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2. Contributions of mean and shape of blood pressure distribution to worldwide trends and variations in raised blood pressure: A pooled analysis of 1018 population-based measurement studies with 88.6 million participants
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Ezzati, M. and Zhou, B. and Bentham, J. and Di Cesare, M. and Bixby, H. and Danaei, G. and Hajifathalian, K. and Taddei, C. and Carrillo-Larco, R.M. and Djalalinia, S. and Khatibzadeh, S. and Lugero, C. and Peykari, N. and Zhang, W.Z. and Bennett, J. and Bilano, V. and Stevens, G.A. and Cowan, M.J. and Riley, L.M. and Chen, Z. and Hambleton, I.R. and Jackson, R.T. and Kengne, A.P. and Khang, Y.-H. and Laxmaiah, A. and Liu, J. and Malekzadeh, R. and Neuhauser, H.K. and Sorić, M. and Starc, G. and Sundström, J. and Woodward, M. and Abarca-Gómez, L. and Abdeen, Z.A. and Abu-Rmeileh, N.M. and Acosta-Cazares, B. and Adams, R.J. and Aekplakorn, W. and Afsana, K. and Aguilar-Salinas, C.A. and Agyemang, C. and Ahmad, N.A. and Ahmadvand, A. and Ahrens, W. and Ajlouni, K. and Akhtaeva, N. and Al-Raddadi, R. and Ali, M.M. and Ali, O. and Alkerwi, A. and Aly, E. and Amarapurkar, D.N. and Amouyel, P. and Amuzu, A. and Andersen, L.B. and Anderssen, S.A. and Ängquist, L.H. and Anjana, R.M. and Ansong, D. and Aounallah-Skhiri, H. and Araújo, J. and Ariansen, I. and Aris, T. and Arlappa, N. and Arveiler, D. and Aryal, K.K. and Aspelund, T. and Assah, F.K. and Assunção, M.C.F. and Avdicová, M. and Azevedo, A. and Azizi, F. and Babu, B.V. and Bahijri, S. and Balakrishna, N. and Bamoshmoosh, M. and Banach, M. and Bandosz, P. and Banegas, J.R. and Barbagallo, C.M. and Barceló, A. and Barkat, A. and Barros, A.J.D. and Barros, M.V. and Bata, I. and Batieha, A.M. and Batyrbek, A. and Baur, L.A. and Beaglehole, R. and Romdhane, H.B. and Benet, M. and Benson, L.S. and Bernabe-Ortiz, A. and Bernotiene, G. and Bettiol, H. and Bhagyalaxmi, A. and Bharadwaj, S. and Bhargava, S.K. and Bi, Y. and Bikbov, M. and Bista, B. and Bjerregaard, P. and Bjertness, E. and Bjertness, M.B. and Björkelund, C. and Blokstra, A. and Bo, S. and Bobak, M. and Boeing, H. and Boggia, J.G. and Boissonnet, C.P. and Bongard, V. and Borchini, R. and Bovet, P. and Braeckman, L. and Brajkovich, I. and Branca, F. and Breckenkamp, J. and Brenner, H. and Brewster, L.M. and Bruno, G. and Bueno-de-Mesquita, H.B. and Bugge, A. and Burns, C. and Bursztyn, M. and de León, A.C. and Cacciottolo, J. and Cai, H. and Cameron, C. and Can, G. and Cândido, A.P.C. and Capuano, V. and Cardoso, V.C. and Carlsson, A.C. and Carvalho, M.J. and Casanueva, F.F. and Casas, J.-P. and Caserta, C.A. and Chamukuttan, S. and Chan, A.W. and Chan, Q. and Chaturvedi, H.K. and Chaturvedi, N. and Chen, C.-J. and Chen, F. and Chen, H. and Chen, S. and Cheng, C.-Y. and Dekkaki, I.C. and Chetrit, A. and Chiolero, A. and Chiou, S.-T. and Chirita-Emandi, A. and Chirlaque, M.-D. and Cho, B. and Cho, Y. and Christofaro, D.G. and Chudek, J. and Cifkova, R. and Cinteza, E. and Claessens, F. and Clays, E. and Concin, H. and Cooper, C. and Cooper, R. and Coppinger, T.C. and Costanzo, S. and Cottel, D. and Cowell, C. and Craig, C.L. and Crujeiras, A.B. and Cruz, J.J. and D'Arrigo, G. and d'Orsi, E. and Dallongeville, J. and Damasceno, A. and Dankner, R. and Dantoft, T.M. and Dauchet, L. and Davletov, K. and De Backer, G. and De Bacquer, D. and de Gaetano, G. and De Henauw, S. and de Oliveira, P.D. and De Smedt, D. and Deepa, M. and Dehghan, A. and Delisle, H. and Deschamps, V. and Dhana, K. and Di Castelnuovo, A.F. and Dias-da-Costa, J.S. and Diaz, A. and Dickerson, T.T. and Do, H.T.P. and Dobson, A.J. and Donfrancesco, C. and Donoso, S.P. and Döring, A. and Dorobantu, M. and Doua, K. and Drygas, W. and Dulskiene, V. and Džakula, A. and Dzerve, V. and Dziankowska-Zaborszczyk, E. and Eggertsen, R. and Ekelund, U. and El Ati, J. and Elliott, P. and Elosua, R. and Erasmus, R.T. and Erem, C. and Eriksen, L. and Eriksson, J.G. and Escobedo-de la Peña, J. and Evans, A. and Faeh, D. and Fall, C.H. and Farzadfar, F. and Felix-Redondo, F.J. and Ferguson, T.S. and Fernandes, R.A. and Fernández-Bergés, D. and Ferrante, D. and Ferrari, M. and Ferreccio, C. and Ferrieres, J. and Finn, J.D. and Fischer, K. and Föger, B. and Foo, L.H. and Forslund, A.-S. and Forsner, M. and Fouad, H.M. and Francis, D.K. and Franco, M.C. and Franco, O.H. and Frontera, G. and Fuchs, F.D. and Fuchs, S.C. and Fujita, Y. and Furusawa, T. and Gaciong, Z. and Galvano, F. and Garcia-de-la-Hera, M. and Gareta, D. and Garnett, S.P. and Gaspoz, J.-M. and Gasull, M. and Gates, L. and Geleijnse, J.M. and Ghasemian, A. and Ghimire, A. and Giampaoli, S. and Gianfagna, F. and Gill, T.K. and Giovannelli, J. and Goldsmith, R.A. and Gonçalves, H. and Gonzalez-Gross, M. and González-Rivas, J.P. and Gorbea, M.B. and Gottrand, F. and Graff-Iversen, S. and Grafnetter, D. and Grajda, A. and Grammatikopoulou, M.G. and Gregor, R.D. and Grodzicki, T. and Grøntved, A. and Grosso, G. and Gruden, G. and Grujic, V. and Gu, D. and Guan, O.P. and Gudmundsson, E.F. and Gudnason, V. and Guerrero, R. and Guessous, I. and Guimaraes, A.L. and Gulliford, M.C. and Gunnlaugsdottir, J. and Gunter, M. and Gupta, P.C. and Gupta, R. and Gureje, O. and Gurzkowska, B. and Gutierrez, L. and Gutzwiller, F. and Hadaegh, F. and Halkjær, J. and Hardy, R. and Kumar, R.H. and Hata, J. and Hayes, A.J. and He, J. and He, Y. and Hendriks, M.E. and Henriques, A. and Cadena, L.H. and Herrala, S. and Heshmat, R. and Hihtaniemi, I.T. and Ho, S.Y. and Ho, S.C. and Hobbs, M. and Hofman, A. and Dinc, G.H. and Horimoto, A.R. and Hormiga, C.M. and Horta, B.L. and Houti, L. and Howitt, C. and Htay, T.T. and Htet, A.S. and Htike, M.M.T. and Hu, Y. and Huerta, J.M. and Huisman, M. and Husseini, A.S. and Huybrechts, I. and Hwalla, N. and Iacoviello, L. and Iannone, A.G. and Ibrahim, M.M. and Wong, N.I. and Ikeda, N. and Ikram, M.A. and Irazola, V.E. and Islam, M. and al-Safi Ismail, A. and Ivkovic, V. and Iwasaki, M. and Jacobs, J.M. and Jaddou, H. and Jafar, T. and Jamrozik, K. and Janszky, I. and Jasienska, G. and Jelaković, A. and Jelaković, B. and Jennings, G. and Jeong, S.-L. and Jiang, C.Q. and Joffres, M. and Johansson, M. and Jokelainen, J.J. and Jonas, J.B. and Jørgensen, T. and Joshi, P. and Jóźwiak, J. and Juolevi, A. and Jurak, G. and Jureša, V. and Kaaks, R. and Kafatos, A. and Kajantie, E.O. and Kalter-Leibovici, O. and Kamaruddin, N.A. and Karki, K.B. and Kasaeian, A. and Katz, J. and Kauhanen, J. and Kaur, P. and Kavousi, M. and Kazakbaeva, G. and Keil, U. and Boker, L.K. and Keinänen-Kiukaanniemi, S. and Kelishadi, R. and Kemper, H.C.G. and Kengne, A.P. and Kerimkulova, A. and Kersting, M. and Key, T. and Khader, Y.S. and Khalili, D. and Khateeb, M. and Khaw, K.-T. and Kiechl-Kohlendorfer, U. and Kiechl, S. and Killewo, J. and Kim, J. and Kim, Y.-Y. and Klumbiene, J. and Knoflach, M. and Kolle, E. and Kolsteren, P. and Korrovits, P. and Koskinen, S. and Kouda, K. and Kowlessur, S. and Koziel, S. and Kriemler, S. and Kristensen, P.L. and Krokstad, S. and Kromhout, D. and Kruger, H.S. and Kubinova, R. and Kuciene, R. and Kuh, D. and Kujala, U.M. and Kulaga, Z. and Kumar, R.K. and Kurjata, P. and Kusuma, Y.S. and Kuulasmaa, K. and Kyobutungi, C. and Laatikainen, T. and Lachat, C. and Lam, T.H. and Landrove, O. and Lanska, V. and Lappas, G. and Larijani, B. and Laugsand, L.E. and Bao, K.L.N. and Le, T.D. and Leclercq, C. and Lee, J. and Lee, J. and Lehtimäki, T. and León-Muñoz, L.M. and Levitt, N.S. and Li, Y. and Lilly, C.L. and Lim, W.-Y. and Lima-Costa, M.F. and Lin, H.-H. and Lin, X. and Lind, L. and Linneberg, A. and Lissner, L. and Litwin, M. and Lorbeer, R. and Lotufo, P.A. and Lozano, J.E. and Luksiene, D. and Lundqvist, A. and Lunet, N. and Lytsy, P. and Ma, G. and Ma, J. and Machado-Coelho, G.L.L. and Machi, S. and Maggi, S. and Magliano, D.J. and Magriplis, E. and Majer, M. and Makdisse, M. and Malhotra, R. and Rao, K.M. and Malyutina, S. and Manios, Y. and Mann, J.I. and Manzato, E. and Margozzini, P. and Marques-Vidal, P. and Marques, L.P. and Marrugat, J. and Martorell, R. and Mathiesen, E.B. and Matijasevich, A. and Matsha, T.E. and Mbanya, J.N. and Posso, A.J.M.D. and McFarlane, S.R. and McGarvey, S.T. and McLachlan, S. and McLean, R.M. and McLean, S.B. and McNulty, B.A. and Mediene-Benchekor, S. and Medzioniene, J. and Meirhaeghe, A. and Meisinger, C. and Menezes, A.B. and Menon, G.R. and Meshram, I.I. and Metspalu, A. and Meyer, H.E. and Mi, J. and Mikkel, K. and Miller, J.C. and Minderico, C.S. and Miquel, J.F. and Miranda, J.J. and Mirrakhimov, E. and Mišigoj-Durakovic, M. and Modesti, P.A. and Mohamed, M.K. and Mohammad, K. and Mohammadifard, N. and Mohan, V. and Mohanna, S. and Yusoff, M.F.M.D. and Møllehave, L.T. and Møller, N.C. and Molnár, D. and Momenan, A. and Mondo, C.K. and Monyeki, K.D.K. and Moon, J.S. and Moreira, L.B. and Morejon, A. and Moreno, L.A. and Morgan, K. and Moschonis, G. and Mossakowska, M. and Mostafa, A. and Mota, J. and Motlagh, M.E. and Motta, J. and Msyamboza, K.P. and ThetMu, T. and Muiesan, M.L. and Müller-Nurasyid, M. and Murphy, N. and Mursu, J. and Musil, V. and Nabipour, I. and Nagel, G. and Naidu, B.M. and Nakamura, H. and Námešná, J. and Nang, E.K. and Nangia, V.B. and Narake, S. and Nauck, M. and Navarrete-Muñoz, E.M. and Ndiaye, N.C. and Neal, W.A. and Nenko, I. and Neovius, M. and Nervi, F. and Nguyen, C.T. and Nguyen, N.D. and Nguyen, Q.N. and Nguyen, Q.V. and Nieto-Martínez, R.E. and Niiranen, T.J. and Ning, G. and Ninomiya, T. and Nishtar, S. and Noale, M. and Noboa, O.A. and Noorbala, A.A. and Norat, T. and Noto, D. and Al Nsour, M. and O'Reilly, D. and Oda, E. and Oehlers, G. and Oh, K. and Ohara, K. and Olinto, M.T.A. and Oliveira, I.O. and Omar, M.A. and Onat, A. and Ong, S.K. and Ono, L.M. and Ordunez, P. and Ornelas, R. and Osmond, C. and Ostojic, S.M. and Ostovar, A. and Otero, J.A. and Overvad, K. and Owusu-Dabo, E. and Paccaud, F.M. and Padez, C. and Pahomova, E. and Pajak, A. and Palli, D. and Palmieri, L. and Pan, W.-H. and Panda-Jonas, S. and Panza, F. and Papandreou, D. and Park, S.-W. and Parnell, W.R. and Parsaeian, M. and Patel, N.D. and Pecin, I. and Pednekar, M.S. and Peer, N. and Peeters, P.H. and Peixoto, S.V. and Peltonen, M. and Pereira, A.C. and Peters, A. and Petersmann, A. and Petkeviciene, J. and Pham, S.T. and Pigeot, I. and Pikhart, H. and Pilav, A. and Pilotto, L. and Pitakaka, F. and Piwonska, A. and Plans-Rubió, P. and Polašek, O. and Porta, M. and Portegies, M.L.P. and Pourshams, A. and Poustchi, H. and Pradeepa, R. and Prashant, M. and Price, J.F. and Puder, J.J. and Puiu, M. and Punab, M. and Qasrawi, R.F. and Qorbani, M. and Bao, T.Q. and Radic, I. and Radisauskas, R. and Rahman, M. and Raitakari, O. and Raj, M. and Rao, S.R. and Ramachandran, A. and Ramos, E. and Rampal, L. and Rampal, S. and Rangel Reina, D.A. and Redon, J. and Reganit, P.M. and Ribeiro, R. and Riboli, E. and Rigo, F. and Rinke de Wit, T.F. and Ritti-Dias, R.M. and Robinson, S.M. and Robitaille, C. and Rodríguez-Artalejo, F. and Rodriguez-Perez, M.C. and Rodríguez-Villamizar, L.A. and Rojas-Martinez, R. and Romaguera, D. and Ronkainen, K. and Rosengren, A. and Roy, J.G.R. and Rubinstein, A. and Ruiz-Betancourt, B.S. and Rutkowski, M. and Sabanayagam, C. and Sachdev, H.S. and Saidi, O. and Sakarya, S. and Salanave, B. and Martinez, E.S. and Salmerón, D. and Salomaa, V. and Salonen, J.T. and Salvetti, M. and Sánchez-Abanto, J. and Sans, S. and Santos, D.A. and Santos, I.S. and Santos, R.N. and Santos, R. and Saramies, J.L. and Sardinha, L.B. and Sarganas, G. and Sarrafzadegan, N. and Saum, K.-U. and Savva, S. and Scazufca, M. and Schargrodsky, H. and Schipf, S. and Schmidt, C.O. and Schöttker, B. and Schultsz, C. and Schutte, A.E. and Sein, A.A. and Sen, A. and Senbanjo, I.O. and Sepanlou, S.G. and Sharma, S.K. and Shaw, J.E. and Shibuya, K. and Shin, D.W. and Shin, Y. and Si-Ramlee, K. and Siantar, R. and Sibai, A.M. and Silva, D.A.S. and Simon, M. and Simons, J. and Simons, L.A. and Sjöström, M. and Skovbjerg, S. and Slowikowska-Hilczer, J. and Slusarczyk, P. and Smeeth, L. and Smith, M.C. and Snijder, M.B. and So, H.-K. and Sobngwi, E. and Söderberg, S. and Solfrizzi, V. and Sonestedt, E. and Song, Y. and Sørensen, T.I.A. and Soric, M. and Jérome, C.S. and Soumare, A. and Staessen, J.A. and Stathopoulou, M.G. and Stavreski, B. and Steene-Johannessen, J. and Stehle, P. and Stein, A.D. and Stergiou, G.S. and Stessman, J. and Stieber, J. and Stöckl, D. and Stocks, T. and Stokwiszewski, J. and Stronks, K. and Strufaldi, M.W. and Sun, C.-A. and Sung, Y.-T. and Suriyawongpaisal, P. and Sy, R.G. and Tai, E.S. and Tammesoo, M.-L. and Tamosiunas, A. and Tan, E.J. and Tang, X. and Tanser, F. and Tao, Y. and Tarawneh, M.R. and Tarqui-Mamani, C.B. and Tautu, O.-F. and Taylor, A. and Theobald, H. and Theodoridis, X. and Thijs, L. and Thuesen, B.H. and Tjonneland, A. and Tolonen, H.K. and Tolstrup, J.S. and Topbas, M. and Topór-Madry, R. and Tormo, M.J. and Torrent, M. and Traissac, P. and Trichopoulos, D. and Trichopoulou, A. and Trinh, O.T.H. and Trivedi, A. and Tshepo, L. and Tulloch-Reid, M.K. and Tullu, F. and Tuomainen, T.-P. and Tuomilehto, J. and Turley, M.L. and Tynelius, P. and Tzourio, C. and Ueda, P. and Ugel, E.E. and Ulmer, H. and Uusitalo, H.M.T. and Valdivia, G. and Valvi, D. and van der Schouw, Y.T. and Van Herck, K. and Van Minh, H. and van Rossem, L. and Van Schoor, N.M. and van Valkengoed, I.G.M. and Vanderschueren, D. and Vanuzzo, D. and Vatten, L. and Vega, T. and Velasquez-Melendez, G. and Veronesi, G. and Verschuren, W.M.M. and Verstraeten, R. and Victora, C.G. and Viet, L. and Viikari-Juntura, E. and Vineis, P. and Vioque, J. and Virtanen, J.K. and Visvikis-Siest, S. and Viswanathan, B. and Vlasoff, T. and Vollenweider, P. and Voutilainen, S. and Wade, A.N. and Wagner, A. and Walton, J. and Wan Bebakar, W.M. and Wan Mohamud, W.N. and Wanderley, R.S., Jr. and Wang, M.-D. and Wang, Q. and Wang, Y.X. and Wang, Y.-W. and Wannamethee, S.G. and Wareham, N. and Wedderkopp, N. and Weerasekera, D. and Whincup, P.H. and Widhalm, K. and Widyahening, I.S. and Wiecek, A. and Wijga, A.H. and Wilks, R.J. and Willeit, J. and Willeit, P. and Williams, E.A. and Wilsgaard, T. and Wojtyniak, B. and Wong-McClure, R.A. and Wong, J.Y.Y. and Wong, T.Y. and Woo, J. and Wu, A.G. and Wu, F.C. and Wu, S. and Xu, H. and Yan, W. and Yang, X. and Ye, X. and Yiallouros, P.K. and Yoshihara, A. and Younger-Coleman, N.O. and Yusoff, A.F. and Zainuddin, A.A. and Zambon, S. and Zampelas, A. and Zdrojewski, T. and Zeng, Y. and Zhao, D. and Zhao, W. and Zheng, W. and Zheng, Y. and Zhu, D. and Zhussupov, B. and Zimmermann, E. and Cisneros, J.Z. and NCD Risk Factor Collaboration (NCD-RisC), Imperial College London, London, W2 1PG, United Kingdom, Imperial College London, United Kingdom, University of Kent, United Kingdom, Middlesex University, United Kingdom, Harvard TH Chan School of Public Health, United States, Cleveland Clinic, United States, Universidad Peruana Cayetano Heredia, Peru, Tehran University of Medical Sciences, Iran, Ministry of Health and Medical Education, Iran, Brandeis University, United States, Mulago Hospital, Uganda, Uganda Heart Institute, Uganda, World Health Organization, Switzerland, University of Oxford, United Kingdom, The University of the West Indies, Barbados, University of Auckland, New Zealand, South African Medical Research Council, South Africa, Seoul National University, South Korea, National Institute of Nutrition, India, Capital Medical University Beijing An Zhen Hospital, China, Robert Koch Institute, Germany, German Center for Cardiovascular Research, Germany, University of Zagreb, Croatia, University of Ljubljana, Slovenia, Uppsala University, Sweden, University of New South Wales, Australia, Caja Costarricense de Seguro Social, Costa Rica, Al-Quds University, Palestine, Birzeit University, Palestine, Instituto Mexicano del Seguro Social, Mexico, The University of Adelaide, Australia, Mahidol University, Thailand, BRAC, Bangladesh, Instituto Nacional de Ciencias Médicas y Nutricion, Mexico, University of Amsterdam, Netherlands, Ministry of Health Malaysia, Malaysia, Non- Communicable Diseases Research Center, Iran, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Germany, National Center for Diabetes and Endocrinology, Jordan, Kazakh National Medical University, Kazakhstan, King Abdulaziz University, Saudi Arabia, Universiti Malaysia Sabah, Malaysia, Luxembourg Institute of Health, Luxembourg, World Health Organization Regional Office for the Eastern Mediterranean, Egypt, Bombay Hospital and Medical Research Centre, India, Lille University and Hospital, France, London School of Hygiene and Tropical Medicine, United Kingdom, Western Norway University of Applied Sciences, Norway, Norwegian School of Sport Sciences, Norway, Bispebjerg and Frederiksberg Hospitals, Denmark, Madras Diabetes Research Foundation, India, Komfo Anokye Teaching Hospital, Ghana, National Institute of Public Health, Tunisia, Universidade do Porto, Portugal, Norwegian Institute of Public Health, Norway, Strasbourg University and Hospital, France, Nepal Health Research Council, Nepal, University of Iceland, Iceland, University of Yaoundé 1, Cameroon, Federal University of Pelotas, Brazil, Regional Authority of Public Health, Banska Bystrica, Slovakia, University of Porto Medical School, Portugal, Shahid Beheshti University of Medical Sciences, Iran, Indian Council of Medical Research, India, University of Science and Technology, Yemen, Medical University of Lodz, Poland, Medical University of Gdansk, Poland, Universidad Autónoma de Madrid, Spain, University of Palermo, Italy, Pan American Health Organization, United States, Université Mohammed V de Rabat, Morocco, University of Pernambuco, Brazil, Dalhousie University, Canada, Jordan University of Science and Technology, Jordan, University of Sydney, Australia, University Tunis El Manar, Tunisia, CAFAM University Foundation, Colombia, University of Utah School of Medicine, United States, Lithuanian University of Health Sciences, Lithuania, University of São Paulo, Brazil, BJ Medical College, India, Chirayu Medical College, India, SL Jain Hospital, India, Shanghai Jiao-Tong University School of Medicine, China, Ufa Eye Research Institute, Russian Federation, University of Southern Denmark, Denmark, University of Greenland, Greenland, University of Oslo, Norway, University of Gothenburg, Sweden, National Institute for Public Health and the Environment, Netherlands, University of Turin, Italy, University College London, United Kingdom, German Institute of Human Nutrition, Germany, Universidad de la República, Uruguay, CEMIC, Argentina, Toulouse University School of Medicine, France, University Hospital of Varese, Italy, Ministry of Health, Seychelles, University of Lausanne, Switzerland, Ghent University, Belgium, Universidad Central de Venezuela, Venezuela, Bielefeld University, Germany, German Cancer Research Center, Germany, Cork Institute of Technology, Ireland, Hadassah-Hebrew University Medical Center, Israel, Universidad de La Laguna, Spain, University of Malta, Malta, Vanderbilt University, United States, Canadian Fitness and Lifestyle Research Institute, Canada, Istanbul University, Turkey, Universidade Federal de Juiz de Fora, Brazil, Cardiologia di Mercato S. Severino, Italy, Karolinska Institutet, Sweden, University of Porto, Portugal, Santiago de Compostela University, Spain, Associazione Calabrese di Epatologia, Italy, India Diabetes Research Foundation, India, Duke-NUS Medical School, Singapore, National Institute of Medical Statistics, India, Academia Sinica, Taiwan, Capital Institute of Pediatrics, China, Duke University, United States, Kailuan General Hospital, China, The Gertner Institute for Epidemiology and Health Policy Research, Israel, University of Bern, Switzerland, Ministry of Health and Welfare, Taiwan, Victor Babes University of Medicine and Pharmacy Timisoara, Romania, Murcia Regional Health Council, Spain, Seoul National University College of Medicine, South Korea, Korea Centers for Disease Control and Prevention, South Korea, Universidade Estadual Paulista, Brazil, Medical University of Silesia, Poland, Charles University in Prague, Czech Republic, Carol Davila University of Medicine and Pharmacy, Romania, Katholieke Universiteit Leuven, Belgium, Agency for Preventive and Social Medicine, Austria, University of Southampton, United Kingdom, IRCCS Istituto Neurologico Mediterraneo Neuromed, Italy, Institut Pasteur de Lille, France, CIBEROBN, Spain, National Council of Research, Italy, Universidade Federal de Santa Catarina, Brazil, Eduardo Mondlane University, Mozambique, Bispebjerg and Frederiksberg Hospital, Denmark, Lille University Hospital, France, Erasmus Medical Center Rotterdam, Netherlands, University of Montreal, Canada, French Public Health Agency, France, Universidade do Vale do Rio dos Sinos, Brazil, National Council of Scientific and Technical Research, Argentina, National Institute of Nutrition, Viet Nam, University of Queensland, Australia, Istituto Superiore di Sanità, Italy, Universidad de Cuenca, Ecuador, Helmholtz Zentrum München, Germany, Ministère de la Santé et de la Lutte Contre le Sida, Cote d'Ivoire, The Cardinal Wyszynski Institute of Cardiology, Poland, University of Latvia, Latvia, National Institute of Nutrition and Food Technology, Tunisia, Institut Hospital del Mar d'Investigacions Mèdiques, Spain, University of Stellenbosch, South Africa, Karadeniz Technical University, Turkey, National Institute for Health and Welfare, Finland, Queen's University of Belfast, United Kingdom, University of Zurich, Switzerland, Centro de Salud Villanueva Norte, Spain, The University of the West Indies, Jamaica, Hospital Don Benito-Villanueva de la Serena, Spain, Ministry of Health, Argentina, Council for Agricultural Research and Economics, Italy, Pontificia Universidad Católica de Chile, Chile, University of Manchester, United Kingdom, University of Tartu, Estonia, Universiti Sains Malaysia, Malaysia, Umeå University, Sweden, Dalarna University, Sweden, Federal University of São Paulo, Brazil, Hospital Universitario Son Espases, Spain, Hospital de Clinicas de Porto Alegre, Brazil, Universidade Federal do Rio Grande do Sul, Brazil, Kindai University, Japan, Kyoto University, Japan, Medical University of Warsaw, Poland, University of Catania, Italy, CIBER en Epidemiología y Salud Pública, Spain, University of KwaZulu-Natal, South Africa, Geneva University Hospitals, Switzerland, Australian Bureau of Statistics, Australia, Wageningen University, Netherlands, B P Koirala Institute of Health Sciences, Nepal, University of Insubria, Italy, Ministry of Health, Israel, The Andes Clinic of Cardio-Metabolic Studies, Venezuela, National Institute of Hygiene, Epidemiology and Microbiology, Cuba, Université de Lille 2, France, Institute for Clinical and Experimental Medicine, Czech Republic, Children'sMemorial Health Institute, Poland, Alexander Technological Educational Institute, Greece, Jagiellonian University Medical College, Poland, Azienda Ospedaliera Universitaria Policlinico Vittorio Emanuele, Italy, University of Novi Sad, Serbia, National Center of Cardiovascular Diseases, China, Singapore Eye Research Institute, Singapore, Icelandic Heart Association, Iceland, Universidad Icesi, Colombia, King's College London, United Kingdom, International Agency for Research on Cancer, France, Healis-Sekhsaria Institute for Public Health, India, Eternal Heart Care Centre and Research Institute, India, University of Ibadan, Nigeria, Children's Memorial Health Institute, Poland, Institute for Clinical Effectiveness and Health Policy, Argentina, Danish Cancer Society Research Centre, Denmark, Kyushu University, Japan, Tulane University, United States, Chinese Center for Disease Control and Prevention, China, Academic Medical Center of University of Amsterdam, Netherlands, National Institute of Public Health, Mexico, Oulu University Hospital, Finland, Chronic Diseases Research Center, Iran, University of Hong Kong, Hong Kong, The Chinese University of Hong Kong, Hong Kong, University of Western Australia, Australia, Celal Bayar University, Turkey, Heart Institute, Brazil, Fundación Oftalmológica de Santander, Colombia, University of Oran 1, Algeria, Independent Public Health Specialist, Myanmar, Ministry of Health, Myanmar, Peking University, China, VU University Medical Center and VU University, Netherlands, American University of Beirut, Lebanon, Cairo University, Egypt, National Institute of Health and Nutrition, Japan, Aga Khan University, Pakistan, UHC Zagreb, Croatia, Niigata University, Japan, Hadassah University Medical Center, Israel, Duke- NUS Medical School, Singapore, Norwegian University of Science and Technology, Norway, University of Zagreb School of Medicine, Croatia, Heart Foundation, Australia, National Health Insurance Service, South Korea, Guangzhou 12th Hospital, China, Simon Fraser University, Canada, Ruprecht-Karls- University of Heidelberg, Germany, Research Centre for Prevention and Health, Denmark, World Health Organization Country Office, India, Czestochowa University of Technology, Poland, University of Crete, Greece, Universiti Kebangsaan Malaysia, Malaysia, Johns Hopkins Bloomberg School of Public Health, United States, University of Eastern Finland, Finland, National Institute of Epidemiology, India, University of Münster, Germany, Israel Center for Disease Control, Israel, Research Institute for Primordial Prevention of Noncommunicable Disease, Iran, VU University Medical Center, Netherlands, Kyrgyz State Medical Academy, Kyrgyzstan, Research Institute of Child Nutrition, Germany, University of Cambridge, United Kingdom, Medical University of Innsbruck, Austria, Muhimbili University of Health and Allied Sciences, Tanzania, National Cancer Center, South Korea, Institute of Tropical Medicine, Belgium, Tartu University Clinics, Estonia, Ministry of Health and Quality of Life, Mauritius, Polish Academy of Sciences Anthropology Unit in Wroclaw, Poland, University of Zürich, Switzerland, University of Groningen, Netherlands, North-West University, South Africa, National Institute of Public Health, Czech Republic, University of Jyväskylä, Finland, Amrita Institute of Medical Sciences, India, All India Institute of Medical Sciences, India, African Population and Health Research Center, Kenya, Ministerio de Salud Pública, Cuba, Sahlgrenska Academy, Sweden, Endocrinology and Metabolism Research Center, Iran, Food and Agriculture Organization of the United Nations, Italy, National University of Singapore, Singapore, Tampere University Hospital, Finland, University of Cape Town, South Africa, West Virginia University, United States, Oswaldo Cruz Foundation Rene Rachou Research Institute, Brazil, National Taiwan University, Taiwan, University of Chinese Academy of Sciences, China, University Medicine Greifswald, Germany, Consejería de Sanidad Junta de Castilla y León, Spain, University of Uppsala, Sweden, Universidade Federal de Ouro Preto, Brazil, The Jikei University School of Medicine, Japan, National Research Council, Italy, Baker Heart and Diabetes Institute, Australia, Agricultural University of Athens, Greece, Hospital Israelita Albert Einstein, Brazil, Shiraz University of Medical Sciences, Iran, Institute of Internal and Preventive Medicine, Russian Federation, Harokopio University, Greece, University of Otago, New Zealand, University of Padova, Italy, Lausanne University Hospital, Switzerland, CIBERCV, Spain, Emory University, United States, UiT The Arctic University of Norway, Norway, Cape Peninsula University of Technology, South Africa, Gorgas Memorial Institute of Health Studies, Panama, Brown University, United States, University of Edinburgh, United Kingdom, Statistics Canada, Canada, University College Dublin, Ireland, Institut National de la Santé et de la Recherche Médicale, France, Lusófona University, Portugal, Universita' degli Studi di Firenze, Italy, Ain Shams University, Egypt, Hypertension Research Center, Iran, University of Pécs, Hungary, Seoul National University Children's Hospital, South Korea, University Medical Science, Cuba, Universidad de Zaragoza, Spain, RCSI Dublin, Ireland, La Trobe University, Australia, International Institute of Molecular and Cell Biology, Poland, Ahvaz Jundishapur University of Medical Sciences, Iran, Gorgas Memorial Institute of Public Health, Panama, World Health Organization Country Office, Malawi, Department of Public Health, Myanmar, University of Brescia, Italy, Bushehr University of Medical Sciences, Iran, Ulm University, Germany, Kobe University, Japan, Suraj Eye Institute, India, University Medicine of Greifswald, Germany, INSERM, France, National Institute of Hygiene and Epidemiology, Viet Nam, The University of Pharmacy and Medicine of Ho Chi Minh City, Viet Nam, Hanoi Medical University, Viet Nam, National Hospital of Endocrinology, Viet Nam, Miami Veterans Affairs Healthcare System, United States, University of Turku Tyks, Finland, Heartfile, Pakistan, Eastern Mediterranean Public Health Network, Jordan, Tachikawa General Hospital, Japan, Academic Hospital of Paramaribo, Suriname, Ministry of Health, Brunei Darussalam, University of Madeira, Portugal, MRC Lifecourse Epidemiology Unit, United Kingdom, Aarhus University, Denmark, Kwame Nkrumah University of Science and Technology, Ghana, Institute for Social and Preventive Medicine, Switzerland, University of Coimbra, Portugal, Cancer Prevention and Research Institute, Italy, Ruprecht-Karls-University of Heidelberg, Germany, IRCCS Casa Sollievo della Sofferenza, Italy, Zayed University, United Arab Emirates, Catholic University of Daegu, South Korea, Jivandeep Hospital, India, University Hospital Centre Zagreb, Croatia, University Medical Center Utrecht, Netherlands, Vietnam National Heart Institute, Viet Nam, University of Sarajevo, Bosnia and Herzegovina, Cardiovascular Prevention Centre Udine, Italy, Ministry of Health and Medical Services, Solomon Islands, Public Health Agency of Catalonia, Spain, University of Split, Croatia, Digestive Oncology Research Center, Iran, Digestive Disease Research Institute, Iran, Alborz University of Medical Sciences, Iran, Ministry of Health, Viet Nam, University of Turku, Finland, Universiti Putra Malaysia, Malaysia, University of Malaya, Malaysia, University of Valencia, Spain, University of the Philippines, Philippines, Minas Gerais State Secretariat for Health, Brazil, Health Center San Agustín, Spain, PharmAccess Foundation, Netherlands, Universidade Nove de Julho, Brazil, Public Health Agency of Canada, Canada, Canarian Health Service, Spain, Universidad Industrial de Santander, Colombia, Instituto Nacional de Salud Pública, Mexico, Sitaram Bhartia Institute of Science and Research, India, Marmara University, Turkey, CIBER de Epidemiología y Salud Pública, Spain, University of Helsinki, Finland, National Institute of Health, Peru, Catalan Department of Health, Spain, Universidade de Lisboa, Portugal, University of Sao Paulo Clinics Hospital, Brazil, South Karelia Social and Health Care District, Finland, Isfahan Cardiovascular Research Center, Iran, Research and Education Institute of Child Health, Cyprus, Hospital Italiano de Buenos Aires, Argentina, Lagos State University College of Medicine, Nigeria, The University of Tokyo, Japan, Samsung Medical Center, South Korea, Federal University of Santa Catarina, Brazil, St Vincent's Hospital, Australia, Academic Medical Center Amsterdam, Netherlands, University of Bari, Italy, Lund University, Sweden, University of Copenhagen, Denmark, Institut Régional de Santé Publique, Benin, University of Bordeaux, France, University of Leuven, Belgium, Bonn University, Germany, Sotiria Hospital, Greece, National Institute of Public Health- National Institute of Hygiene, Poland, Fu Jen Catholic University, Taiwan, Ministry of Health, Jordan, Health Service of Murcia, Spain, IB-SALUT Area de Salut de Menorca, Spain, Institut de Recherche pour le Développement, France, Hellenic Health Foundation, Greece, GovernmentMedical College, India, Sefako Makgatho Health Science University, South Africa, Addis Ababa University, Ethiopia, Dasman Diabetes Institute, Kuwait, Ministry of Health, New Zealand, Universidad Centro-Occidental Lisandro Alvarado, Venezuela, University of Tampere Tays Eye Center, Finland, Utrecht University, Netherlands, Hanoi University of Public Health, Viet Nam, Amsterdam Public Health Research Institute, Netherlands, Universidade Federal de Minas Gerais, Brazil, Finnish Institute of Occupational Health, Finland, Universidad Miguel Hernandez, Spain, North Karelian Center for Public Health, Finland, University of the Witwatersrand, South Africa, University of Strasbourg, France, Institute for Medical Research, Malaysia, Xinjiang Medical University, China, Capital Medical University, China, St George's, University of London, United Kingdom, Medical University of Vienna, Austria, Universitas Indonesia, Indonesia, National Institute of Public Health-National Institute of Hygiene, Poland, Institute of Food and Nutrition Development of Ministry of Agriculture, China, Children's Hospital of Fudan University, China, University of Cyprus, Cyprus, Universiti Teknologi MARA, Malaysia, Inner Mongolia Medical University, China, Universidad Politécnica de Madrid, Spain, State University of Montes Claros, Brazil, and University of Limpopo, South Africa
- Subjects
sense organs - Abstract
Background: Change in the prevalence of raised blood pressure could be due to both shifts in the entire distribution of blood pressure (representing the combined effects of public health interventions and secular trends) and changes in its high-blood-pressure tail (representing successful clinical interventions to control blood pressure in the hypertensive population). Our aim was to quantify the contributions of these two phenomena to the worldwide trends in the prevalence of raised blood pressure. Methods: We pooled 1018 population-based studies with blood pressure measurements on 88.6 million participants from 1985 to 2016. We first calculated mean systolic blood pressure (SBP), mean diastolic blood pressure (DBP) and prevalence of raised blood pressure by sex and 10-year age group from 20-29 years to 70-79 years in each study, taking into account complex survey design and survey sample weights, where relevant. We used a linear mixed effect model to quantify the association between (probittransformed) prevalence of raised blood pressure and age-group- and sex-specific mean blood pressure. We calculated the contributions of change in mean SBP and DBP, and of change in the prevalence-mean association, to the change in prevalence of raised blood pressure. Results: In 2005-16, at the same level of population mean SBP and DBP, men and women in South Asia and in Central Asia, the Middle East and North Africa would have the highest prevalence of raised blood pressure, and men and women in the highincome Asia Pacific and high-income Western regions would have the lowest. In most region-sex-age groups where the prevalence of raised blood pressure declined, one half or more of the decline was due to the decline in mean blood pressure. Where prevalence of raised blood pressure has increased, the change was entirely driven by increasing mean blood pressure, offset partly by the change in the prevalence-mean association. Conclusions: Change in mean blood pressure is the main driver of the worldwide change in the prevalence of raised blood pressure, but change in the high-blood-pressure tail of the distribution has also contributed to the change in prevalence, especially in older age groups. © The Author(s) 2018.
- Published
- 2018
3. Worldwide trends in blood pressure from 1975 to 2015: a pooled analysis of 1479 population-based measurement studies with 19·1 million participants
- Author
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and Cisneros, J.Z. and Zhu, D. and Eggertsen, R. and NCD Risk Factor Collaboration (NCD-RisC), Imperial College London, United Kingdom, Middlesex University, United Kingdom, World Health Organization, Switzerland, University of California, Berkeley, United States, Tufts University, United States, Universidad Peruana Cayetano Heredia, Peru, Tehran University of Medical Sciences, Iran, Brandeis University, United States, Mulago Hospital, Uganda, Yale University, United States, University of Lausanne, Switzerland, Ministry of Health, Seychelles, National Center for Cardiovascular Diseases, China, National Institute of Health and Nutrition, Japan, University of Auckland, New Zealand, Simon Fraser University, Canada, South African Medical Research Council, South Africa, National Institute for Health and Welfare, Finland, University of Hong Kong, Hong Kong, National Institute of Nutrition, India, Capital Medical University Beijing An Zhen Hospital, China, Robert Koch Institute, Germany, Uppsala University, Sweden, London School of Hygiene and Tropical Medicine, United Kingdom, University of Zagreb, Croatia, University of Sydney, Australia, University of Oxford, United Kingdom, Caja Costarricense de Seguro Social, Costa Rica, Al-Quds University, Palestine, Qatar University, Qatar, Birzeit University, Palestine, Instituto Mexicano del Seguro Social, Mexico, The University of Adelaide, Australia, Mahidol University, Thailand, BRAC, Bangladesh, Instituto Nacional de Ciencias Médicas y Nutricion, Mexico, University of Amsterdam, Netherlands, Non-Communicable Diseases Research Center, Iran, Leibniz Institute for Prevention Research and Epidemiology—BIPS, Germany, Ministry of Health, Saudi Arabia, Ministry of Health, Kuwait, World Health Organization Regional Office for the Eastern Mediterranean, Egypt, Luxembourg Institute of Health, Luxembourg, Lille University and Hospital, France, Sogn and Fjordane University College, Norway, Norwegian School of Sport Sciences, Norway, Bispebjerg and Frederiksberg Hospitals, Denmark, Madras Diabetes Research Foundation, India, Komfo Anokye Teaching Hospital, Ghana, National Institute of Public Health, Tunisia, University of Porto, Portugal, Norwegian Institute of Public Health, Norway, Ministry of Health Malaysia, Malaysia, Nepal Health Research Council, Nepal, Strasbourg University and Hospital, France, University of Yaoundé 1, Cameroon, Federal University of Pelotas, Brazil, Regional Authority of Public Health, Banska Bystrica, Slovakia, University of Porto Medical School, Portugal, Shahid Beheshti University of Medical Sciences, Iran, Indian Council of Medical Research, India, King Abdulaziz University, Saudi Arabia, Medical University of Gdansk, Poland, Universidad Autónoma de Madrid, Spain, University of Palermo, Italy, Pan American Health Organization, United States, Université Mohammed V de Rabat, Morocco, University of Pernambuco, Brazil, Dalhousie University, Canada, Jordan University of Science and Technology, Jordan, University Tunis El Manar, Tunisia, University Medical Science, Cuba, University of Utah School of Medicine, United States, Lithuanian University of Health Sciences, Lithuania, University of São Paulo, Brazil, B J Medical College, India, Chirayu Medical College, India, SL Jain Hospital, India, Shanghai Jiao-Tong University School of Medicine, China, Ufa Eye Research Institute, Russian Federation, University of Southern Denmark, Denmark, University of Greenland, Greenland, University of Oslo, Norway, University of Gothenburg, Sweden, National Institute for Public Health and the Environment, Netherlands, University of Turin, Italy, University College London, United Kingdom, German Institute of Human Nutrition, Germany, Universidad de la República, Uruguay, CEMIC, Argentina, Toulouse University School of Medicine, France, Ghent University, Belgium, Universidad Central de Venezuela, Venezuela, Bielefeld University, Germany, German Cancer Research Center, Germany, Cork Institute of Technology, Ireland, Hadassah-Hebrew University Medical Center, Israel, Universidad de La Laguna, Spain, University of Malta, Malta, Canadian Fitness and Lifestyle Research Institute, Canada, Istanbul University, Turkey, Universidade Federal de Juiz de Fora, Brazil, Cardiologia di Mercato S Severino, Italy, Karolinska Institutet, Sweden, Santiago de Compostela University, Spain, Associazione Calabrese di Epatologia, Italy, India Diabetes Research Foundation, India, Duke-NUS Medical School, Singapore, National Institute of Medical Statistics, India, Academia Sinica, Taiwan, Capital Institute of Pediatrics, China, Duke University, United States, Kailuan General Hospital, China, The Gertner Institute for Epidemiology and Health Policy Research, Israel, Lausanne University Hospital, Switzerland, Ministry of Health and Welfare, Taiwan, Victor Babeș University of Medicine and Pharmacy Timisoara, Romania, Seoul National University College of Medicine, South Korea, Korea Centers for Disease Control and Prevention, South Korea, Medical University of Silesia, Poland, Charles University in Prague, Czech Republic, Katholieke Universiteit Leuven, Belgium, Agency for Preventive and Social Medicine, Austria, University of Southampton, United Kingdom, IRCCS Istituto Neurologico Mediterraneo Neuromed, Italy, Institut Pasteur de Lille, France, Westmead University of Sydney, Australia, CIBEROBN, Spain, National Council of Research, Italy, Federal University of Santa Catarina, Brazil, Eduardo Mondlane University, Mozambique, Research Centre for Prevention and Health, Denmark, Lille University Hospital, France, Erasmus Medical Center Rotterdam, Netherlands, University of Montreal, Canada, French Public Health Agency, France, Universidade do Vale do Rio dos Sinos, Brazil, National Council of Scientific and Technical Research, Argentina, National Institute of Nutrition, Viet Nam, University of Queensland, Australia, Istituto Superiore di Sanità, Italy, Universidad de Cuenca, Ecuador, Helmholtz Zentrum München, Germany, Ministère de la Santé et de la Lutte Contre le Sida, Cote d'Ivoire, The Cardinal Wyszynski Institute of Cardiology, Poland, University of Latvia, Latvia, Medical University of Łodz, Poland, National Institute of Nutrition and Food Technology, Tunisia, Institut Hospital del Mar d'Investigacions Mèdiques, Spain, University of Stellenbosch, South Africa, Karadeniz Technical University, Turkey, The Queen's University of Belfast, United Kingdom, University of Zurich, Switzerland, Centro de Salud Villanueva Norte, Spain, The University of the West Indies, Jamaica, Hospital Don Benito-Villanueva de la Serena, Spain, Ministry of Health, Argentina, Council for Agricultural Research and Economics, Italy, Pontificia Universidad Católica de Chile, Chile, University of Manchester, United Kingdom, University of Tartu, Estonia, Universiti Sains Malaysia, Malaysia, Umeå University, Sweden, Dalarna University, Sweden, Stanford University, United States, Federal University of São Paulo, Brazil, Hospital Universitario Son Espases, Spain, Hospital de Clinicas de Porto Alegre, Brazil, Universidade Federal do Rio Grande do Sul, Brazil, Kindai University, Japan, Kyoto University, Japan, Medical University of Warsaw, Poland, University of KwaZulu-Natal, South Africa, Geneva University Hospitals, Switzerland, CIBER en Epidemiología y Salud Pública, Spain, Australian Bureau of Statistics, Australia, Murcia Regional Health Council, Spain, Wageningen University, Netherlands, Endocrinology and Metabolism Research Institute, Iran, B P Koirala Institute of Health Sciences, Nepal, University of Insubria, Italy, Ministry of Health, Israel, Universidad Politécnica de Madrid, Spain, The Andes Clinic of Cardio-Metabolic Studies, Venezuela, Université de Lille 2, France, Institute for Clinical and Experimental Medicine, Czech Republic, The Children's Memorial Health Institute, Poland, Jagiellonian University Medical College, Poland, University of Novi Sad, Serbia, Singapore Eye Research Institute, Singapore, University of Iceland, Iceland, Universidad Icesi, Colombia, State University of Montes Claros, Brazil, King's College London, United Kingdom, Icelandic Heart Association, Iceland, Healis-Sekhsaria Institute for Public Health, India, University of Ibadan, Nigeria, Institute for Clinical Effectiveness and Health Policy, Argentina, Danish Cancer Society Research Centre, Denmark, The University of the West Indies, Barbados, Kyushu University, Japan, Tulane University, United States, Academic Medical Center Amsterdam, Netherlands, National Institute of Public Health, Mexico, Universitas Indonesia, Indonesia, Oulu University Hospital, Finland, Chronic Diseases Research Center, Iran, The Chinese University of Hong Kong, Hong Kong, University of Western Australia, Australia, Celal Bayar University, Turkey, Fundación Oftalmológica de Santander, Colombia, Universidade Federal de Pelotas, Brazil, University of Oran 1, Algeria, University of Public Health, Myanmar, Ministry of Health, Myanmar, Peking University, China, International Agency for Research on Cancer, France, American University of Beirut, Lebanon, Cairo University, Egypt, Aga Khan University, Pakistan, UHC Zagreb, Croatia, Niigata University, Japan, Hadassah University Medical Center, Israel, Norwegian University of Science and Technology, Norway, University of Zagreb School of Medicine, Croatia, Guangzhou 12th Hospital, China, Ruprecht-Karls-University of Heidelberg, Germany, World Health Organization Country Office, India, University of Ljubljana, Slovenia, University of Crete, Greece, Universiti Kebangsaan Malaysia, Malaysia, Johns Hopkins Bloomberg School of Public Health, United States, University of Eastern Finland, Finland, National Institute of Epidemiology, India, University of Münster, Germany, Israel Center for Disease Control, Israel, Research Institute for Primordial Prevention of Non-Communicable Disease, Iran, VU University Medical Center, Netherlands, Research Institute of Child Nutrition, Germany, Seoul National University, South Korea, University of Cambridge, United Kingdom, Medical University of Innsbruck, Austria, Muhimbili University of Health and Allied Sciences, Tanzania, National Cancer Center, South Korea, Institute of Tropical Medicine, Belgium, Tartu University Clinics, Estonia, Polish Academy of Sciences Anthropology Unit in Wroclaw, Poland, University of Groningen, Netherlands, North-West University, South Africa, National Institute of Public Health, Czech Republic, University of Jyväskylä, Finland, Amrita Institute of Medical Sciences, India, All India Institute of Medical Sciences, India, African Population and Health Research Center, Kenya, Ministerio de Salud Pública, Cuba, Sahlgrenska Academy, Sweden, Endocrinology and Metabolism Research Center, Iran, Food and Agriculture Organization, Italy, National University of Singapore, Singapore, Tampere University Hospital, Finland, Universiti Putra Malaysia, Malaysia, University of Cape Town, South Africa, West Virginia University, United States, Oswaldo Cruz Foundation Rene Rachou Research Institute, Brazil, National Taiwan University, Taiwan, University of Chinese Academy of Sciences, China, University Medicine Greifswald, Germany, Consejería de Sanidad Junta de Castilla y León, Spain, Universidade do Porto, Portugal, University of Uppsala, Sweden, Universidade Federal de Ouro Preto, Brazil, The Jikei University School of Medicine, Japan, National Research Council, Italy, Baker IDI Heart and Diabetes Institute, Australia, Hospital Israelita Albert Einstein, Brazil, Institute of Internal and Preventive Medicine, Russian Federation, Harokopio University, Greece, University of Otago, New Zealand, University of Padova, Italy, Emory University, United States, UiT The Arctic University of Norway, Norway, Cape Peninsula University of Technology, South Africa, Gorgas Memorial Institute of Health Studies, Panama, Brown University, United States, University of Edinburgh, United Kingdom, University College Dublin, Ireland, Penang Medical College, Malaysia, Institut National de la Santé et de la Recherche Médicale, France, Ain Shams University, Egypt, Hypertension Research Center, Iran, University of Pécs, Hungary, University of Limpopo, South Africa, Universidad de Zaragoza, Spain, RCSI Dublin, Ireland, International Institute of Molecular and Cell Biology, Poland, Ahvaz Jundishapur University of Medical Sciences, Iran, Gorgas Memorial Institute of Public Health, Panama, University of Brescia, Italy, Ulm University, Germany, Institute of Public Health, Malaysia, Kobe University, Japan, Suraj Eye Institute, India, INSERM, France, The University of Pharmacy and Medicine of Ho Chi Minh City, Viet Nam, Hanoi Medical University, Viet Nam, Universidad Centro-Occidental Lisandro Alvarado, Venezuela, Heartfile, Pakistan, Eastern Mediterranean Public Health Network, Jordan, Aarhus University, Denmark, Kwame Nkrumah University of Science and Technology, Ghana, Institute for Social and Preventive Medicine, Switzerland, University of Coimbra, Portugal, Cancer Prevention and Research Institute, Italy, University of Bari, Italy, Zayed University, United Arab Emirates, University Medical Center Utrecht, Netherlands, Public Health Agency of Canada, Canada, Heart Institute, Brazil, National Institute of Hygiene, Epidemiology and Microbiology, Cuba, Vietnam National Heart Institute, Viet Nam, Federal Ministry of Health, Bosnia and Herzegovina, Cardiovascular Prevention Centre Udine, Italy, University of New South Wales, Australia, Public Health Agency of Catalonia, Spain, University of Split, Croatia, Alborz University of Medical Sciences, Iran, Turku University Hospital, Finland, Julius Centre University of Malaya, Malaysia, University of Valencia, Spain, University of the Philippines, Philippines, Minas Gerais State Secretariat for Health, Brazil, Health Center San Agustín, Spain, PharmAccess Foundation, Netherlands, Canarian Health Service, Spain, Universidad Industrial de Santander, Colombia, Instituto Nacional de Salud Pública, Mexico, University of Madeira, Portugal, Sitaram Bhartia Institute of Science and Research, India, Marmara University, Turkey, University of Helsinki, Finland, National Institute of Health, Peru, Catalan Department of Health, Spain, Universidade de Lisboa, Portugal, University of Sao Paulo Clinics Hospital, Brazil, South Karelia Social and Health Care District, Finland, Robert Koch Institut, Germany, Isfahan Cardiovascular Research Center, Iran, Research and Education Institute of Child Health, Cyprus, Hospital Italiano de Buenos Aires, Argentina, Lagos State University College of Medicine, Nigeria, Digestive Diseases Research Institute, Iran, The University of Tokyo, Japan, St Vincent's Hospital, Australia, Lund University, Sweden, University of Copenhagen, Denmark, Institut Régional de Santé Publique, Benin, University of Bordeaux, France, University of Leuven, Belgium, Heart Foundation, Australia, Bonn University, Germany, Sotiria Hospital, Greece, National Institute of Public Health-National Institute of Hygiene, Poland, Fu Jen Catholic University, Taiwan, Ministry of Health, Jordan, IB-SALUT Area de Salut de Menorca, Spain, Institut de Recherche pour le Développement, France, Harvard T H Chan School of Public Health, United States, Hellenic Health Foundation, Greece, Government Medical College, India, Sefako Makgatho Health Science University, South Africa, Dasman Diabetes Institute, Kuwait, Ministry of Health, New Zealand, University of Tampere Tays Eye Center, Finland, Centro di Prevenzione Cardiovascolare Udine, Italy, Universidade Federal de Minas Gerais, Brazil, Finnish Institute of Occupational Health, Finland, Universidad Miguel Hernandez, Spain, Centre for Research in Environmental Epidemiology, Spain, University of the Witwatersrand, South Africa, University of Strasbourg, France, University College Cork, Ireland, Institute for Medical Research, Malaysia, Xinjiang Medical University, China, Beijing Tongren Hospital, China, St George's, University of London, United Kingdom, Medical University of Vienna, Austria, Institute of Food and Nutrition Development of Ministry of Agriculture, China, Children's Hospital of Fudan University, China, Chinese Center for Disease Control and Prevention, China, University of Cyprus, Cyprus, Ministry of Health, Malaysia, and Inner Mongolia Medical University, China
- Abstract
Background Raised blood pressure is an important risk factor for cardiovascular diseases and chronic kidney disease. We estimated worldwide trends in mean systolic and mean diastolic blood pressure, and the prevalence of, and number of people with, raised blood pressure, defined as systolic blood pressure of 140 mm Hg or higher or diastolic blood pressure of 90 mm Hg or higher. Methods For this analysis, we pooled national, subnational, or community population-based studies that had measured blood pressure in adults aged 18 years and older. We used a Bayesian hierarchical model to estimate trends from 1975 to 2015 in mean systolic and mean diastolic blood pressure, and the prevalence of raised blood pressure for 200 countries. We calculated the contributions of changes in prevalence versus population growth and ageing to the increase in the number of adults with raised blood pressure. Findings We pooled 1479 studies that had measured the blood pressures of 19·1 million adults. Global age-standardised mean systolic blood pressure in 2015 was 127·0 mm Hg (95% credible interval 125·7–128·3) in men and 122·3 mm Hg (121·0–123·6) in women; age-standardised mean diastolic blood pressure was 78·7 mm Hg (77·9–79·5) for men and 76·7 mm Hg (75·9–77·6) for women. Global age-standardised prevalence of raised blood pressure was 24·1% (21·4–27·1) in men and 20·1% (17·8–22·5) in women in 2015. Mean systolic and mean diastolic blood pressure decreased substantially from 1975 to 2015 in high-income western and Asia Pacific countries, moving these countries from having some of the highest worldwide blood pressure in 1975 to the lowest in 2015. Mean blood pressure also decreased in women in central and eastern Europe, Latin America and the Caribbean, and, more recently, central Asia, Middle East, and north Africa, but the estimated trends in these super-regions had larger uncertainty than in high-income super-regions. By contrast, mean blood pressure might have increased in east and southeast Asia, south Asia, Oceania, and sub-Saharan Africa. In 2015, central and eastern Europe, sub-Saharan Africa, and south Asia had the highest blood pressure levels. Prevalence of raised blood pressure decreased in high-income and some middle-income countries; it remained unchanged elsewhere. The number of adults with raised blood pressure increased from 594 million in 1975 to 1·13 billion in 2015, with the increase largely in low-income and middle-income countries. The global increase in the number of adults with raised blood pressure is a net effect of increase due to population growth and ageing, and decrease due to declining age-specific prevalence. Interpretation During the past four decades, the highest worldwide blood pressure levels have shifted from high-income countries to low-income countries in south Asia and sub-Saharan Africa due to opposite trends, while blood pressure has been persistently high in central and eastern Europe. Funding Wellcome Trust. © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY license
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- 2017
4. Structural racism and diminished health returns on education among Palestinian refugees in Lebanon.
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Abdulrahim S, Kunichoff D, Asi Y, Bahour N, Hammoudeh W, Mills D, Tanous O, Wispelwey B, and Bassett MT
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- Humans, Lebanon, Female, Male, Middle Aged, Adult, Cardiovascular Diseases ethnology, Hypertension ethnology, Diabetes Mellitus ethnology, Adolescent, Aged, Young Adult, Health Status, Refugees statistics & numerical data, Refugees psychology, Arabs statistics & numerical data, Arabs psychology, Racism statistics & numerical data, Racism psychology, Educational Status
- Abstract
Drawing on structural racism, eco-social, and weathering theories, we examined whether the association between education and health is diminished among Palestinian refugees in Lebanon (PRL) who live under conditions of structural gendered racism. The study utilized data from a national household survey of PRL conducted by a humanitarian organization in December 2022. In a subsample of 7872 PRL 18 years and older, we assessed the association between education and diabetes, hypertension, and cardiovascular disease (CVD). Adjusted risk-ratios (aRR) were calculated to compare the proportions of the outcomes between each gender and education group of interest, adjusting for age, area of residence, and self-reported socioeconomic status. Analyses were conducted on the entire sample and a subsample of those 55 years and older. Among PRL women, increasing education resulted in a sequential decrease in aRR for diabetes, hypertension, and CVD, although not all estimates were statistically significant. This pattern did not persist in the sub-sample of women 55 years or older. Conversely, increasing education level among men showed no differences in risk. For example, compared to men with elementary or less education, men with university education or higher have a higher aRR of 1.12 (95% C.I. 0.83-1.50) for the outcome of diabetes. This trend persisted when comparing outcome risk in the sub-sample of those 55 years of age and older. The findings reveal a gendered association between education and chronic disease risk that is reflective of structural gendered racism. Whilst PRL women demonstrated a typical overall inverse association, PRL men exhibited a pattern of diminished health return on education. PRL men encounter racialized structures in the Lebanese mainstream economy, which stymies the health benefits they may accrue from education and access to other tangible resources., (Copyright © 2025 Elsevier Ltd. All rights reserved.)
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- 2025
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5. Burnout Among Nurses Working in Critical Care Units During the COVID-19 Pandemic.
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Almahmoud O, Asmar I, Kahala A, Awadallah N, Awad W, Sarhan N, and Joulany S
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- Humans, Male, Female, Cross-Sectional Studies, Adult, Surveys and Questionnaires, Nursing Staff, Hospital psychology, Middle Aged, COVID-19 epidemiology, COVID-19 psychology, COVID-19 nursing, Burnout, Professional epidemiology, Burnout, Professional psychology, Critical Care Nursing, Intensive Care Units
- Abstract
Burnout is a state of emotional and physical depletion. Its occurrence among critical care nurses (CCNs) is a concept that has gained traction yet remains an issue with global consequences. Nurses are especially vulnerable to burnout due to the persistent stressors they are exposed to, which include the general work environment, biological factors, and emerging changes caused by COVID-19. This study aims to assess the severity of burnout among CCNs during the COVID-19 pandemic and its associated factors. A descriptive cross-sectional questionnaire was used in this study to measure the estimated burnout rate among CCNs in Palestine and establish associations with potential factors. Maslach Burnout Inventory questionnaire was used for the task. The results showed out of the 173 participants, more than 35% reported severe overall burnout. Per burnout domains, it was found that around 70% of participants suffered from low personal accomplishment, while 59.5% had severe levels of depersonalization, and finally, more than 65% of critical nurses had severe emotional exhaustion. Out of the various variables tested, gender, age, type of hospital, PPE, and fear of transmission were found to be associated with overall burnout. CCNs in Palestine were found to be severely burned out and should be dealt with before getting out of hand. The research found variables related to burnout contributed to burnout. Recommendations for further studies and prioritization should be made., Competing Interests: The author has no conflicts of interest in the manuscript, including financial, consultant, institutional, and other relationships that might lead to bias or a conflict of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
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- 2024
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6. Sexual and reproductive health interventions geared toward adolescent males: A scoping review.
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Sawalma M, Shalash A, Wahdan Y, Nemer M, Khalawi H, Hijazi B, and Abu-Rmeileh N
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- Pregnancy, Female, Adolescent, Male, Humans, Reproductive Health, Sexual Behavior, Sex Education, Sexual Health, Sexually Transmitted Diseases epidemiology, Sexually Transmitted Diseases prevention & control
- Abstract
Problem: Male adolescent sexual and reproductive health (SRH) interventions are rare worldwide. The high prevalence of sexually transmitted infections and pregnancies among female and male adolescents worldwide highlights the need for comprehensive interventions that include both genders in the educational process., Objective: Our main focus is studying and analysing male-focused SRH interventions globally to include males in evidence-based interventions that improve SRH of adolescent males., Eligibility Criteria: This Review was conducted using the PRISMA extension for scoping reviews. The following databases were searched: PubMed, Embase, Web of science, Scopus, CINAHL and PsycInfo., Inclusion Criteria: 1) No time or date limits; 2)all types of studies; 3)SRH campaign; 4)males; 5)10 to 19 years., Sample: Five thousand and sixty-eight articles were identified and 166 peer-reviewed articles met the inclusion criteria., Results: Family planning was identified as the primary domain covered for adolescents. While interactive activities was the most common method used to deliver information to adolescents about sexual health. SRH interventions for males were most prevalent in America. While in the Eastern Mediterranean region (EMR), no male interventions were found in our review., Conclusion: This scoping review emphasizes the need to include adolescent males in sexual and reproductive health interventions, particularly in low- and middle-income countries (LMICs) and the EMR. Policymakers should develop comprehensive programs that address male-specific needs, improve training for intervention providers, and enhance reporting processes to identify gaps and barriers to male inclusion., Implication: Future research should be directed toward the obstacles that prevent SRH interventions targeting males from being carried out., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)
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- 2023
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7. Effect of incredible years autism spectrum and language delays (IY-ASD) program on stress and behavioral management skills among parents of children with autism spectrum disorder in Palestine.
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Wahdan MM, Malak MZ, Al-Amer R, Ayed A, Russo S, and Berte DZ
- Subjects
- Child, Humans, Parenting, Arabs, Parents, Autism Spectrum Disorder therapy, Autistic Disorder
- Abstract
Purpose: This study purposed to evaluate the effect of the Incredible Years Autism Spectrum and Language Delays (IY-ASD) program in reducing parents' stress and improving aggressive and disruptive behaviors in the parents among parents of children with autism spectrum disorder in Palestine., Design and Methods: A one-group pre-posttest design was used. Thirty-four parents who enrolled in the Palestinian Child Institute in Nablus were recruited., Results: Findings revealed a significant difference between parents' total stress pre and post-IY-ASD (t = 1.2, p < 0.01 and parents' behavioral management skills toward their children with autism spectrum disorder. The study demonstrated that the IY-ASD program for 16 sessions reduced stress among parents of children with autism spectrum disorder in Palestine and improved aggressive and disruptive behaviors in the parents., Conclusion: The IY-ASD program can be successfully implemented for parents of this cohort group., Practice Implications: Healthcare providers can adopt such a program for enhancing parenting roles with their children experiencing autism spectrum disorder., Competing Interests: Declaration of Competing Interest No potential conflict of interest was reported by the authors., (Copyright © 2023 Elsevier Inc. All rights reserved.)
- Published
- 2023
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8. Assessment of immunoglobin G (spike and nucleocapsid protein) response to COVID-19 vaccination in Palestine.
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Asmar I, Almahmoud O, Yaseen K, Jamal J, Omar A, Naseef H, and Hasan S
- Abstract
Introduction: Many countries have begun immunization programs and established protocols to combat pandemics caused by the SARS-CoV-2 virus. Six months after vaccination, the antibody titers produced by the immunization begin to decline, and individuals whose first immunization (either one or two doses) did not provide adequate protection may require a booster dose., Methods: A quantitative cross-sectional survey of 18-year-olds and older was undertaken in the West Bank from June 15 to June 27, 2022. Each participant had 5 mL of blood drawn to be tested for IgG-S, IgG-N, and blood group., Results: All participants had positive IgG-S results; IgG-S values ranged between 77 and 40,000 AU/ml, with a mean value of 1254 AU/ml. The value of IgG-N ranged from 0 to 139.3 U/ml for all participants, with a mean value of 22.4 U/ml. 64 (37.2%) of the participants demonstrated positive IgG-N screening results, with mean values of 51.2 U/ml. Female participants' mean IgG concentration was higher than male participants. Furthermore, the results revealed that smokers had lower levels of vaccine-induced antibodies than nonsmokers. High significance was found in the time from the last vaccine till the blood sample test (T = 3.848, P < .001), and the group between 6 and 9 months was found to have higher mean values than the 9-months group (M = 15952)., Conclusions: Participants vaccinated with a higher number of vaccines tend to have higher IgG-S. To elevate total antibodies, booster doses are essential. Additional researchers are needed to examine the positive correlation between IgG-S and IgG-N., Competing Interests: There are no conflicts of interest reported by any of the researchers in this work., (© 2023 The Authors.)
- Published
- 2023
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9. Impact of political instability on 1948-Palestinian shoppers' satisfaction: Palestinian tourist destination as a case study.
- Author
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Abahre J, Al-Rimmawi H, Abu Raida L, Alkhateeb M, Bishawi W, Mahmoud S, Suleiman A, and Khlaif ZN
- Abstract
This study examines tourist satisfaction and its relationship with demographic variables in Nablus, Palestine. Two hundred two tourists were surveyed using a structured questionnaire to collect data on their satisfaction level and demographic information. The results reveal that the overall tourist satisfaction level in Nablus is high. However, significant differences in satisfaction were found based on gender, education level, number of family members, occupation, and income. The study highlights the importance of considering demographic factors in shaping visitor satisfaction and tailoring tourism services to meet the needs and preferences of diverse clients. The findings also shed light on the negative impact of tourist blackmailing, which is the exploitation of tourists by various stakeholders, and the role of positive perceptions of the destination in attracting tourists and mitigating the impact of security threats. The study provides valuable insights for tourism service providers and stakeholders in promoting sustainable and competitive tourism in Nablus and the West Bank region., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 The Authors. Published by Elsevier Ltd.)
- Published
- 2023
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10. Noise Exposure in Palestinian Workers Without a Diagnosis of Hearing Impairment: Relations to Speech-Perception-in-Noise Difficulties, Tinnitus, and Hyperacusis.
- Author
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Shehabi AM, Prendergast G, Guest H, and Plack CJ
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- Humans, Hyperacusis epidemiology, Hyperacusis diagnosis, Speech, Arabs, Tinnitus diagnosis, Tinnitus epidemiology, Hearing Loss epidemiology, Speech Perception
- Abstract
Purpose: Many workers in developing countries are exposed to unsafe occupational noise due to inadequate health and safety practices. We tested the hypotheses that occupational noise exposure and aging affect speech-perception-in-noise (SPiN) thresholds, self-reported hearing ability, tinnitus presence, and hyperacusis severity among Palestinian workers., Method: Palestinian workers ( N = 251, aged 18-70 years) without diagnosed hearing or memory impairments completed online instruments including a noise exposure questionnaire; forward and backward digit span tests; hyperacusis questionnaire; the short-form Speech, Spatial and Qualities of Hearing Scale (SSQ12); the Tinnitus Handicap Inventory; and a digits-in-noise (DIN) test. Hypotheses were tested via multiple linear and logistic regression models, including age and occupational noise exposure as predictors, and with sex, recreational noise exposure, cognitive ability, and academic attainment as covariates. Familywise error rate was controlled across all 16 comparisons using the Bonferroni-Holm method. Exploratory analyses evaluated effects on tinnitus handicap. A comprehensive study protocol was preregistered., Results: Nonsignificant trends of poorer SPiN performance, poorer self-reported hearing ability, greater prevalence of tinnitus, greater tinnitus handicap, and greater severity of hyperacusis as a function of higher occupational noise exposure were observed. Greater hyperacusis severity was significantly predicted by higher occupational noise exposure. Aging was significantly associated with higher DIN thresholds and lower SSQ12 scores, but not with tinnitus presence, tinnitus handicap, or hyperacusis severity., Conclusions: Workers in Palestine may suffer from auditory effects of occupational noise and aging despite no formal diagnosis. These findings highlight the importance of occupational noise monitoring and hearing-related health and safety practices in developing countries., Supplemental Material: https://doi.org/10.23641/asha.22056701.
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- 2023
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11. Binaural temporal coding and the middle ear muscle reflex in audiometrically normal young adults.
- Author
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Shehabi AM, Prendergast G, Guest H, and Plack CJ
- Subjects
- Female, Humans, Young Adult, Acoustic Stimulation, Auditory Threshold, Muscles, Audiometry, Pure-Tone, Ear, Middle, Reflex
- Abstract
Noise exposure may damage the synapses that connect inner hair cells with auditory nerve fibers, before outer hair cells are lost. In humans, this cochlear synaptopathy (CS) is thought to decrease the fidelity of peripheral auditory temporal coding. In the current study, the primary hypothesis was that higher middle ear muscle reflex (MEMR) thresholds, as a proxy measure of CS, would be associated with smaller values of the binaural intelligibility level difference (BILD). The BILD, which is a measure of binaural temporal coding, is defined here as the difference in thresholds between the diotic and the antiphasic versions of the digits in noise (DIN) test. This DIN BILD may control for factors unrelated to binaural temporal coding such as linguistic, central auditory, and cognitive factors. Fifty-six audiometrically normal adults (34 females) aged 18 - 30 were tested. The test battery included standard pure tone audiometry, tympanometry, MEMR using a 2 kHz elicitor and 226 Hz and 1 kHz probes, the Noise Exposure Structured Interview, forward digit span test, extended high frequency (EHF) audiometry, and diotic and antiphasic DIN tests. The study protocol was pre-registered prior to data collection. MEMR thresholds did not predict the DIN BILD. Secondary analyses showed no association between MEMR thresholds and the individual diotic and antiphasic DIN thresholds. Greater lifetime noise exposure was non-significantly associated with higher MEMR thresholds, larger DIN BILD values, and lower (better) antiphasic DIN thresholds, but not with diotic DIN thresholds, nor with EHF thresholds. EHF thresholds were associated with neither MEMR thresholds nor any of the DIN outcomes, including the DIN BILD. Results provide no evidence that young, audiometrically normal people incur CS with impacts on binaural temporal processing., Competing Interests: Declaration of Competing Interest The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022. Published by Elsevier B.V.)
- Published
- 2023
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12. Reassembling the Pieces: Settler Colonialism and the Reconception of Palestinian Health.
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Asi YM, Hammoudeh W, Mills D, Tanous O, and Wispelwey B
- Subjects
- Humans, Human Rights, Arabs, Colonialism
- Published
- 2022
13. Molecular determination, serotyping, antibiotic profile and virulence factors of group B Streptococcus isolated from invasive patients at Arabcare Hospital Laboratory, Palestine.
- Author
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Awwad E, Srour M, Hasan S, and Khatib S
- Subjects
- Adult, Aged, Anti-Bacterial Agents pharmacology, Anti-Bacterial Agents therapeutic use, Drug Resistance, Bacterial genetics, Female, Humans, Infant, Infant, Newborn, Male, Microbial Sensitivity Tests, Phylogeny, Serotyping, Streptococcus agalactiae genetics, Virulence Factors genetics, Laboratories, Hospital, Streptococcal Infections epidemiology, Streptococcal Infections microbiology
- Abstract
Background: Streptococcus agalactiae (group B Streptococcus) is beta-hemolytic, catalase negative, gram-positive cocci, recognized as main bacterial pathogen causing infections in newborns, infants, adults, and elderly people around the world. The aim of this study is to investigate group B Streptococcus samples recovered from invasive patients and determine serotype, virulent genes, and antibiotic-resistant profile of Streptococcus agalactiae in Palestine., Methods: A total of 95 group B Streptococcus strains were isolated from neonates, infants, pregnant and non-pregnant women and males at Arabcare Hospital Laboratory, Palestine, between the period of June 2018 and September 2020. Species identification was carried out through cultivation and conventional biochemical tests. A conventional Polymerase Chain Reaction (cPCR) was used to determine the 5 serotypes and virulent genes of the Streptococcus agalactiae strains. The antibiotic resistance test of group B Streptococcus was evaluated using Kirby-Bauer disk susceptibility. Sequencing and BLAST analysis were used to determine the relationship of the isolates in this study to worldwide isolates., Results: Serotype III (35%) was the major group B Streptococcus strains serotype causing invasive infections in neonates, infants, pregnant and nonpregnant women, and males, followed by serotypes V (19%), Ia, and II (15%), Ib (6%), respectively. All our isolates encoding for surface protein virulent factors, including a highly virulent gene (HvgA) were mostly found in strains isolated from pregnant women (12%). These group B Streptococcus strains exhibited a high rate of resistance to clindamycin (26%). The overall percentage of levofloxacin resistance was 11%, while vancomycin and ampicillin showed higher resistance, at 14.7 and 16% respectively. In addition, the phylogenetic relationship dendrogram illustrates that Streptococcus agalactiae isolated from an invasive patient (newborn) in Palestine was similar to strains found in China and Japan., Conclusions: The outcomes of this study demonstrate that resistant group B Streptococcus strains are common in Palestine, therefore, evidence-based infection prevention and antibiotic stewardship efforts are necessary., (Copyright © 2022 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.)
- Published
- 2022
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14. Systematic review and meta-analysis: Prevalence of hypertension among adolescents in the Arab countries.
- Author
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Almahmoud OH, Arabiat DH, and Saleh MY
- Subjects
- Adolescent, Body Mass Index, Humans, Prevalence, Risk Factors, Waist Circumference, Arabs, Hypertension epidemiology
- Abstract
Problem: Hypertension (HTN) is one of the non-communicable diseases which prevalence is rising in both developed and developing countries. There is a scarcity of data on the prevalence of HTN in Arab countries. This review outlines what is currently known about prevalence and risk factors of HTN in adolescence in Arab world., Eligibility Criteria: A systematic review and meta-analysis were conducted using PubMed, Cochrane Library, Scopus, CINAHL, Science Direct, and Google Scholar databases from 2011 to 2021., Sample: Fourteen studies from 9 Arab countries met inclusion criteria. Studies included a total of 777 adolescents with HTN and 2147 adolescents with pre-HTN., Results: The overall prevalence of HTN among adolescents in the Arab World was estimated at 12.6% (95CI 0.083-0.176), while pre-HTN was 13.9% (95CI 0.084-0205). Overweight and obesity resemble the higher risk of developing hypertension. Family history, high consumption of salt, smoking and low physical activity also increase the risk of HTN. The development of adolescent HTN can be predicted through anthropometric measurements such as Body Mass Index (BMI), wrist circumferences, and high waist circumference., Conclusion: The prevalence of HTN among adolescents in the Arab world was significant, ranging from 4 to 26%. The heterogeneity between studies was high., Implication: Local governments and policymakers must consider strengthening regulations to address environmental risk factors and improve public awareness about risk factors to HTN. A combined use of nurse- and patient targeted educational interventions could also help in reducing the burden of HTN in this population., Competing Interests: Declaration of Competing Interest The authors declare No conflict of interest exist., (Copyright © 2022 Elsevier Inc. All rights reserved.)
- Published
- 2022
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15. Can filaments, pellets and powder be used as feedstock to produce highly drug-loaded ethylene-vinyl acetate 3D printed tablets using extrusion-based additive manufacturing?
- Author
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Samaro A, Shaqour B, Goudarzi NM, Ghijs M, Cardon L, Boone MN, Verleije B, Beyers K, Vanhoorne V, Cos P, and Vervaet C
- Subjects
- Drug Liberation, Humans, Powders, Tablets, Vinyl Compounds, Ethylenes, Printing, Three-Dimensional
- Abstract
Personalized medicine, produced through 3D printing, is a promising approach for delivering the required drug dose based on the patient's profile. The primary purpose of this study was to investigate the potential of two different extrusion-based additive manufacturing techniques - fused filament fabrication (FFF) and screw-based 3D printing, also known as direct extrusion additive manufacturing (DEAM). Different ethylene-vinyl acetate (EVA) copolymers (9 %VA, 12 %VA, 16 %VA, 18 %VA, 25 %VA, 28 %VA, and 40 %VA) were selected and loaded with 50% (w/w) metoprolol tartrate (MPT). Hot-melt extrusion was performed to produce the drug-loaded filaments. These filaments were used for FFF in which the mechanical and rheological properties were rate-limiting steps. The drug-loaded filament based on the 18 %VA polymer was the only printable formulation due to its appropriate mechanical and rheological properties. As for the highest VA content (40 %VA), the feeding pinch rolls cause buckling of the filaments due to insufficient stiffness, while other filaments were successfully feedable towards the extrusion nozzle. However, poor flowability out of the extrusion nozzle due to the rheological limitation excluded these formulations from the initial printing trials. Filaments were also pelletized and used for pellets-DEAM. This method showed freedom in formulation selection because the screw rotation drives the material flow with less dependence on their mechanical properties. All drug-loaded pellets were successfully printed via DEAM, as sufficient pressure was built up towards the nozzle due to single screw extrusion processing method. In contrast, filaments were used as a piston to build up the pressure required for extrusion in filament-based printing, which highly depends on the filament's mechanical properties. Moreover, printing trials using a physical mixture in powder form were also investigated and showed promising results. In vitro drug release showed similar release patterns for MPT-loaded 3D printed tablets regardless of the printing technique. Additionally, pellets-DEAM enabled the production of tablets with the highest VA content, which failed in FFF 3D printing but showed an interesting delayed release profile., (Copyright © 2021 Elsevier B.V. All rights reserved.)
- Published
- 2021
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16. Parental Child Rearing Practices in Palestine: A Cross-Sectional Study.
- Author
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Atout M, Alrimawi I, Dreidi M, Rajeh Saifan A, Abusalameh E, and Al-Yateem N
- Abstract
The objectives of this study were to explore parenting practices from the perspectives of Palestinian parents and their children, and concordance between parents and children in their reports of parenting practices, in a culture that is underrepresented in the literature. A descriptive cross-sectional design was used. The Alabama Parenting Questionnaire (APQ) was administered to 120 parents and 120 children drawn from 4 districts in Palestine. Children had higher scores on parental involvement, positive parenting, poor monitoring, inconsistent discipline, and corporal punishment. Three significant parent-child relationships were obtained1: parental involvement ( r = .276, P = .003), positive parenting ( r = .0301, P = .001), and poor parental monitoring ( r = -.241, P = .008). The findings of this study might be used by Palestinian authorities and policy-makers to formulate guidelines and training to aid parental decision-making about child rearing., Competing Interests: Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2021.)
- Published
- 2021
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17. Measurement and prevalence of adult physical activity levels in Arab countries.
- Author
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Murtagh E, Shalash A, Martin R, and Abu Rmeileh N
- Subjects
- Adolescent, Adult, Cross-Sectional Studies, Humans, Observational Studies as Topic, Prevalence, Arabs, Exercise
- Abstract
Objectives: This study aims to examine the reported prevalence of sufficient physical activity among adults in Arab countries and to determine the use of validated instruments for assessing physical activity., Study Design: This is a systematic literature review., Methods: This review follows recommendations outlined in the Meta-Analysis of Observational Studies in Epidemiology guidelines. The protocol for this study was preregistered with PROSPERO. Cross-sectional, cohort and intervention studies with a minimum of 300 adults aged ≥18 years assessing physical activity using a questionnaire or other self-report measure in the Arabic language were identified from seven electronic databases (MEDLINE, Embase, Cochrane Database of Systematic Reviews, CINAHL, PsycINFO, SPORTDiscu and PubMed). Databases were searched from 1st January 2008 to 17th September 2018. Descriptive analysis was performed using frequency and percentages. The prevalence of physical activity was calculated as the average prevalence for the reported percentages from the studies with similar tools., Results: Fifty studies involving 298,242 participants were included in this review. The mean (range) sample size was 5964.8.1 (323-197,681). Data were collected from participants in 16 of the 22 Arab countries. Great variation exists across the studies in determining whether adults were sufficiently active or not. Twenty studies reported usable data from the Global Physical Activity Questionnaire and the International Physical Activity Questionnaire (moderate & high categories). In these studies, prevalence of physical activity ranged from 34.2 to 96.9%. It was not possible to compare the other studies owing to variation in instruments used to assess physical activity and in the case definition used for 'physically active'., Conclusions: This study highlights the need for wider reporting of physical activity and the adoption of valid and reliable instruments to support the development of evidence-informed policy and programmes at both country and regional level. International tools need to be correctly validated, or context-specific tools must be developed to accurately measure physical activity., (Copyright © 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
- Published
- 2021
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18. New insights on the clinical variability of FKBP10 mutations.
- Author
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Essawi OH, Tapaneeyaphan P, Symoens S, Gistelinck C C, Malfait F, Eyre DR, Essawi T, Callewaert B, and Coucke PJ
- Subjects
- Adolescent, Adult, Amino Acids metabolism, Arthrogryposis pathology, Cells, Cultured, Child, Female, Homozygote, Humans, Male, Osteogenesis Imperfecta pathology, Pedigree, RNA Splice Sites, Arthrogryposis genetics, Mutation, Osteogenesis Imperfecta genetics, Phenotype, Tacrolimus Binding Proteins genetics
- Abstract
To date 45 autosomal recessive disease-causing variants are reported in the FKBP10 gene. Those variant were found to be associated with Osteogenesis Imperfecta (OI) for which the hallmark phenotype is bone fractuers or Bruck Syndrome (BS) where bone fractures are accompanied with contractures. In addition, a specific homozygous FKBP10 mutation (p.Tyr293del) has been described in Yup'ik Inuit population to cause Kuskokwim syndrome (KS) in which contractures without fractures are observed. Here we present an extended Palestinian family with 10 affected individuals harboring a novel homozygous splice site mutation, c.391+4A > T in intron 2 of the FKBP10 gene, in which the three above mentioned syndromes segregate as a result of skipping of exon 2 and absence of the FKBP65 protein. At the biochemical level, Hydroxylysyl pyridinoline (HP)/lysyl pyridinoline (LP) values were inversely correlated with OI phenotypes, a trend we could confirm in our patients. Our findings illustrate that single familial FKBP10 mutations can result in a phenotypic spectrum, ranging from fractures without contractures, to fractures and contractures and even to only contractures. This broad intra-familial clinical variability within one single family is a new finding in the field of bone fragility., (Copyright © 2020 The Authors. Published by Elsevier Masson SAS.. All rights reserved.)
- Published
- 2020
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19. Screening of pharmaceutical polymers for extrusion-Based Additive Manufacturing of patient-tailored tablets.
- Author
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Samaro A, Janssens P, Vanhoorne V, Van Renterghem J, Eeckhout M, Cardon L, De Beer T, and Vervaet C
- Subjects
- Drug Liberation, Humans, Printing, Three-Dimensional, Solubility, Tablets, Polymers, Technology, Pharmaceutical
- Abstract
The main objective of this work was to explore the potential of coupling hot-melt extrusion (HME) to Fused Filament Fabrication (FFF), also known as Extrusion-Based Additive Manufacturing (EBAM) or 3D Printing, in order to manufacture 3D printed tablets with different release behavior from plasticizer-free filament matrices. The suitability of different thermoplastic polymers towards FFF was investigated, and a link between the mechanical properties of filaments produced by HME and the feeding performance into the FFF printer was established. Model drugs with different aqueous solubility (metoprolol tartrate and theophylline anhydrous) were processed with hydrophilic and hydrophobic polymers, and the influence of the formulation, drug concentration and applied process settings on the release kinetics was investigated. Filaments with up to 40% drug load were successfully extruded with a smooth surface and a diameter of 1.75 ± 0.05 mm. However, filaments with high brittleness and low toughness were broken by the feeding gears. In contrast, none of the filaments were squeezed aside by the gears, which indicated that they were sufficiently stiff as indicated by the high Young's moduli of all formulations. For all formulations, the release from the tablets with 50% infill degree was faster as compared to the tablets with 100% infill degree. Theophylline (20% w/w) release from Kollicoat® IR matrix was completed within 40 min from 50% infill tablets. In contrast, 80% metoprolol tartrate was released from the hydrophobic Capa® 6506 polymer within 24hrs from 50% infill 3D tablets containing 40% w/w MPT., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier B.V. All rights reserved.)
- Published
- 2020
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20. Challenges facing research ethics in fragile settings.
- Author
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Abu-Rmeileh N
- Subjects
- Humans, India, Ethics, Research, Public Health
- Abstract
The first time I was introduced to the concept of research ethics was when I started my work as a research assistant at the Institute of Community and Public Health, Birzeit University (ICPH-BZU). I was fascinated by the concept and tried to read as much as I could. While reading the different guidelines and regulations, I felt they were prepared to be implemented in an ideal world without taking into account the local context. With time, the international institutions realised that "one size does not fit all." Recently, context and topic specific guidelines have emerged.
- Published
- 2019
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21. Context-led capacity building in time of crisis: fostering non-communicable diseases (NCD) research skills in the Mediterranean Middle East and North Africa.
- Author
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Phillimore P, Sibai AM, Rizk A, Maziak W, Unal B, Abu Rmeileh N, Ben Romdhane H, Fouad FM, Khader Y, Bennett K, Zaman S, Mataria A, Ghandour R, Kılıç B, Ben Mansour N, Fadhil I, O'Flaherty M, Capewell S, and Critchley JA
- Subjects
- Africa, Northern, Curriculum, Health Policy, Humans, Mediterranean Region, Middle East, Public Health, Social Determinants of Health, Capacity Building organization & administration, Noncommunicable Diseases, Professional Competence, Research Personnel education
- Abstract
Background: This paper examines one EC-funded multinational project (RESCAP-MED), with a focus on research capacity building (RCB) concerning non-communicable diseases (NCDs) in the Mediterranean Middle East and North Africa. By the project's end (2015), the entire region was engulfed in crisis., Objective: Designed before this crisis developed in 2011, the primary purpose of RESCAP-MED was to foster methodological skills needed to conduct multi-disciplinary research on NCDs and their social determinants. RESCAP-MED also sought to consolidate regional networks for future collaboration, and to boost existing regional policy engagement in the region on the NCD challenge. This analysis examines the scope and sustainability of RCB conducted in a context of intensifying political turmoil., Methods: RESCAP-MED linked two sets of activities. The first was a framework for training early- and mid-career researchers through discipline-based and writing workshops, plus short fellowships for sustained mentoring. The second integrated public-facing activities designed to raise the profile of the NCD burden in the region, and its implications for policymakers at national level. Key to this were two conferences to showcase regional research on NCDs, and the development of an e-learning resource (NETPH)., Results: Seven discipline-based workshops (with 113 participants) and 6 workshops to develop writing skills (84 participants) were held, with 18 fellowship visits. The 2 symposia in Istanbul and Beirut attracted 280 participants. Yet the developing political crisis tagged each activity with a series of logistical challenges, none of which was initially envisaged. The immediacy of the crisis inevitably deflected from policy attention to the challenges of NCDs., Conclusions: This programme to strengthen research capacity for one priority area of global public health took place as a narrow window of political opportunity was closing. The key lessons concern issues of sustainability and the paramount importance of responsively shaping a context-driven RCB.
- Published
- 2019
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22. Complications of type 2 diabetes mellitus in Ramallah and al-Bireh: The Palestinian Diabetes Complications and Control Study (PDCCS).
- Author
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Ghandour R, Mikki N, Abu Rmeileh NME, Jerdén L, Norberg M, Eriksson JW, and Husseini A
- Subjects
- Adult, Biomarkers blood, Blood Glucose metabolism, Comorbidity, Cross-Sectional Studies, Diabetes Complications diagnosis, Diabetes Complications therapy, Diabetes Mellitus, Type 2 blood, Diabetes Mellitus, Type 2 diagnosis, Diabetes Mellitus, Type 2 therapy, Female, Glycated Hemoglobin metabolism, Humans, Male, Middle Aged, Middle East epidemiology, Prevalence, Risk Factors, Young Adult, Arabs, Diabetes Complications ethnology, Diabetes Mellitus, Type 2 ethnology
- Abstract
Background: Type 2 diabetes mellitus (T2DM) is a growing pandemic that will lead, if not managed and controlled, to frequent complications, poor quality of life, and high rates of disability and death. Little is known about T2DM complications in Palestine. The aim of this study is to estimate the prevalence of T2DM complications in Ramallah and al-Bireh governorate of Palestine., Methods: The study was conducted in eleven primary healthcare clinics offering services for persons with T2DM. Macrovascular complications were assessed using the Diabetes complication index. Microvascular complications were measured by physical examinations and laboratory tests. Questionnaires, laboratory tests, and physical examinations were used to assess socio-demographic characteristics, co-morbidities and other risk factors., Results: 517 adult men and nonpregnant women participated in the study (166 men, 351 women). The response rate was 84%. Mean age and mean duration of diabetes were 58.1 and 9.4 years respectively. Prevalence of diagnosed microvascular and macrovascular complications was 67.2% and 28.6% respectively. 78.2% of the participants had poor glycemic control (HbA1c≥7.0%)., Conclusion: Significant proportions of persons with T2DM had macro- and microvascular complications and poor metabolic control. These findings are important for policy development and the planning of health services., (Copyright © 2018 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.)
- Published
- 2018
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23. Molecular dynamics simulations suggest changes in electrostatic interactions as a potential mechanism through which serine phosphorylation inhibits DNA polymerase β activity.
- Author
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Homouz D, Joyce-Tan KH, ShahirShamsir M, Moustafa IM, and Idriss HT
- Subjects
- DNA Polymerase beta metabolism, Hydrogen Bonding, Phosphorylation, Protein Conformation, Structure-Activity Relationship, DNA Polymerase beta chemistry, Molecular Dynamics Simulation, Serine chemistry, Static Electricity
- Abstract
DNA polymerase β is a 39 kDa enzyme that is a major component of Base Excision Repair in human cells. The enzyme comprises two major domains, a 31 kDa domain responsible for the polymerase activity and an 8 kDa domain, which bind ssDNA and has a deoxyribose phosphate (dRP) lyase activity. DNA polymerase β was shown to be phosphorylated in vitro with protein kinase C (PKC) at serines 44 and 55 (S44 and S55), resulting in loss of its polymerase enzymic activity, but not its ability to bind ssDNA. In this study, we investigate the potential phosphorylation-induced structural changes for DNA polymerase β using molecular dynamics simulations. The simulations show drastic conformational changes of the polymerase structure as a result of S44 phosphorylation. Phosphorylation-induced conformational changes transform the closed (active) enzyme structure into an open one. Further analysis of the results points to a key hydrogen bond and newly formed salt bridges as potential drivers of these structural fluctuations. The changes observed with S55/44 and S55 phosphorylation were less dramatic and the integrity of the H-bond was not compromised. Thus the phosphorylation of S44 is the major contributor to structural fluctuations that lead to loss of enzymatic activity., (Copyright © 2018 Elsevier Inc. All rights reserved.)
- Published
- 2018
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24. A study of VHI scores and acoustic features in street vendors as occupational voice users.
- Author
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Natour YS, Darawsheh WB, Bashiti S, Wari M, Taha J, and Odeh T
- Subjects
- Adult, Female, Humans, Male, Phonation, Voice Disorders physiopathology, Commerce, Speech Acoustics, Voice Quality
- Abstract
Purpose: to investigate acoustic features of phonation and perception of voice handicap in street vendors., Methods: Eighty-eight participants (44 street vendors, 44 controls) were recruited. The mean age of the group was 38.9±16.0 years (range: 20-78 years). Scores of the Arabic version of the Voice Handicap Index (VHI-Arab) were used for analysis. Acoustic measures of fundamental frequency (F
0 ), jitter, shimmer, and signal-to-noise ratio (SNR) were also analyzed., Results: Analysis showed a significant difference between street vendors and controls in the total score of the VHI-Arab (p<0.001) as well as scores of all three VHI-Arab subsections: functional (p<0.001), physical (p<0.001), and emotional (p=0.025). Weak correlations were found among all of the VHI scores and acoustic measures (-0.219≤ r≤0.355), except for SNR where a moderate negative correlations were found (r=-0.555; -0.4) between the VHI (physical and total) scores and SNR values. Significant differences also were found in F0 , jitter, and SNR among specific subgroups of street vendors when stratified by weekly hours worked (p<0.05), and in jitter (p=0.39) when stratified by educational level., Conclusions: Perception of voice handicap and a possible effect on vocal quality in street vendors were noted. The effect of factors, namely work hours and educational level, on voice quality should be further studied., (Copyright © 2017. Published by Elsevier Inc.)- Published
- 2018
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25. The prognostic value of a new left bundle branch block in patients with acute myocardial infarction: A systematic review and meta-analysis.
- Author
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Al Rajoub B, Noureddine S, El Chami S, Haidar MH, Itani B, Zaiter A, and Akl EA
- Subjects
- Electrocardiography, Global Health, Humans, Incidence, Odds Ratio, Prognosis, Survival Rate trends, Bundle-Branch Block diagnosis, Bundle-Branch Block epidemiology, Bundle-Branch Block etiology, Myocardial Infarction complications, Risk Assessment methods
- Abstract
Objective: To assess the prognostic value of new left bundle branch block (LBBB) in patients with acute myocardial infarction (AMI)., Background: LBBB develops in many cardiac conditions, including AMI. The empirical evidence for the contribution of LBBB to mortality in AMI is not consistent., Methods: Medline, PubMed, CINAHL, and EMBASE were searched. Inverse variance meta-analysis was performed with odds ratios as the effect estimates. The I
2 statistic and risk of bias were assessed., Results: Eight studies involving 105,861 participants were eligible. New LBBB was associated with higher mortality at 30 days (OR: 2.10, 95% CI 1.27 to 3.48) and 1-year follow up (OR: 2.81, 95% CI 1.64 to 4.80), and increased heart failure risk (OR: 2.64, 95% CI 1.84 to 3.77)., Conclusions: AMI patients with new LBBB are a high risk group and must be treated accordingly. Yet, more research is needed given the limitations of studies., (Copyright © 2016 Elsevier Inc. All rights reserved.)- Published
- 2017
- Full Text
- View/download PDF
26. Intensive Care Unit Physician's Attitudes on Do Not Resuscitate Order in Palestine.
- Author
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Abdallah FS, Radaeda MS, Gaghama MK, and Salameh B
- Abstract
Background: There is some ambiguity concerning the do-not-resuscitate (DNR) orders in the Arabic world. DNR is an order written by a doctor, approved by the patient or patient surrogate, which instructs health care providers to not do CPR when cardiac or respiratory arrest occurs. Therefore, this research study investigated the attitudes of Intensive Care Unit physicians and nurses on DNR order in Palestine., Materials and Methods: A total of 123 males and females from four different hospitals voluntarily participated in this study by signing a consent form; which was approved by the Ethical Committee at Birzeit University and the Ministry of Health. A non-experimental, quantitative, descriptive, and co-relational method was used, the data collection was done by a three page form consisting of the consent form, demographical data, and 24 item-based questionnaire based on a 5-point-Likert scale from strongly agree (score 1) to strongly disagree (score 5)., Results: The Statistical Package for Social Sciences (SPSS) software program version 17.0 was used to analyze the data. Finding showed no significant relationship between culture and opinion regarding the DNR order, but religion did. There was statistical significance difference between the physicians' and nurses' religious beliefs, but there was no correlation. Moreover, a total of 79 (64.3%) physicians and nurses agreed with legalizing the DNR order in Palestine., Conclusion: There was a positive attitude towards the legalization of the DNR order in Palestine, and culture and religion did not have any affect towards their attitudes regarding the legalization in Palestine.
- Published
- 2016
- Full Text
- View/download PDF
27. Politics drives human functioning, dignity, and quality of life.
- Author
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Barber BK, Spellings C, McNeely C, Page PD, Giacaman R, Arafat C, Daher M, El Sarraj E, and Mallouh MA
- Subjects
- Adult, Female, Humans, Interviews as Topic, Male, Middle Aged, Safety, Socioeconomic Factors, Arabs psychology, Politics, Quality of Life psychology, Refugees psychology
- Abstract
Too little is known about human functioning amidst chronic adversity. We addressed that need by studying adult Palestinians in the occupied Palestinian territories (oPt), a population that has experienced longstanding economic and political hardships. Fourteen group interviews were conducted in February, 2010 in Arabic by local fieldworkers with 68 participants representing the main stratifications of Palestinian society: gender, region, refugee status, and political affiliation. Interview tasks included each participant: describing someone doing well and not well, free listing domains of functioning, and prioritizing domains to the three most important. Thematic analyses highlighted the dominating role of the political domain of functioning (e.g., political structures, constraints, effects, identity, and activism) and the degree to which political conditions impacted all other realms of functioning (economic, education, family, psychological, etc.). The discussion links the findings to relevant theory and empirical work that has called attention to the need to include the political in frameworks of quality of life. It also emphasized that values, such as justice, rights, dignity and self-determination, that underlie political structures and policies, are key elements of human functioning. This is the case not only in the oPt, but in any society where power imbalances marginalize segments of the population., (Copyright © 2014 Elsevier Ltd. All rights reserved.)
- Published
- 2014
- Full Text
- View/download PDF
28. [Occupational safety of cleaning personnel in Palestinian district hospitals].
- Author
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Al-Khatib IA
- Subjects
- Guideline Adherence statistics & numerical data, Guidelines as Topic, Health Services Research, Humans, Infection Control standards, Inservice Training organization & administration, Middle East epidemiology, Needlestick Injuries epidemiology, Needlestick Injuries prevention & control, Organizational Policy, Personnel, Hospital education, Protective Devices statistics & numerical data, Safety Management organization & administration, Vaccination statistics & numerical data, Workload statistics & numerical data, Hospitals, District organization & administration, Housekeeping, Hospital organization & administration, Medical Waste Disposal standards, Occupational Health statistics & numerical data, Occupational Health Services organization & administration, Personnel, Hospital statistics & numerical data
- Abstract
This study examined occupational safety among cleaning workers in Palestinian hospitals and its relation with the medical waste management in these hospitals. The level of occupational safety was below standard requirements, as protective equipment and clothes are not available for most workers. Over 40% of workers had been pricked with needles while handling medical waste. There was no clear policy for vaccination of workers against infectious diseases and no medical examination for workers before or during employment. Only 37.2% were trained in handling medical waste and 23.2% were working 15 hours per day or more; 55.8% had spent 1 year or less in their work.
- Published
- 2006
29. [Assessment of medical waste management in a Palestinian hospital].
- Author
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Al-Khatib IA and Khatib RA
- Subjects
- Benchmarking, Guidelines as Topic, Health Policy, Health Services Research, Humans, Inservice Training organization & administration, Local Government, Medical Waste Disposal statistics & numerical data, Middle East, Needs Assessment, Personnel, Hospital education, Program Evaluation, Hospitals, Municipal organization & administration, Medical Waste Disposal methods, Medical Waste Disposal standards
- Abstract
We studied medical waste management in a Palestinian hospital in the West Bank and the role of municipality in this management. In general, "good management practices" were inadequate; there was insufficient separation between hazardous and non-hazardous wastes, an absence of necessary rules and regulations for the collection of wastes from the hospital wards and the on-site transport to a temporary storage location inside and outside the hospital and inadequate waste treatment and disposal of hospital wastes along with municipal garbage. Moreover, training of personnel was lacking and protective equipment and measures for staff were not available. No special landfills for hazardous wastes were found within the municipality.
- Published
- 2006
30. [Work injuries in building construction, metal shaping, and food production sectors in Jericho District in the Palestinian territory].
- Author
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Al-Khatib A, Maqdadi R, Habash R, Aliyan G, Khofash F, and Grayesh S
- Subjects
- Adult, Age Distribution, Causality, Data Collection, Health Surveys, Humans, Middle East epidemiology, Occupational Health, Population Surveillance, Accidents, Occupational trends, Facility Design and Construction, Food Industry, Metallurgy, Wounds and Injuries epidemiology, Wounds and Injuries etiology
- Abstract
Work injuries and accidents have a considerable impact on public and community health. This study targeted three work sectors: metal shaping, food production and building construction. Work injuries that occurred in these sectors were compared for the years 1999 and 2000 in Jericho District in the West Bank of Palestine. One hundred three injuries were examined and information recorded about the nature of the injury, site of injury in the body, direct cause of injury and some personal information about the injured worker. The most vulnerable group were young people in their twenties, and mostly those working in the metal shaping and building construction sectors. The kinds and sites of injuries varied. The data were compared with data from 1997, 1998 and 2001-2003, although only loosley as the available data about work injuries for these years were limited and inaccurate.
- Published
- 2005
31. [Causes of drinking-water contamination in rain-fed cisterns in three villages in Ramallah and Al-Bireh District, Palestine].
- Author
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Al-Khatib IA and Orabi M
- Subjects
- Causality, Colony Count, Microbial, Disinfection, Enterobacter isolation & purification, Escherichia coli isolation & purification, Humans, Klebsiella isolation & purification, Middle East, Sewage, Water Pollution prevention & control, Water Pollution statistics & numerical data, Water Purification, Water Supply statistics & numerical data, Rain microbiology, Water Microbiology, Water Pollution analysis, Water Supply analysis
- Abstract
We studied the biological characteristics of drinking-water in three villages in Ramallah and al-Bireh district, by testing the total coliforms. Water samples were collected from rain-fed cisterns between October and November 2001. The results show that 87% of tested samples of drinking-water were highly contaminated and in need of coagulation, filtration and disinfection based on the World Health Organization guidelines for drinking-water, and 10.5% had low contamination and were in need of treatment by disinfection only. Only 2.5% of the tested samples were not contaminated and were suitable for drinking without treatment. The main cause of drinking-water con tamination was the presence of cesspits, wastewater and solid waste dumping sites near the cisterns.
- Published
- 2004
32. A community of citizens: disability rehabilitation in the Palestinian transition to statehood.
- Author
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Giacaman R
- Subjects
- Arabs, Community Participation, Consumer Organizations, Cost of Illness, Female, Gender Identity, Health Care Reform, Humans, Israel, Male, Outcome Assessment, Health Care, Social Class, Social Justice trends, Women, Working classification, Workforce, Attitude to Health ethnology, Caregivers, Civil Rights trends, Community Health Services organization & administration, Persons with Disabilities rehabilitation, Volunteers
- Abstract
Purpose: It has been widely argued that community based programmes offer considerable advantages to the classical institutional forms of health and rehabilitation services delivery. With about 10 years of experience in operating community based rehabilitation projects (CBR) for the disabled, the Palestinian experience points to potentially serious problems relating to the conception and operationalization of such programmes in real life situations., Issues: Of importance is the issue of the impact of communal care on the already burdened lives of women, especially when such care is expected to be voluntary in nature. Caretaking in the Palestinian context, especially of the disabled, elderly and the sick, is a pre-defined sex linked role dictated by a patriarchal society and system of policy making that excludes women from economic and social life. The voluntary care aspect entailed in the CBR conception and practice, can and does contribute further to the exclusion of women not only from the labour force, but from most other aspects of life as well. This represents an apparent contradiction between the needs of two excluded groups, the disabled and women. The other problematic entailed in the communal model of caring for the disabled is the strategic and operational bias focusing on community, to the exclusion of the notion of social rights of all citizens, and the role and duty of state structures in the fulfilment of the disabled basic needs. Such an approach can only relegate the disabled rights back to their original place as charity. On the other hand, when CBR projects are operated holistically, in the context of social movements existing within power relation and with a broader democratic agenda engaging different groups-including a disability movement-as is currently taking place in Palestine, CBR projects can also turn into a mobilizing force for the social rights of all excluded groups., Conclusion: Thus the question is not merely one of governmental involvement as opposed to the involvement of non-governmental organizations and charitable societies in community based projects. Rather, it is a question of the right to a decent life for all, in dignity and security, that citizenship and statehood promise, but have yet to deliver in many developing countries, especially in Palestine.
- Published
- 2001
- Full Text
- View/download PDF
33. Molecular, antibiogram and serological typing of Staphylococcus aureus isolates recovered from Al-Makased Hospital in East Jerusalem.
- Author
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Essawi T, Na'was T, Hawwari A, Wadi S, Doudin A, and Fattom AI
- Subjects
- Arabs, Bacterial Capsules classification, Cross Infection microbiology, DNA, Bacterial genetics, Electrophoresis, Gel, Pulsed-Field, Genome, Bacterial, Genotype, Hospitals, General, Humans, Israel, Methicillin Resistance, Microbial Sensitivity Tests methods, Microbial Sensitivity Tests statistics & numerical data, Phenotype, Serotyping methods, Serotyping statistics & numerical data, Staphylococcal Infections microbiology, Staphylococcus aureus classification, Staphylococcus aureus drug effects, Staphylococcus aureus enzymology, Staphylococcus aureus genetics, beta-Lactamases biosynthesis, Anti-Bacterial Agents pharmacology, Staphylococcus aureus isolation & purification
- Abstract
Staphylococcus aureus is a major cause of nosocomial infections and a risk in patients who have either undergone surgery or are on haemodialysis. The S. aureus infections in patients admitted to the clinical departments of Al-Makased Charitable Hospital in Jerusalem during a period of one year were investigated. Isolates included were from blood, surgical wounds, or other nonsuperficial sites. Of 63 isolates available for analysis, 46 (73.0%) expressed type 8 capsular polysaccharide; 13 (20.7%), type 5 capsular polysaccharide; only 4 isolates (6.3%) did not express type 5 or type 8 antibodies. The strains fitted in 7 different antibiogram types, with the type showing resistance only to penicillin and ampicillin prevalent in 34 out of 63 isolates (54.0%). Of the 12 methicillin-resistant S. aureus (MRSA) isolates (19.1%), 8(66.7%) possessed the type 8 capsule and 4(33.7%) the type 5 capsule. Pulsed-field gel electrophoresis of all isolates with the restriction-endonuclease enzymes Sma I revealed 34 patterns demonstrating that no single methicillin-sensitive S. aureus strain was endemic in the hospital. However, all MRSA isolates with a type 8 capsule showed identical PFGE patterns using the 2 restriction-endonuclease enzymes Sma I and SST II. Moreover, type 5 isolates showed identical patterns (one isolate differed from the rest with one band only). These data suggest and confirm the clonality of type 5 and type 8 MRSA isolates. Analysing the results of the capsular and antibiogram typing schemes in conjunction proved useful and suggested that such an analysis can be employed as a helpful epidemiological tool in hospitals with limited resources.
- Published
- 1998
- Full Text
- View/download PDF
34. The anti-epileptic effect of 3-aminopropylarsonate on electrically-kindled and N-methyl-D-aspartate-kindled amygdala.
- Author
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Abdul-Ghani AS, Attwell PJ, and Bradford HF
- Subjects
- Animals, Male, Rats, Rats, Sprague-Dawley, Amygdala drug effects, Arsenicals pharmacology, Kindling, Neurologic physiology, N-Methylaspartate pharmacology, gamma-Aminobutyric Acid analogs & derivatives
- Abstract
The effects of 3-aminopropylarsonate, an arsono analogue of GABA, was tested on the development of electrically-kindled amygdala and on the expression of generalized seizure activity in electrically and NMDA fully amygdala-kindled rats. Intra-amygdaloid microinjection of 3-aminopropylarsonate (10 nmol in 0.5 microl injection vehicle) inhibited electrical epileptogenesis by keeping the seizure score at or below stage 1 on the Racine scale, and the afterdischarge duration (ADD) at or below 19.70 +/- 4.59 s. The effect was reversible after withdrawal of the drug, since the animals developed a generalized seizure activity when kindling stimuli continued in the absence of drug. In fully electrically kindled animals with stage 5 amygdala-kindled seizures, the drug increased afterdischarge threshold (ADT) by 30-70%, without any effect on mean seizure score or ADD. The changes were reversible after 7 days. In fully NMDA-kindled rats, intra-amygdala administration of 3-aminopropylarsonate (10 nmol/0.5 microl) 20 min before injection of NMDA (4 nmol/0.5 microl) reduced the seizure score from 3.80 +/- 0.37(5) on the Racine scale to 0.83 +/- 0.40(6) (P < 0.01). The effect was partially reversible after washing with phosphate buffer. 2-Amino-4-arsonobutyrate, the analogue of glutamate, had no effect on seizure score following treatment with the same concentration of the drug and the same route of injection. The inhibitory effect of 3-aminopropylarsonate on NMDA kindled activity was dose-dependent, since higher doses of NMDA reduced the effect of the drug. The effect of 3-aminopropylarsonate was also selective to NMDA receptors since it had no effect on kainate-induced seizures. With both models of kindling, no gross behavioural abnormalities were observed 3-6 months after treatment with the drug. These findings show the potent antiepileptogenic and anti-convulsant activity of the arsonoanalogue of GABA which appears to be non-toxic and therefore potentially useful as the basis for developing a new family of clinically useful anticonvulsants for treating epilepsy.
- Published
- 1996
- Full Text
- View/download PDF
35. Islam is the solution: Jordanian Islamists and the dilemma of the 'modern woman'.
- Author
-
Taraki L
- Subjects
- Cultural Characteristics, Female, Gender Identity, Humans, Jordan, Male, Social Change, Social Class, Women education, Women, Working, Islam, Women's Rights
- Abstract
During the past decade, the issue of gender relations and women's conduct and dress has been occupying an increasingly prominent place in the discourse of Islamist movements. This article attempts to situate Arab Islamists' preoccupation with women within the legacy of colonialism and social transformations relating to gender and class. With regard to Jordan, the author links the urgency of the issue with social transformations at the level of gender and class during recent decades, and points out that the key to understanding the prominence of the 'woman question' in Islamist thinking is the fact that the social groups which comprise the traditional constituency of the Islamists are finally experiencing for themselves the socially disruptive implications of new patterns in women's work, education and visibility. In short, the issue of women's modesty and conduct, which was more abstract as recent as one generation ago (when only upper middle and upper class women were visible in the public domain), acquires concreteness and urgency in the rapidly changing social environment. The article also tries to show how the Islamists' framing of the issue in cultural terms has a primal appeal, especially to those social groups most alienated from the insular world of the westernized elite and in search of 'authentic' ways of living in the modern world.
- Published
- 1995
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