BRICS (Brazil, Russian, Indian, China, and South Africa) countries bear 49% of the world's tuberculosis (TB) burden and they are committed to ending tuberculosis., Objectives: The aim of this paper is to map the scientific landscape related to TB research in BRICS countries., Methods: Were combined bibliometrics and social network analysis techniques to map the scientific publications related to TB produced by the BRICS. Was made a descriptive statistical data covering the full period of analysis (1993-2016) and the research networks were made for 2007-2016 (8,366 records). The bubble charts were generated by VantagePoint and the networks by the Gephi 0.9.1 software (Gephi Consortium 2010) from co-occurrence matrices produced in VantagePoint. The Fruchterman-Reingold algorithm provided the networks' layout., Findings: During the period 1993-2016, there were 38,315 peer-reviewed, among them, there were 11,018 (28.7%) articles related by one or more authors in a BRICS: India 38.7%; China 23.8%; South Africa 21.1%; Brazil 13.0%; and Russia 4.5% (The total was greater than 100% because our criterion was all papers with at least one author in a BRICS). Among the BRICS, there was greater interaction between India and South Africa and organisations in India and China had the highest productivity; however, South African organisations had more interaction with countries outside the BRICS. Publications by and about BRICS generally covered all research areas, especially those in India and China covered all research areas, although Brazil and South Africa prioritised infectious diseases, microbiology, and the respiratory system., Main Conclusions: An overview of BRICS scientific publications and interactions highlighted the necessity to develop a BRICS TB research plan to increase efforts and funding to ensure that basic science research successfully translates into products and policies to help end the TB epidemic.

Background: Obsessive-compulsive disorder (OCD) has a lifetime prevalence of 2-3% and is a leading cause of global disability. Brain circuit abnormalities in individuals with OCD have been identified, but important knowledge gaps remain. The goal of the new global initiative described in this paper is to identify robust and reproducible brain signatures of measurable behaviors and clinical symptoms that are common in individuals with OCD. A global approach was chosen to accelerate discovery, to increase rigor and transparency, and to ensure generalizability of results., Methods: We will study 250 medication-free adults with OCD, 100 unaffected adult siblings of individuals with OCD, and 250 healthy control subjects at five expert research sites across five countries (Brazil, India, Netherlands, South Africa, and the U.S.). All participants will receive clinical evaluation, neurocognitive assessment, and magnetic resonance imaging (MRI). The imaging will examine multiple brain circuits hypothesized to underlie OCD behaviors, focusing on morphometry (T1-weighted MRI), structural connectivity (Diffusion Tensor Imaging), and functional connectivity (resting-state fMRI). In addition to analyzing each imaging modality separately, we will also use multi-modal fusion with machine learning statistical methods in an attempt to derive imaging signatures that distinguish individuals with OCD from unaffected siblings and healthy controls (Aim #1). Then we will examine how these imaging signatures link to behavioral performance on neurocognitive tasks that probe these same circuits as well as to clinical profiles (Aim #2). Finally, we will explore how specific environmental features (childhood trauma, socioeconomic status, and religiosity) moderate these brain-behavior associations., Discussion: Using harmonized methods for data collection and analysis, we will conduct the largest neurocognitive and multimodal-imaging study in medication-free subjects with OCD to date. By recruiting a large, ethno-culturally diverse sample, we will test whether there are robust biosignatures of core OCD features that transcend countries and cultures. If so, future studies can use these brain signatures to reveal trans-diagnostic disease dimensions, chart when these signatures arise during development, and identify treatments that target these circuit abnormalities directly. The long-term goal of this research is to change not only how we conceptualize OCD but also how we diagnose and treat it.

Background: This paper describes the health and economic burden of cardiovascular diseases (CVD) in Mexico and other mega-countries through a review of literature and datasets., Methods: Mega-countries with a low (Nigeria), middle (India), high (China/Brazil/Mexico), and very high (the U.S.A./Japan) human development index were included. The review was focused on prevalence of dyslipidemias and CVD economic impact and conducted according to the PRISMA statement. Public datasets of CVD indicators were explored., Results: Heterogeneity in economic data and limited information on dyslipidemias were found. Hypertriglyceridemia and hypercholesterolemia were higher in Mexico compared with other countries. Higher contribution of dietary risk factors for cardiovascular mortality and greater probability of dying prematurely from CVD were observed in developing countries. From 1990-2016, a greater decrease in cardiovascular mortality in developed countries was registered. In 2015, a CVD expense equivalent to 4% of total health expenditure was reported in Mexico. CVD ranked first in health expenditures in almost all these nations and the economic burden will remain significant for decades to come., Conclusions: Resources should be assured to optimize CVD risk monitoring. Educational and medical models must be improved to enhance CVD diagnosis and the prescription and adherence to treatments. Long-term benefits could be attained by modifying the food system.

Background: Leishmaniasis is a parasitic disease caused by a protozoan of the Leishmania genus, and is considered a neglected tropical disease. It still remains a main public health concern at global level and in Arab world mainly in low-income countries. Therefore, this study was designed to evaluate the Arab world's growing contribution to global leishmaniasis research., Methods: This study describes a bibliometric review of all leishmaniasis research publications published between January 1998 and December 2017 indexed on the Scopus database., Results: The total number of publications published at global level was 17,570 papers, which achieves an average annual productivity of 878.50 papers publications. Brazil was responsible for the greatest output with the total number of publications of 3865 followed by the Unites States (n = 2729), India (n = 2119), the United Kingdom (n = 1363), and Spain (n = 1274). By limiting the analysis to the publications that have been published by Arab world, the research productivity was 993 papers, which represents 5.65% of total research output at global level in research regarding leishmaniasis. Tunisia was responsible for the greatest output from Arab world with the total number of publications of 297 followed by Sudan (n = 192), Saudi Arabia (n = 131), Morocco (n = 119) and Egypt (n = 67). Since 1998, the growth of publications on leishmaniasis fluctuates, overall showing a rising trend in both global and Arab world. There is a highly significant correlation between publication productivity related to leishmaniasis at global level and the Arab world (r = 0.936; p-value< 0.001). Leishmaniasis treatment, intracellular mechanism of infection, and lifecycle of leishmania are the major current hot topics for the research in this subject at global level and the Arab world., Conclusions: The current study presents a novel review of the current Arab leishmaniasis-related research, and how these results are related to worldwide output. In comparison to the global research output, the Arab world produced less leishmaniasis research. The data presented in the current study by this innovative approach may serve relevant researchers to direct the global leishmaniasis research to Arab counties in which leishmaniasis is endemic.

In a neo-classical aggregate production and Stochastic Impacts by Regression on Population, Affluence and Technology (STIRPAT) modeling framework, the paper attempts to explore the relationship between disaggregated energy consumption, economic growth, and carbon dioxide emissions in case of five emerging market economies-Brazil, Russia, China, India, and South Africa (BRICS) over the period 1992 to 2016. The study applied the robust unit root, cointegration, and long-run elasticity estimation methods like Pooled Mean Group and differenced panel generalized method of moments for empirical exercise. Having detected the panel heterogeneity and cross-sectional dependence, the cointegration tests documented the evidence of a long-run association among the variables. In the long-run, capital, labor, and non-renewable energy consumption are found to affect the economic growth positively. On the contrary, the impact of renewable energy consumption on the economic growth is found be positive but statistically insignificant. Moreover, population, per-capita income, and non-renewable energy consumption are found to increase the emissions whereas renewable energy consumption decreases them. Therefore, along with a proper emissions controls, BRICS countries should design and implement effective support policies so as to ensure the economic growth along with environmental sustainability.

This paper empirically examines the effects of urbanization and income inequality on CO 2 emissions in the BRICS economies (i.e., Brazil, Russia, India, China, and South Africa) during the periods 1994-2013. The method we used is the panel quantile regression, which takes into account the unobserved individual heterogeneity and distributional heterogeneity. Our empirical results indicate that urbanization has a significant and negative impact on carbon emissions, except in the 80 th , 90 th , and 95 th quantiles. We also quantitatively investigate the direct and indirect effect of urbanization on carbon emissions, and the results show that we may underestimate urbanization's effect on carbon emissions if we ignore its indirect effect. In addition, in middle- and high-emission countries, income inequality has a significant and positive impact on carbon emissions. The results of our study indicate that in the BRICS economies, there is an inverted U-shaped environmental Kuznets curve (EKC) between the GDP per capita and carbon emissions. The conclusions of this study have important policy implications for policymakers. Policymakers should try to narrow the income gap between the rich and the poor to improve environmental quality; the BRICS economies can speed up urbanization to reduce carbon emissions, but they must improve energy efficiency and use clean energy to the greatest extent in the process.

Metachromadora (Bradylaimoides) benepapillata, was first discovered from the coastal mangroves of Bangladesh by Timm (1961). This species was later synonymised with Pseudochromadora cazca, which was described from the Brazilian coast by Gerlach (1956). The present paper proposes to update the taxonomic status of the Timm's species as Pseudochromadora benepapillata comb. n. along with its distribution and comparative morphology. The major differences between P. cazca and P. benepapillata are found in the characteristics of the head capsule; length of cephalic sensilla; length and position of somatic setae; shape of amphideal fovea; shape of spicules and gubernaculum; number and morphology of copulatory and postcloacal thorns. The present report on the occurrence of this species along the eastern most coast of India extends its distribution from the eastern part of Bay of Bengal to its western part.

Background: Compensation for research related injuries is a subject that is increasingly gaining traction in developing countries which are burgeoning destinations of multi center research. However, the existence of disparate compensation rules violates the ethical principle of fairness. The current paper presents a comparison of the policies of Brazil, Russia, India, China and South Africa (BRICS)., Methods: A systematic search of good clinical practice guidelines was conducted employing search strategies modeled in line with the recommendations of ADPTE Collaboration (2007). The search focused on three main areas namely bibliographic data bases, clinical practice guidelines data bases and a restricted internet search. A manual search of references cited in relevant guideline documents was also conducted. The search terms, Medical Subject Headings (MeSH) and key words were developed for a PubMed platform and then adapted for all other data bases. The search terms were kept constant for each country with the only difference being the country name. The documents so obtained were subjected to systematic content analysis., Results: The study revealed that there is vast panoply of regulations which exist on a continuum. On one extreme is India with comprehensive regulations that are codified into law, and on the other end there is China which does not have specific laws regulating research related injuries. There are a number of differences and similarities such as mandatory insurance requirements, existence of no fault compensation, compensable injuries and the role of research ethics committees., Conclusions: It is imperative to enact legislations that protect participants without stifling the research enterprise. There is need for consistency and ideally harmonization of such regulations at a global level. A model policy on compensation for research related injuries should borrow from the best aspects of the different country policies and should be informed by the cardinal ethics principles of autonomy, justice and beneficence.

In this first paper in a series of four papers on midwifery, we aimed to examine, comprehensively and systematically, the contribution midwifery can make to the quality of care of women and infants globally, and the role of midwives and others in providing midwifery care. Drawing on international definitions and current practice, we mapped the scope of midwifery. We then developed a framework for quality maternal and newborn care using a mixed-methods approach including synthesis of findings from systematic reviews of women's views and experiences, effective practices, and maternal and newborn care providers. The framework differentiates between what care is provided and how and by whom it is provided, and describes the care and services that childbearing women and newborn infants need in all settings. We identified more than 50 short-term, medium-term, and long-term outcomes that could be improved by care within the scope of midwifery; reduced maternal and neonatal mortality and morbidity, reduced stillbirth and preterm birth, decreased number of unnecessary interventions, and improved psychosocial and public health outcomes. Midwifery was associated with more efficient use of resources and improved outcomes when provided by midwives who were educated, trained, licensed, and regulated. Our findings support a system-level shift from maternal and newborn care focused on identification and treatment of pathology for the minority to skilled care for all. This change includes preventive and supportive care that works to strengthen women's capabilities in the context of respectful relationships, is tailored to their needs, focuses on promotion of normal reproductive processes, and in which first-line management of complications and accessible emergency treatment are provided when needed. Midwifery is pivotal to this approach, which requires effective interdisciplinary teamwork and integration across facility and community settings. Future planning for maternal and newborn care systems can benefit from using the quality framework in planning workforce development and resource allocation., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

In this paper we examine whether Brazil, Russia and India have similar financing patterns to those observed globally. We assess how national health allocations compare with epidemiological estimates for burden of disease. We identify the major causes of burden of disease in each country, as well as the contribution HIV/AIDS, tuberculosis and malaria make to the total burden of disease estimates. We then use budgetary allocation information to assess the alignment of funding with burden of disease data. We focus on central government allocations through the Ministry of Health or its equivalent. We found that of the three cases examined, Brazil and India showed the most bias when it came to financing HIV/AIDS over other diseases. And this occurred despite evidence indicating that HIV/AIDS (among all three countries) was not the highest burden of disease when measured in terms of age-standardized DALY rates. We put forth several factors building on Reich's (2002) framework on 'reshaping the state from above, from within and from below' to help explain this bias in favour of HIV/AIDS in Brazil and India, but not in Russia: 'above' influences include the availability of external funding, the impact of the media coupled with recognition and attention from philanthropic institutions, the government's close relationship with UNAIDS (UN Joint Programme on HIV/AIDS), WHO (World Health Organization) and other UN bodies; 'within' influences include political and bureaucratic incentives to devote resources to certain issues and relationships between ministries; and 'below' influences include civil society activism and relationships with government. Two additional factors explaining our findings cross-cutting all three levels are the strength of the private sector in health, specifically the pharmaceutical industry, and the influence of transnational advocacy movements emanating from the USA and Western Europe for particular diseases.

Background: Attempted suicide is a strong risk factor for subsequent suicidal behaviors. Innovative strategies to deal with people who have attempted suicide are needed, particularly in resource-poor settings., Aims: To evaluate a brief educational intervention and periodic follow-up contacts (BIC) for suicide attempters in five culturally different sites (Campinas, Brazil; Chennai, India; Colombo, Sri Lanka; Karaj, Islamic Republic of Iran; and Yuncheng, People's Republic of China) as part of the WHO Multisite Intervention Study on Suicidal Behaviors (SUPRE-MISS)., Methods: Among the 1,867 suicide attempters enrolled in the emergency departments of the participating sites, 922 (49.4%) were randomly assigned to a brief intervention and contact (BIC) group and 945 (50.6%) to a treatment as usual (TAU) group. Repeated suicide attempts over the 18 months following the index attempt - the secondary outcome measure presented in this paper - were identified by follow-up calls or visits. Subsequent completed suicide - the primary outcome measure - has been reported in a previous paper., Results: Overall, the proportion of subjects with repeated suicide attempts was similar in the BIC and TAU groups (7.6% vs. 7.5%, chi(2) = 0.013; p = .909), but there were differences in rates across the five sites., Conclusions: This study from five low- and middle-income countries does not confirm the effectiveness of brief educational intervention and follow-up contacts for suicide attempters in reducing subsequent repetition of suicide attempts up to 18 months after discharge from emergency departments.

Introduction: This paper describes the collaborative efforts of research teams from medical schools in India, Chile, Egypt, the Philippines, Brazil, and the United States to develop and implement a core protocol for household surveys on family violence and to conduct standardized training for field workers. Our objectives are to share successes and difficulties encountered in training and field work and to offer recommendations for similar undertakings., Methods: Study methods, developed by a multidisciplinary group of international investigators, were documented in a procedures manual. On-site standardized training was conducted and field workers were monitored for adherence to protocol. Special attention was given to safety and ethical issues., Results: Overall, the training protocol and field methods were successful with relatively few problems encountered. Study participants were receptive to the interview and cooperated in safety procedures. The most common problem in the field was interruptions of the interview, mostly by children. Community advisory boards were actively involved in some of the sites, providing guidance on the safety and logistical aspects of the study, facilitating access to study communities, and providing community service information that could be shared with all study participants., Conclusions: WorldSAFE successes were attributed to rigorous standardized training and monitoring of field work; meticulous protocol implementation; unflagging attention to the ethical issues and to safeguarding study participants, field workers, and data; and openness and trust developed among the collaborators during the extended developmental phase.

Background: Poverty and female gender have been found to be associated with depression and anxiety in developed countries. The rationale behind this paper was to bring together five epidemiological data sets from four low to middle income countries to examine whether key economic and development indicators such as income and poor education, and female gender, were associated with common mental disorders., Method: The paper is based on five datasets: three based on primary care attenders in Goa, India; Harare, Zimbabwe and Santiago, Chile; and two based on community samples in Pelotas, Brazil and Olinda, Brazil. All five studies estimated prevalence of common mental disorders along with variables to measure economic deprivation and education., Findings: In all five studies, female gender, low education and poverty were strongly associated with common mental disorders. When income was divided into tertiles, with the lowest tertile as a reference value, there was a significant trend for reduced morbidity for the lower two tertiles., Discussion: These findings have considerable implications since the rapid economic changes in all four societies have been associated with rising income disparity and economic inequality. Examples of population based prevention strategies based on increasing the proportion of those who complete schooling and on high-risk strategies such as providing loan facilities to the impoverished are potential outcomes of these findings. Development agencies who focus on women as a priority group have failed to recognize their unique vulnerability to common mental disorders and need to reorient their priorities accordingly.

Programmes to control Ascaris lumbricoides, Trichuris trichiura and hookworm infections have often been targeted at each infection separately, but the advent of benign and broad-spectrum anthelmintics suggests that combined control may be feasible. The extent to which the infections co-occur in communities will determine the need for, and potential benefits of, such a combined approach. This paper examines the comparative distribution of the three geohelminths in different geographical areas and shows that A. lumbricoides and T. trichiura have closely related distributions, while hookworm infection is largely independent of the other two. These results indicate that many communities are at risk of disease from infection by more than one species of helminth. The similar distributions and epidemiological characteristics of A. lumbricoides and T. trichiura suggest that simultaneous control of these two parasites by the same strategy would be feasible and highly beneficial to communities. Multiple species control strategies which aim to control hookworm infection may require a more complicated protocol with more precise locality targeting.

In this paper we first present methods and preliminary results of pilot surveys of "serious" mental retardation (IQ less than or equal to 55); the surveys included screening and diagnostic components and were carried out in the less-developed world. Next we discuss two problems raised by these surveys: one is the diagnosis of a case and its clinical dimensions, and the other is the interpretation of prevalence. In the next section we illustrate epidemiological approaches to the analysis of such data, in particular their relevance to prevention. Lastly, we propose that the two-stage survey approach developed in the course of the pilot work can provide a valuable basis for planning and prevention, if certain key conditions can be met.