50 results on '"The University of the West Indies, Barbados"'
Search Results
2. Editorial: Planning, policies and strategies for using ICT
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Marshall, Stewart; The University of the West Indies, Barbados, West Indies; stewartmar@gmail.com, Taylor, Wal; The University of the West Indies, Barbados, West Indies; waltaylor@gmail.com, Marshall, Stewart; The University of the West Indies, Barbados, West Indies; stewartmar@gmail.com, and Taylor, Wal; The University of the West Indies, Barbados, West Indies; waltaylor@gmail.com
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- 2008
3. Editorial: ICT in education and in promoting health
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Marshall, Stewart; The University of the West Indies, Barbados, West Indies; stewartmar@gmail.com, Taylor, Wal; The University of the West Indies, Barbados, West Indies; waltaylor@gmail.com, Marshall, Stewart; The University of the West Indies, Barbados, West Indies; stewartmar@gmail.com, and Taylor, Wal; The University of the West Indies, Barbados, West Indies; waltaylor@gmail.com
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- 2008
4. Perceptions of information and communication technology among undergraduate management students in Barbados
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Gay, Glenda; Department of Management Studies, The University of the West Indies, Cave Hill C; glenda.gay@uwichill.edu.bb, Mahon, Sonia; The University of the West Indies, Barbados; smahon@uwichill.edu.bb, Devonish, Dwayne; The University of the West Indies, Barbados; ddevonish@uwichill.edu.bb, Alleyne, Philmore A; The University of the West Indies, Barbados; philmore.alleyne@uwichill.edu.bb, Alleyne, Peter G; The University of the West Indies, Barbados; brigadergen@yahoo.com, Gay, Glenda; Department of Management Studies, The University of the West Indies, Cave Hill C; glenda.gay@uwichill.edu.bb, Mahon, Sonia; The University of the West Indies, Barbados; smahon@uwichill.edu.bb, Devonish, Dwayne; The University of the West Indies, Barbados; ddevonish@uwichill.edu.bb, Alleyne, Philmore A; The University of the West Indies, Barbados; philmore.alleyne@uwichill.edu.bb, and Alleyne, Peter G; The University of the West Indies, Barbados; brigadergen@yahoo.com
- Abstract
This exploratory study examined attitudes and usage of ICT among undergraduate management students in Barbados. Of the sample of 166 students, the majority indicated they had access to a computer, and had access and regularly used the Internet. In addition, more females than males had access to a computer off campus. Over 90% used the course-based WebCT, whereas only 30% used the Campus Pipeline. The study showed that students were generally favourable towards ICT. Males were more inclined to incorporate ICT in web-based instruction compared to other teaching activities. Older students were more interested in using ICT only as a supplement to teaching activities. The findings suggest high usage of and positive attitudes toward ICT among tertiary level students. University administrators need to address the gender and age differences regarding ICT usage as well as develop strategies to maintain positive student attitudes and high usage of ICT.
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- 2006
5. Enhancing Ecosystem Stewardship in Small-Scale Fisheries: Prospects for Latin America and the Caribbean
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CAPES, Medeiros, Rodrigo Pereira; Centro de Estudos do Mar (CEM), Universidade Federal do Paraná (UFPR), Pontal do Sul, PR, Brasil., Serafini, Thiago Zagonel; Departamento de Ciências do Mar (DCMar), Universidade Federal de São Paulo (UNIFESP), Santos, SP, Brasil., McConney, Patrick; Centre for Resource Management and Environmental Studies (CERMES), University of the West Indies, Barbados., CAPES, Medeiros, Rodrigo Pereira; Centro de Estudos do Mar (CEM), Universidade Federal do Paraná (UFPR), Pontal do Sul, PR, Brasil., Serafini, Thiago Zagonel; Departamento de Ciências do Mar (DCMar), Universidade Federal de São Paulo (UNIFESP), Santos, SP, Brasil., and McConney, Patrick; Centre for Resource Management and Environmental Studies (CERMES), University of the West Indies, Barbados.
- Abstract
Despite recognition of small-scale fisheries (SSF) contribution to livelihood diversity and food security worldwide, a better understanding of their social and ecological dynamics is required. This paper is a synthesis of the main findings from the special issue “Enhancing ecosystem stewardship in small-scale fisheries” published in this journal. Contributors explored ecosystem stewardship in three dimensions: impacts, monitoring and stewardship. Results suggested that ecosystem stewardship encompasses collaborative action to foster: i) new perspectives on SSF management; ii) a broader perspective on managers and stakeholders – as stewards for implementing these new perspectives; and iii) enabling environments through partnership, networking, communication and collective action. This special issue is an output from the Too Big to Ignore (TBTI) Working Group 4 - “Enhancing the Stewardship”. TBTI is a global research network and knowledge mobilization partnership intended to better comprehend SSF contributions on issues such as food security and poverty alleviation, as well as the associated impacts of global changes, through the efforts of diverse partners around the world., Apesar da reconhecida importância da pesca artesanal ou de pequena escala para a diversidade de modos de vida e segurança alimentar, ainda há a necessidade de melhor compreensão da sua dinâmica social e ecológica. Este artigo compreende uma síntese dos principais resultados da edição “Fortalecendo o ecosystem stewardship na pesca artesanal”, publicada nesta revista. As contribuições abordaram o conceito de ecosystem stewardship em três dimensões: impactos, monitoramento e stewardship. Os resultados indicam que ecosystem stewardship compreende ações colaborativas para promover: i) novas perspectivas de gestão da pesca artesanal; ii) uma perspectiva mais abrangente sobre gestores e atores da gestão – como responsáveis na implementação destas novas abordagens; e iii) um ambiente institucional apropriado a partir de parcerias, formação de redes, comunicação e ação coletiva. Esta edição é um dos produtos do Grupo de Trabalho 4 - “Enhancing Stewardship” - do projeto Too Big to Ignore (TBTI). TBTI é uma rede internacional de pesquisa e mobilização de conhecimento formada para melhor compreender a contribuição da pesca artesanal para a segurança alimentar e a redução da pobreza, bem como os impactos associados com mudanças globais, a partir do esforço de trabalho colaborativo em diferentes regiões.
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- 2014
6. Editorial: Innovation, Education and Development
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Marshall, Stewart; The University of the West Indies, Barbados, West Indies; stewartmar@gmail.com and Marshall, Stewart; The University of the West Indies, Barbados, West Indies; stewartmar@gmail.com
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- 2010
7. Volume 6, Issue 3: Complete Issue (1.1 MB)
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; The University of the West Indies, Barbados, West Indies; stewart.marshall@open.uwi.edu and ; The University of the West Indies, Barbados, West Indies; stewart.marshall@open.uwi.edu
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- 2010
8. Editorial: ICT in support of school education
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Marshall, Stewart; The University of the West Indies, Barbados, West Indies; stewart.marshall@open.uwi.edu, Taylor, Wal; ; waltaylor@gmail.com, Marshall, Stewart; The University of the West Indies, Barbados, West Indies; stewart.marshall@open.uwi.edu, and Taylor, Wal; ; waltaylor@gmail.com
- Abstract
Please note that articles will be paginated when the issue is complete.
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- 2010
9. Editorial: Special Issue on Problem Based Learning and ICT
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Marshall, Stewart; The University of the West Indies, Barbados, West Indies; stewartmar@gmail.com, Taylor, Wal; The Information Society Institute (TISI), South Africa; waltaylor@cqnet.com.au, Marshall, Stewart; The University of the West Indies, Barbados, West Indies; stewartmar@gmail.com, and Taylor, Wal; The Information Society Institute (TISI), South Africa; waltaylor@cqnet.com.au
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- 2009
10. Editorial: Special Issue - e/merge in Africa
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Marshall, Stewart; The University of the West Indies, Barbados, West Indies; stewartmar@gmail.com, Taylor, Wal; TISI, Cape Town, South Africa; stewartmar@gmail.com, Marshall, Stewart; The University of the West Indies, Barbados, West Indies; stewartmar@gmail.com, and Taylor, Wal; TISI, Cape Town, South Africa; stewartmar@gmail.com
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- 2009
11. Editorial: Special Issue on eLearning in the Caribbean
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Marshall, Stewart; Open Campus, The University of the West Indies, Barbados, West Indies; stewartmar@gmail.com, Taylor, Wal; TISI, Cape Town, South Africa; stewartmar@gmail.com, Marshall, Stewart; Open Campus, The University of the West Indies, Barbados, West Indies; stewartmar@gmail.com, and Taylor, Wal; TISI, Cape Town, South Africa; stewartmar@gmail.com
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- 2009
12. Editorial: Technology integration and adoption in education and the community
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Marshall, Stewart; The University of the West Indies, Barbados, West Indies; stewartmar@gmail.com, Taylor, Wal; ; waltaylor@gmail.com, Marshall, Stewart; The University of the West Indies, Barbados, West Indies; stewartmar@gmail.com, and Taylor, Wal; ; waltaylor@gmail.com
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- 2009
13. Review of 'Efficient learning for the poor: Insights from the frontier of cognitive neuroscience'
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Brandon, Ed; The University of the West Indies, Barbados, West Indies; stewartmar@gmail.com and Brandon, Ed; The University of the West Indies, Barbados, West Indies; stewartmar@gmail.com
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- 2008
14. Review of 'The Power of Greed: Collective Action in International Development'
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Brandon, Ed; The University of the West Indies, Barbados, West Indies; stewartmar@gmail.com and Brandon, Ed; The University of the West Indies, Barbados, West Indies; stewartmar@gmail.com
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- 2008
15. Editorial: Using ICT to transform education
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Marshall, Stewart; The University of the West Indies, Barbados, West Indies; stewartmar@gmail.com, Taylor, Wal; Cape Peninsula University of Technology, Cape Town, South Africa; TaylorW@cput.ac.za, Marshall, Stewart; The University of the West Indies, Barbados, West Indies; stewartmar@gmail.com, and Taylor, Wal; Cape Peninsula University of Technology, Cape Town, South Africa; TaylorW@cput.ac.za
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- 2007
16. Editorial: Participation, collaboration and effective use of ICT
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Marshall, Stewart; The University of the West Indies, Barbados, West Indies; stewartmar@gmail.com, Taylor, Wal; Cape Peninsula University of Technology, South Africa; TaylorW@cput.ac.za, Marshall, Stewart; The University of the West Indies, Barbados, West Indies; stewartmar@gmail.com, and Taylor, Wal; Cape Peninsula University of Technology, South Africa; TaylorW@cput.ac.za
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- 2007
17. Editorial: ICT for education and training
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Marshall, Stewart; The University of the West Indies, Barbados, West Indies; stewartmar@gmail.com, Taylor, Wal;, Marshall, Stewart; The University of the West Indies, Barbados, West Indies; stewartmar@gmail.com, and Taylor, Wal;
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- 2006
18. Review of 'Private Education and Public Policy in Latin America'
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Brandon, Ed; The University of the West Indies, Barbados, West Indies; edbrandon@sunbeach.net and Brandon, Ed; The University of the West Indies, Barbados, West Indies; edbrandon@sunbeach.net
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- 2006
19. Editorial: Using ICT to empower marginalised groups
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Marshall, Stewart; The University of the West Indies, Barbados, West Indies; stewartmar@gmail.com, Taylor, Wal;, Marshall, Stewart; The University of the West Indies, Barbados, West Indies; stewartmar@gmail.com, and Taylor, Wal;
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- 2006
20. Editorial: ICT for capacity building and knowledge communities
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Marshall, Stewart; The University of the West Indies, Barbados, West Indies; stewartmar@gmail.com, Taylor, Wal; ; TaylorW@cput.ac.za, Marshall, Stewart; The University of the West Indies, Barbados, West Indies; stewartmar@gmail.com, and Taylor, Wal; ; TaylorW@cput.ac.za
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- 2005
21. Editorial: ICT for education and development in Southern Africa
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Marshall, Stewart; The University of the West Indies, Barbados, West Indies; stewartmar@gmail.com, Taylor, Wal; ; TaylorW@cput.ac.za, Marshall, Stewart; The University of the West Indies, Barbados, West Indies; stewartmar@gmail.com, and Taylor, Wal; ; TaylorW@cput.ac.za
- Abstract
Welcome to this very special second issue of the International Journal of Education and Development using Information and Communication Technology (IJEDICT).
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- 2005
22. Volume 1, Issue 2: Front Pages
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; The University of the West Indies, Barbados, West Indies; stewartmar@gmail.com and ; The University of the West Indies, Barbados, West Indies; stewartmar@gmail.com
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- 2005
23. Facilitating the use of ICT for community development through collaborative partnerships between universities, governments and communities
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Marshall, Stewart; The University of the West Indies, Barbados, West Indies; smarshall@uwichill.edu.bb, Taylor, Wal; Cape Peninsula University of Technology, South Africa; waltaylor@cqnet.com.au, Marshall, Stewart; The University of the West Indies, Barbados, West Indies; smarshall@uwichill.edu.bb, and Taylor, Wal; Cape Peninsula University of Technology, South Africa; waltaylor@cqnet.com.au
- Abstract
Despite the huge potential of information and communication technology (ICT) to assist communities to increase their overall well-being through community development, there are relatively few examples of sustained community networks built around ICT when compared to commercial applications, even in the developed countries where the technology has been increasingly available for up to 20 years. Researchers report a wide range of potential success factors and impediments. Pre-eminent amongst these is that collaborative partnerships, social network strategies and the building of social capital at the local level are key issues for the successful adoption of ICT for development. In this paper, the authors describe two successful community ICT projects whose success depended on the use of a collaborative methodology involving universities, governments and communities. Central to this approach is the involvement of the community in all parts of the project. By using such an approach, we acknowledge the rich creativity that exists in each local community and that this creativity can be harnessed in the creation of a community network, which in turn empowers the community. Researchers in universities can play a crucial role in facilitating this collaborative approach. Can the authors now facilitate similar projects with equal success in South Africa and in the small island developing states of the Caribbean?
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- 2005
24. The Caribbean Universities Project for Integrated Distance Education (CUPIDE)
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Marshall, Stewart; The University of the West Indies, Barbados, West Indies; smarshall@uwichill.edu.bb and Marshall, Stewart; The University of the West Indies, Barbados, West Indies; smarshall@uwichill.edu.bb
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- 2005
25. Editorial: Collaboration as a critical success factor in using ICT for capacity building and community development
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Marshall, Stewart; The University of the West Indies, Barbados, West Indies; smarshall@uwichill.edu.bb, Taylor, Wal; Cape Peninsula University of Technology, South Africa, Marshall, Stewart; The University of the West Indies, Barbados, West Indies; smarshall@uwichill.edu.bb, and Taylor, Wal; Cape Peninsula University of Technology, South Africa
- Abstract
Welcome to the first issue of the International Journal of Education and Development using Information and Communication Technology (IJEDICT) - an e-journal that provides free and open access to all of its content. IJEDICT emphasises collaboration across disciplines, across professions, across institutions, across sectors, and across continents in an attempt to freely share and promote best practice and best research. The journal is itself an example of the usefulness of such an approach, being the result of collaboration between two institutions, one in the Caribbean and the other in Cape Town, South Africa.
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- 2005
26. Volume 1, Issue 1: Front Pages
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; The University of the West Indies, Barbados, West Indies; smarshall@uwichill.edu.bb and ; The University of the West Indies, Barbados, West Indies; smarshall@uwichill.edu.bb
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- 2005
27. Editorial: ICT for development in Asia and the Pacific
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Marshall, Stewart; The University of the West Indies, Barbados, West Indies; stewartmar@gmail.com, Taylor, Wal; ; TaylorW@cput.ac.za, Marshall, Stewart; The University of the West Indies, Barbados, West Indies; stewartmar@gmail.com, and Taylor, Wal; ; TaylorW@cput.ac.za
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- 2005
28. 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, 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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
29. Worldwide trends in blood pressure from 1975 to 2015: a pooled analysis of 1479 population-based measurement studies with 19·1 million participants
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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 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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
- Published
- 2017
30. Assessing cardiovascular disease risk and social determinants of health: A comparative analysis of five risk estimation instruments using data from the Eastern Caribbean Health Outcomes Research Network.
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Schwartz JI, Howitt C, Raman S, Nair S, Hassan S, Oladele C, Hambleton IR, Sarpong DF, Adams OP, Maharaj RG, Nazario CM, Nunez M, and Nunez-Smith M
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- Humans, Middle Aged, Male, Female, Adult, Aged, Risk Assessment methods, Caribbean Region epidemiology, Risk Factors, Cohort Studies, Heart Disease Risk Factors, Cardiovascular Diseases epidemiology, Social Determinants of Health
- Abstract
Background: Accurate assessment of cardiovascular disease (CVD) risk is crucial for effective prevention and resource allocation. However, few CVD risk estimation tools consider social determinants of health (SDoH), despite their known impact on CVD risk. We aimed to estimate 10-year CVD risk in the Eastern Caribbean Health Outcomes Research Network Cohort Study (ECS) across multiple risk estimation instruments and assess the association between SDoH and CVD risk., Methods: Five widely used CVD risk estimation tools (Framingham and WHO laboratory, both laboratory and non-laboratory-based, and ASCVD) were applied using data from ECS participants aged 40-74 without a history of CVD. SDoH variables included educational attainment, occupational status, household food security, and perceived social status. Multivariable logistic regression models were used to compare differences in the association between selected SDoH and high CVD risk according to the five instruments., Findings: Among 1,777 adult participants, estimated 10-year CVD risk varied substantially across tools. Framingham non-lab and ASCVD demonstrated strong agreement in categorizing participants as high risk. Framingham non-lab categorized the greatest percentage as high risk, followed by Framingham lab, ASCVD, WHO lab, and WHO non-lab. Fifteen times more people were classified as high risk by Framingham non-lab compared with WHO non-lab (31% vs 2%). Mean estimated 10-year risk in the sample was over 2.5 times higher using Framingham non-lab vs WHO non-lab (17.3% vs 6.6%). We found associations between food insecurity, those with the lowest level compared to the highest level of education, and non-professional occupation and increased estimated CVD risk., Interpretation: Our findings highlight significant discrepancies in CVD risk estimation across tools and underscore the potential impact of incorporating SDoH into risk assessment. Further research is needed to validate and refine existing risk tools, particularly in ethnically diverse populations and resource-constrained settings, and to develop race- and ethnicity-free risk estimation models that consider SDoH., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2025 Schwartz et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
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- 2025
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31. Comment on: Effectiveness of Endovenous Radiofrequency Ablation for Elderly Patients with Varicose Veins of Lower Extremities.
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Manjra S
- Abstract
Competing Interests: Declaration of Competing InterestThe author declares that he has no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
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- 2023
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32. Experiences with SARS-CoV-2 (Covid-19) in Trinidad and Tobago, a small island developing state: realities and opportunities.
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Dookeeram D, Hariharan S, Hambleton I, Ali K, Teelucksingh S, Ramsewak S, Dookeeram D, and Maharaj SB
- Abstract
The COVID-19 pandemic has exerted significant global challenges that are expressed in a variety of socio-politico-economic scenarios, depending upon individual countries' preparedness and resilience. The impact COVID-19 in Small Island Developing States (SIDS), most of which are categorized as Lower and Middle-Income Countries, has been pronounced. Furthermore, many of these SIDS possess specific vulnerabilities to global threats. This paper contextualizes the experience of Trinidad and Tobago from some perspectives of geoeconomics, healthcare, and international relations. In many ways, the experience is similar to that of other SIDS with the inherent nuances of a post-colonial world. Trinidad and Tobago was ranked number one by the Oxford University COVID-19 Government Response Tracker (OxCGRT) "Lockdown rollback checklist: Do countries meet WHO recommendations for rolling back lockdown?". Despite the significant political support to combat the disease, by the end of 2022, the country had recorded over four thousand deaths and just over 50% of the population is vaccinated. This paper seeks to discuss the successes and challenges faced by this twin island state., Competing Interests: None of the authors listed have any financial benefits from the development and publication of this manuscript., (© 2023 The Authors.)
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- 2023
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33. Understanding the relationship between built environment features and physical activity in the Caribbean: A scoping review.
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Rocke K, Howitt C, and Hambleton I
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Background: Transforming the urban infrastructure to become safe, inclusive and sustainable remains a challenge in most developing settings. The Caribbean has high burdens of physical inactivity and non-communicable diseases. Therefore, understanding the role of the built environment (BE) in modifying individual activity is important for informing the design of community interventions to improve levels of physical activity (PA). Anecdotally, there is limited evidence on the BE in the Caribbean, however evidence from other Small Island Developing States (SIDS) and from Latin America (LA) may offer useful information given their similar urbanization profiles and shared geo-collaborative histories., Objective: Our review identifies and characterizes individual features of the BE and examines their relationships with PA outcomes., Methods: We systematically searched a range of multi-discipline research databases, including studies from SIDS and LA that objectively measured BE features as an exposure and PA as an outcome between 2010 and 2021. Grey literature was not considered for this review. We characterized BE measures into 9 neighbourhood design domains using the Walkability for Health framework, and mapped gaps in the published evidence. We performed a narrative summary of BE-PA relationships, focusing on association strength and direction of effect., Results: Fifty-one studies from published scientific literature in Brazil, Colombia, Mexico, Chile, and Singapore were included that described 306 BE-PA relationships. The BE was mostly characterized by number of and proximity to spaces for social interaction, green spaces, increasing housing density or street connectivity, and mixed residential and commercial land use. BE-PA relationships, although inconsistent, largely promoted PA., Conclusion: Although the review is suggestive of the benefits of the benefits of BE interventions for promoting active commuting and leisurely PA, translational research is needed to understand whether results can be successfully adapted for SIDS, which often have an urban structure defined by a single urban centre with connections to outlying communities., Competing Interests: The authors declare that they have no conflict of interests., (© 2022 The Authors. Published by Elsevier Inc.)
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- 2022
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34. Predictors for depression and perceived stress among a small island developing state university population.
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Rocke K and Roopchand X
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- Caribbean Region epidemiology, Cross-Sectional Studies, Humans, Risk Factors, Universities, Depression epidemiology, Stress, Psychological psychology, Students psychology
- Abstract
The prevalence of depression remains particularly high among university students. Factors known to be associated with this high burden range from social to poor academic performance. Thus, this study sought to determine the prevalence and predictors of depression and perceived stress among university students attending a Caribbean university. This was a cross-sectional study involving 800 students. Depression was assessed using the 21-item Beck Depression Inventory (BDI) and perceived stress was assessed using the Cohen Perceived Stress Scale. Logistic regression models were used to examine the relationship between predictors on depression and perceived stress. The BDI score was 11.97 ± 8.77 with a prevalence of depression at 25.88% and perceived stress of 57.50%. Living or associating with family and friends, were significant predictors of depression while school, money and associating with family/friends were significant for perceived stress. Talking with someone and exercise were associated with a lower likelihood of depression, while eating, drinking alcohol and shopping were associated with reduced levels of perceived stress. The level of depression and perceived high stress in this populations was moderate compared to similar international populations. These findings can be used to inform and design future interventions to improve the mental health of university students.
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- 2021
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35. Profiles of sleep and depression risk among Caribbean Blacks.
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Lincoln KD, Ailshire J, Nguyen A, Taylor RJ, Govia I, and Ifatunji MA
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- Caribbean Region, Ethnicity, Humans, Sleep, United States epidemiology, Black or African American, Depression epidemiology
- Abstract
Objectives: Sleep problems are associated with a host of psychiatric disorders and have been attributed to race disparities in health and wellness. Studies of sleep and mental health do not typically consider within-group differences among Blacks. Thus, our understanding of how the sleep-mental health relationship among Caribbean Blacks is limited. This study identified sleep profiles among Caribbean-born Blacks who reside in the United States. Design: Latent class analysis and data from the National Survey of American Life Re-interview study were used to identify and compare the associations between 'sleep quality classes,' sociodemographic factors, stress, and depression risk among Caribbean Blacks. Results: Two sleep quality classes were identified - 'good sleep quality' and 'poor sleep quality' - with each class demonstrating a complex pattern of sleep experiences, and illuminating the association between sleep and depression risk. Conclusions: Findings provide insight into the influence of sociodemographic factors and social stressors on the sleep experience of Caribbean Blacks and the importance of considering within-group differences to better understand risk and resilience among Caribbean Blacks living in the United States. Findings also highlight the importance of screening for sleep problems in an effort to reduce the burden of depression experienced by this population.
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- 2021
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36. The quantity and distribution of biofilm growth of Escherichia coli strain ATCC 9723 depends on the carbon/energy source.
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Sutrina SL, Callender S, Grazette T, Scantlebury P, O'Neal S, Thomas K, Harris DC, and Mota-Meira M
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- Culture Media metabolism, Escherichia coli genetics, Escherichia coli metabolism, Escherichia coli Proteins genetics, Escherichia coli Proteins metabolism, Biofilms, Carbon metabolism, Escherichia coli physiology
- Abstract
Escherichia coli strain 15 (ATCC 9723) formed robust biofilms of two distinct forms on glass tubes. In rich, low-osmolarity medium, the biofilms were restricted to the air/liquid interface, resulting in rings attached to the glass. As it was not evident that these biofilms extended across the liquid surface, we termed them 'ring' rather than 'pellicle' biofilms. In minimal medium supplemented with a non-fermentable substrate as the carbon/energy source, we observed either robust ring biofilms or little biofilm of any type, depending on the substrate. In contrast, fermentable substrates (sugars and sugar derivatives) supported robust biofilms covering most of the solid/liquid interface, which we termed 'tube-covering biofilms'. Maximal biofilm growth was observed when the sugar was a relatively poor substrate, supporting slow growth and known to cause minimal dephosphorylation of regulatory protein Enzyme IIA
Glucose of the phosphotransferase system. Compounds found to be inhibitors of biofilm growth, such as lactate, caused a shift from tube-covering to ring form at low concentration and complete loss of biofilm growth at high when added to minimal medium supplemented with a fermentable substrate. Exogenous cAMP activated biofilm growth under all conditions tested, leading to more intense ring or tube-covering biofilms and/or to a shift from ring to tube-covering form.- Published
- 2019
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37. Screening for gestational diabetes mellitus: a Caribbean perspective.
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Bassaw B, Fletcher H, Rattray C, McIntyre G, Sarkharkar V, Sankat S, Sirjusingh A, and Chinnia J
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- Caribbean Region, Female, Humans, Pregnancy, Diabetes, Gestational diagnosis, Mass Screening
- Abstract
Gestational diabetes mellitus (GDM) is defined as a glucose intolerance first recognised in pregnancy. The World Health Organization (WHO) in 2015 revised the definition into either diabetes in pregnancy (DIP) which includes pre-existing diabetes (type 1 or type 2) that antedates pregnancy or diabetes diagnosed during pregnancy with the WHO diagnostic criteria for diabetes mellitus (DM) in the non-pregnant state, and GDM for milder forms of hyperglycaemia in pregnancy. The main purpose of the screening and diagnosis of GDM is to identify pregnancies in which the foetus is at a high risk of an adverse perinatal outcome, and the mother and the offspring are of serious long-term sequelae. This review of the literature provides an overview of associated prevalence, risk factors and diagnosis of GDM. It also addresses the benefits of screening with supportive evidence. Based on this review, we recommend especially in low-resourced countries such as the Caribbean, adoption of a universal screening with the two-step method.
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- 2018
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38. M1/M2 Macrophages in Diabetic Nephropathy: Nrf2/HO-1 as Therapeutic Targets.
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Landis RC, Quimby KR, and Greenidge AR
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- Gene Expression Regulation drug effects, Humans, Macrophages drug effects, Diabetic Nephropathies drug therapy, Heme Oxygenase-1 metabolism, Macrophages classification, Macrophages physiology, NF-E2-Related Factor 2 metabolism
- Abstract
The process of inflammation is orchestrated by macrophages, according to their state of differentiation: thus, classically activated (M1) macrophages initiate the process by elaborating proinflammatory cytokines and reactive oxygen species, whereas the latter phase is controlled by alternatively activated macrophages (M2) to resolve inflammation and promote tissue remodelling with the release of growth factors. In a simple human inflammatory response, such as acute crystal arthropathy, macrophages progress linearly through M1 and M2 phases; however, in chronic inflammatory responses, such as atherosclerosis and Diabetic Nephropathy (DN), both M1 and M2 macrophages may coexist, leading to persistent inflammation and fibrosis. A key macrophage receptor that regulates conversion from M1 to M2 is CD163, the hemoglobin scavenger receptor. Scavenging of hemoglobin:haptoglobin (Hb:Hp) complexes via CD163 leads to nuclear translocation of the transcription factor Nrf2 (NF-E2-related factor 2), upregulation of heme oxygenase (HO)-1 cytoprotective protein, and release of interleukin (IL)-10 anti-inflammatory cytokine; IL-10 is then linked in a positive feedback loop to further CD163 expression. The potency of this M1/M2 switching pathway is underscored by the fact that human Hp2 polymorphisms are associated with worsened clinical outcomes for diabetic complications, including DN. Parallel observations in animals show that HO-1 activation by hemin protects against DN in rodent models of diabetes. This review discusses the concept that Nrf2/HO-1 acts as a 'therapeutic funnel' through which a range of natural and synthetic anti-oxidants may drive M1 to M2 switching and improved kidney function in diabetes. We also discuss our observations on the evolution of M1/M2 phenotypes in a human model of wound healing which has presented intriguing potential drug targets for DN, such as eotaxin/CCR3., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.)
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- 2018
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39. 2013 ACC/AHA Cholesterol Guideline and Implications for Healthy People 2020 Cardiovascular Disease Prevention Goals.
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Egan BM, Li J, White K, Fleming DO, Connell K, Hernandez GT, Jones DW, Ferdinand KC, and Sinopoli A
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- Adult, Aged, Cholesterol, LDL metabolism, Female, Goals, Healthy People Programs, Humans, Hypercholesterolemia prevention & control, Male, Middle Aged, Numbers Needed To Treat, Practice Guidelines as Topic, Primary Prevention, Secondary Prevention, Young Adult, Anticholesteremic Agents therapeutic use, Atherosclerosis prevention & control, Cholesterol, LDL drug effects, Hydroxymethylglutaryl-CoA Reductase Inhibitors therapeutic use
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Background: Healthy People 2020 aim to reduce fatal atherosclerotic cardiovascular disease (ASCVD) by 20%, which translates into 310 000 fewer events annually assuming proportional reduction in fatal and nonfatal ASCVD. We estimated preventable ASCVD events by implementing the American College of Cardiology/American Heart Association (ACC/AHA) 2013 Cholesterol Guideline in all statin-eligible adults. Absolute risk reduction (ARR) and number needed-to-treat (NNT) were calculated., Methods and Results: National Health and Nutrition Examination Survey data for 2007-2012 were analyzed for adults aged 21 to 79 years and extrapolated to the US population. Literature-guided assumptions were used including (1) low-density lipoprotein cholesterol falls 33% with moderate-intensity statins and 51% with high-intensity statins; (2) for each 39 mg/dL decline in low-density lipoprotein cholesterol, 10-year ASCVD10 risk would fall 21% when ASCVD10 risk was ≥20% and 33% when ASCVD10 risk was <20%; and (3) either all statin-eligible untreated adults or all with ASCVD10 risk ≥7.5% would receive statins. Of 175.9 million adults aged 21 to 79 years not taking statins, 44.8 million (25.5%) were statin eligible. Treating all statin-eligible adults would prevent an estimated 243 589 ASCVD events annually (ARR 5.4%, 10-year NNT 18). Treating all statin-eligible adults with ASCVD10 risk ≥7.5% reduces the number treated to 32.2 million (28.2% fewer), whereas ASCVD events prevented annually fall only 10.5% to 217 974 (6.8% ARR, NNT 15)., Conclusions: Implementing the ACC/AHA 2013 Cholesterol Guideline in all untreated, statin-eligible adults could achieve ≈78% of the Healthy People 2020 ASCVD prevention goal. Most of the benefit is attained by individuals with 10-year ASCVD risk ≥7.5%., (© 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.)
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- 2016
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40. The Use and Reporting of the Cross-Over Study Design in Clinical Trials and Systematic Reviews: A Systematic Assessment.
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Nolan SJ, Hambleton I, and Dwan K
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- Cross-Over Studies, Cystic Fibrosis genetics, Humans, Clinical Trials as Topic methods
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Background: Systematic reviews of treatment interventions in stable or chronic conditions often require the synthesis of clinical trials with a cross-over design. Previous work has indicated that methodology for analysing cross-over data is inadequate in trial reports and in systematic reviews assessing trials with this design., Objective: We assessed systematic review methodology for synthesising cross-over trials among Cochrane Cystic Fibrosis and Genetic Disorders Group reviews published to July 2015, and assessed the quality of reporting among the cross-over trials included in these reviews., Methodology: We performed data extraction of methodology and reporting in reviews, trials identified and trials included within reviews., Principal Findings: We reviewed a total of 142 Cochrane systematic reviews including 53 reviews which synthesised evidence from 218 cross-over trials. Thirty-three (63%) Cochrane reviews described a clear and appropriate method for the inclusion of cross-over data, and of these 19 (56%) used the same method to analyse results. 145 cross-over trials were described narratively or treated as parallel trials in reviews but in 30 (21%) of these trials data existed in the trial reports to account for the cross-over design. At the trial level, the analysis and presentation of results were often inappropriate or unclear, with only 69 (32%) trials presenting results that could be included in meta-analysis., Conclusions: Despite development of accessible, technical guidance and training for Cochrane systematic reviewers, statistical analysis and reporting of cross-over data is inadequate at both the systematic review and the trial level. Plain language and practical guidance for the inclusion of cross-over data in meta-analysis would benefit systematic reviewers, who come from a wide range of health specialties. Minimum reporting standards for cross-over trials are needed.
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- 2016
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41. Neighbourhood of residence and the risk of type 2 diabetes.
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Unwin N and Hambleton IR
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- Humans, Risk, Socioeconomic Factors, Diabetes Mellitus, Type 2, Residence Characteristics
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- 2016
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42. Intravenous infusion of haptoglobin for the prevention of adverse clinical outcome in Sickle Cell Disease.
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Quimby KR, Hambleton IR, and Landis RC
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- Albuminuria diagnosis, Anti-Inflammatory Agents, Antigens, CD metabolism, Antigens, Differentiation, Myelomonocytic metabolism, Biomarkers metabolism, Child, Child, Preschool, Hemoglobins therapeutic use, Hemolysis, Hemopexin metabolism, Humans, Hydroxyurea therapeutic use, Infusions, Intravenous, Interleukin-10 metabolism, Models, Theoretical, Reactive Oxygen Species metabolism, Receptors, Cell Surface metabolism, Treatment Outcome, CD163 Antigen, Anemia, Sickle Cell drug therapy, Anemia, Sickle Cell prevention & control, Haptoglobins administration & dosage, Haptoglobins therapeutic use
- Abstract
Sickle Cell Disease (SCD) is a genetic condition which manifests as altered hemoglobin (Hb) protein that can aggregate under hypoxic conditions. The resultant sickled erythrocytes experience premature hemolysis, releasing an estimated 10g of free Hb (fHb) into the intravascular space. FHb participates in redox reactions creating various reactive oxygen species which rapidly and irreversibly scavenge nitric oxide, thereby attenuating its vasodilatory, antithrombotic, and anti-inflammatory properties. FHb also induces endothelial expression of adhesion molecules, triggering leukocyte margination at the vessel wall. These mechanisms participate in diverse SCD-associated clinical events including nephropathy, pulmonary hypertension, chronic leg ulceration, and ischemic events. FHb also exerts a direct reno-toxic effect contributing to albuminuria which is an early, frequent manifestation of glomerular injury. Under normal conditions, fHb is effectively scavenged by the Hb-scavenging mechanism (HSM); this involves binding to haptoglobin (Hp), uptake via the Hb-scavenging receptor (CD163) on monocytes and metabolism by heme-oxygenase-1. This culminates in increased CD163 expression and release of anti-inflammatory by-products e.g. interleukin-10 (IL-10). In SCD, the Hb-binding capacity is overwhelmed by chronic hemolysis; our previous research shows serum Hp as the depleted component. This deficiency could result in the harmful consequences of circulating fHb going unbridled. The hypothesis we explore here is that Hp infusions, in excess of fHb concentration, will allow the HSM to remain functional, and thereby achieve improved clinical outcomes, tracking albuminuria as a sentinel. Albuminuria was selected because of its high prevalence in SCD and its relative ease of diagnosis and monitoring. The hypothesis may be evaluated in four phases: Phase 1 will determine the concentration of Hp needed to trigger the HSM as measured by induction of CD163 and IL-10 and the recovery of hemopexin. Phase 2 will investigate the half-life of HSM induction by analyzing the time-course of CD163 expression and IL-10 and hemopexin serum concentration. Phase 3 will determine patient eligibility for therapy, whether as treatment or prevention. Phase 4 will test the efficacy of Hp transfusions in a randomized control trial as measured by correction of albuminuria. Angiotensin converting enzyme inhibitors (ACEi) are currently the first-line treatment for SCD nephropathy, however hyperkalemia limits its use. Hydroxyurea, which has therapeutic value in many SCD adverse events, has yielded inconsistent effects on albuminuria. We are proposing the addition of an intervention more proximal in the hemolytic cascade. Boosting the exhausted Hb-scavenging capacity via Hp replacement therapy has the potential to modify multiple downstream clinical events., (Copyright © 2015 Elsevier Ltd. All rights reserved.)
- Published
- 2015
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43. The SPIRIT 2013 statement--defining standard protocol items for trials.
- Author
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Agha RA, Altman DG, and Rosin D
- Subjects
- Checklist, Clinical Trials as Topic methods, Humans, Research Design, Clinical Protocols standards, Clinical Trials as Topic standards
- Published
- 2015
- Full Text
- View/download PDF
44. Diabetes in North America and the Caribbean: an update.
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Yisahak SF, Beagley J, Hambleton IR, and Narayan KM
- Subjects
- Adolescent, Adult, Aged, Caribbean Region epidemiology, Child, Child, Preschool, Disease Management, Female, Humans, Infant, Infant, Newborn, Male, Middle Aged, North America epidemiology, Prevalence, Risk Factors, Young Adult, Diabetes Mellitus, Type 1 epidemiology, Diabetes Mellitus, Type 2 epidemiology
- Abstract
The North America and Caribbean (NAC) Region faces a high burden of diabetes. In 2013, the number of children (aged 0-14 years) with type 1 diabetes was 108,600, with 16.7 new cases diagnosed per 100,000 children. Furthermore, there were 36,755,500 individuals with diabetes (mostly type 2 diabetes) in adults (20-79 years), and an additional 44,277,700 individuals had impaired glucose tolerance. The age-adjusted prevalence of diabetes in adults was 9.6%; the second highest among the seven Regions of the International Diabetes Federation. This estimate is expected to grow to 9.9% by 2035. There was some heterogeneity in the estimates within the Region with the age-adjusted prevalence for the USA estimated at 9.2%, 7.9% for Canada, 12.6% for Mexico, and 9.6% for the Caribbean islands. Mortality due to diabetes in the NAC Region is not limited to older age groups, with 37.6% of deaths occurring in people under the age of 60. The economic impact was also enormous, with healthcare expenditure due to diabetes estimated at 263.2 billion USD for 2013 - the highest of all IDF Regions. Diabetes threatens the public health and economies of countries in the NAC Region, and efforts in prevention and management must be intensified in order to surmount this growing problem., (Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.)
- Published
- 2014
- Full Text
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45. Editor's perspectives--ASiT abstracts.
- Author
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Rosin RD
- Subjects
- Barbados, Education, Medical, General Surgery trends, Humans, United Kingdom, United States, Abstracting and Indexing, General Surgery education, Publications
- Published
- 2013
- Full Text
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46. Measuring the quality of performance of a genitourinary medicine primary care team.
- Author
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Lwegaba A and Kilaru K
- Subjects
- Adolescent, Adult, Aged, Ambulatory Care Facilities, Barbados, Female, Female Urogenital Diseases economics, Humans, Interviews as Topic, Male, Male Urogenital Diseases economics, Middle Aged, Outcome and Process Assessment, Health Care, Patient Care Team, Patient Satisfaction, Prescription Fees, Prospective Studies, Young Adult, Clinical Audit, Female Urogenital Diseases diagnosis, Female Urogenital Diseases therapy, Male Urogenital Diseases diagnosis, Male Urogenital Diseases therapy, Primary Health Care standards
- Abstract
Objectives: To measure the quality of the clinical Genitourinary (G-U) Medicine and Sexually Transmitted Infection (GUM/STI) management process at a primary care polyclinic and establish a baseline for future monitoring and evaluation., Methods: This was a prospective cohort study on 220 data abstracted clinical notes randomly selected and stratified by gender, age and first point of contact from 2131 GU/STI patients of the GUM/STI clinic seen from 2003-5. Data were also obtained by tele-interview of a subset of 27 individuals. Measurements were incidence (95% CI) as proportions of successful level of activity and outcome indicators for diagnosis, treatment and prognosis., Results: Among 220 patients, the incidence (95% CI) of accurate clinical diagnosis and treatment was 40.5% (33%, 46%) before laboratory results boosted it to 96% (93%, 99%). Successful prognosis at 1st, 2nd and 3rd follow-up was 23.2%, 56.6% and 86.2%. The risk at follow-up for 1, 2 and >2 GU/STI episodes was 28.9%, 45.8% and 25.3%. Follow-up of partners was low, 4.7%. Adequate health promotion and preventive services were reported in 86.5% (78%, 88%) of 220 patients' records and by 84.5% (71%, 98%) of 26 who were tele-interviewed. In 88.5% (76%, 100%) of those (27) tele-interviewed, there was satisfaction with the service, but 73.8% (56%, 90%) would have preferred appointments and 29.6% (12%, 47%) preferred extended hours. Per capita ideal cost of medication could have been BB$6.30 (+/- 1.56) instead of actual BB$13.05 (+/- 1.84); (BB$2 = US$1)., Conclusions: GU/STI quality performance improvement in Barbados requires rapid laboratory diagnosis, standardized data formats with prompt expedited partner notification and treatment appointments and use of recommended algorithm that can half the cost of medication. Genitourinary medicine should be strategized instead of STI to better encapsulate the spectrum diversity of presentations and points of service.
- Published
- 2009
47. Mentors' perspectives on group mentorship: a descriptive study of two programs in child and adolescent psychiatry.
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Alleyne SD, Horner MS, Walter G, Hall Fleisher S, Arzubi E, and Martin A
- Subjects
- Adolescent, Child, Congresses as Topic, Curriculum, Data Collection, Faculty, Medical, Group Structure, Humans, Program Evaluation, United States, Adolescent Psychiatry education, Attitude of Health Personnel, Child Psychiatry education, Group Processes, Mentors education, Mentors psychology
- Abstract
Objective: The authors assess mentors' perceptions of mentoring and experiences participating in an intensive, small-group mentorship program, with particular attention to potential challenges in their retention and the recruitment of new mentors to similar, future programs., Methods: Similar group mentorship programs were implemented at two child and adolescent psychiatry conferences, one national and the other international. The program included three daily small group meetings, one closing meeting for all participants, and administration of a web-based survey., Results: Of the 43 mentors, 42 (98%) completed the survey, and results were comparable across both programs. Among respondents, 93% found the group experience personally fulfilling and an equally valuable teaching and learning opportunity. Mentors unanimously agreed that co-mentoring enhanced the group mentoring experience. Group diversity enhanced the mentorship process, although differences in trainees' interests and levels of experience as posed concrete challenges. Sixty-two percent of the mentors thought that they would be able to adapt lessons and experiences from the mentorship program in their home institutions, and 95% agreed to participate if invited to mentor in future programs., Conclusion: Mentors found the intensive, brief group mentorship model to be a powerful, time-efficient, and enjoyable approach to mentoring, increasing trainees' exposure to child and adolescent psychiatry. Although group composition, schedule coordination, and logistics warrant closer scrutiny, these positive perceptions bode well for mentor recruitment and retention and for using a similar program in other settings.
- Published
- 2009
- Full Text
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48. Sex and the city: differences in disease- and disability-free life years, and active community participation of elderly men and women in 7 cities in Latin America and the Caribbean.
- Author
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Rose AM, Hennis AJ, and Hambleton IR
- Subjects
- Aged, Aged, 80 and over, Caribbean Region epidemiology, Chronic Disease epidemiology, Cities, Comorbidity, Female, Geriatric Assessment, Humans, Latin America epidemiology, Life Expectancy, Male, Middle Aged, Prevalence, Sex Distribution, Volunteers, Activities of Daily Living, Persons with Disabilities statistics & numerical data, Health Status
- Abstract
Background: The world's population is ageing, and four of the top 10 most rapidly ageing developing nations are from the region of Latin America and the Caribbean (LAC). Although an ageing population heralds likely increases in chronic disease, disability-related dependence, and economic burden, the societal contribution of the chronically ill or those with disability is not often measured., Methods: We calculated country-specific prevalences of 'disability' (difficulty with at least one activity of daily living), 'disease' and 'co-morbidity' (presence of at least one, and at least two, of seven chronic diseases/conditions, respectively), and 'active community engagement' (using five levels of community participation, from less than weekly community contact to voluntary or paid work) in seven LAC cities. We estimated remaining life expectancy (LE) with and without disability, disease and co-morbidity, and investigated age, sex, and regional variations in disability-free LE. Finally, we modeled the association of disease, co-morbidity and disability with active community participation using an ordinal regression model, adjusted for depression., Results: Overall, 77% of the LAC elderly had at least one chronic disease/condition, 44% had co-morbidity and 19% had a disability. The proportion of disability-free LE declined between the youngest (60-64 years) and the eldest (90 years and over) age-groups for both men (from 85% to 55%) and women (from 75% to 45%). Disease-free and co-morbidity-free LE, however, remained at approximately 30% and 62%, respectively, for men (20% and 48% for women), until 80-84 years of age, then increased. Only Bridgetown's participants had statistically significantly longer disability-free LE than the regional average (IRR = 1.08; 95%CI 1.05-1.10; p < 0.001). Only Santiago's participants had disability-free LE which was shorter than the regional average (IRR = 0.94; 95%CI 0.92-0.97; p < 0.001). There was 75% active community participation overall, with more women than men involved in active help (49% vs 32%, respectively) and more men involved in voluntary/paid work (46% vs 25%, respectively). There was either no, or borderline significance in the association between having one or more diseases/conditions and active community engagement for both sexes. These associations were limited by depression (odds ratio [OR] reduced by 15-17% for men, and by 8-11% for women), and only remained statistically significant in men. However, disability remained statistically significantly associated with less community engagement after adjusting for depression (OR = 0.58, 95%CI 0.49-0.69, p < 0.001 for women and OR = 0.50, 95%CI 0.47-0.65, p < 0.001 for men)., Conclusion: There is an increasing burden of disease and disability with older age across the LAC region. As these nations cope with resulting social and economic demands, governments and civic societies must continue to develop and maintain opportunities for community participation by this increasingly frail, but actively engaged group.
- Published
- 2008
- Full Text
- View/download PDF
49. Sir W. Ernest Miles.
- Author
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Zbar AP
- Subjects
- England, History, 19th Century, History, 20th Century, Humans, Rectal Neoplasms history, Digestive System Surgical Procedures history, Rectal Neoplasms surgery
- Published
- 2007
- Full Text
- View/download PDF
50. Human external ophthalmomyiasis occurring in Barbados.
- Author
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Levett PN, Brooker L, Reifer C, Prussia PR, and Eberhard ML
- Subjects
- Animals, Barbados, Eye Infections, Parasitic therapy, Female, Goats parasitology, Humans, Larva, Middle Aged, Sheep parasitology, Zoonoses parasitology, Diptera growth & development, Eye Infections, Parasitic diagnosis, Myiasis diagnosis
- Abstract
Human infection with the sheep nasal botfly Oestrus ovis occurs sporadically. In most cases, there is a history of a strike in the eye by the adult fly. Human O. ovis has been reported rarely from the Americas. We report the first case of O. ovis infection in the Caribbean region, which occurred in an urban area of Barbados. The patient responded to removal of the larvae from the conjunctiva and symptomatic treatment.
- Published
- 2004
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