Worldwide hernia repair: variations in the treatment of primary unilateral inguinal hernias in adults in the United Kingdom and in low- and middle-income countries

Hernia ◽  
2019 ◽  
Vol 23 (3) ◽  
pp. 503-507 ◽  
Author(s):  
P. Estridge ◽  
D. L. Sanders ◽  
A. N. Kingsnorth
Keyword(s):  
United Kingdom ◽  
Hernia Repair ◽  
Middle Income ◽  
Middle Income Countries ◽  
The United Kingdom ◽  
Inguinal Hernias ◽  
Low And Middle Income

scholarly journals Asthma inflammatory phenotypes on four continents: most asthma cases are non-eosinophilic

2020 ◽  
Author(s):  
Lucy Pembrey ◽  
Collin Brooks ◽  
Harriet Mpairwe ◽  
Camila A Figueiredo ◽  
Aida Y. Oviedo ◽  
...  
Keyword(s):  
United Kingdom ◽  
New Zealand ◽  
Sputum Sample ◽  
High Income ◽  
Eosinophilic Asthma ◽  
Middle Income ◽  
Middle Income Countries ◽  
The United Kingdom ◽  
Inflammatory Phenotypes ◽  
Low And Middle Income

AbstractRationaleIn high-income countries less than half of asthma cases involve eosinophilic airways inflammation. Few studies have measured inflammatory asthma phenotypes in low- and-middle-income countries.ObjectivesTo assess asthma inflammatory phenotypes in Brazil, Ecuador, Uganda, New Zealand and the United Kingdom.MethodsWe recruited 998 asthmatics and 356 non-asthmatics: 204/40 in Brazil, 176/67 in Ecuador, 235/132 in New Zealand, 207/50 in Uganda, and 176/67 in the United Kingdom. All centres studied children and adolescents (age-range 8-20 years), except the UK centre involved 26-27 year olds. Information was collected using questionnaires, clinical characterisation, blood, and induced sputum.Measurements and main results87% provided a sputum sample, ranging from 74% (Brazil) to 93% (United Kingdom); of these, 71% were countable. The proportion of asthmatics classified as eosinophilic asthma (EA) was 39% (95% confidence interval 35%-43%) overall: 35% in Brazil, 32% in Ecuador, 50% in New Zealand, 33% in Uganda, and 33% in the United Kingdom. The non-eosinophilic asthmatics (NEA) had similar severity/control to the eosinophilic asthmatics (EA). Of the 61% (95%CI 57%-65%) of cases with NEA, 50% showed no signs of inflammation (paucigranulocytic), with 11% having neutrophilic inflammation.ConclusionsThis is the first time that sputum induction has been used to compare asthma inflammatory phenotypes in high-income countries and low-and-middle-income countries. Most cases were non-eosinophilic. This has major implications for asthma prevention and management in both of these contexts, and supports the need to recognise asthma as a heterogeneous condition, and to develop new prevention strategies and new therapies which target NEA.

Building Institutions for Priority-Setting

2019 ◽  
pp. 265-282
Author(s):  
Amanda Glassman ◽  
Kalipso Chalkidou ◽  
Ursula Giedion ◽  
Yot Teerawattananon ◽  
Rachel Silverman
Keyword(s):  
Priority Setting ◽  
Ad Hoc ◽  
Health Technology ◽  
Middle Income ◽  
Middle Income Countries ◽  
Competing Interests ◽  
The United Kingdom ◽  
Seven Principles ◽  
Explicit Processes ◽  
Low And Middle Income

The rationing problem—the challenge of squaring finite resources with unlimited demand for services—is common to all health systems. In most low- and middle-income countries, rationing occurs as an ad hoc series of nontransparent choices, reflecting the competing interests of governments, donors, and other stakeholders. Yet in a growing number of countries, more explicit processes are under development; these merit better support. This chapter reflects the findings of a Center for Global Development working group on priority-setting in health. The authors briefly review global and national efforts to strengthen priority-setting and describe a “7 + 7 framework”—seven principles and seven processes—to guide priority-setting, applying that framework to a real-world example from the United Kingdom. The authors consider common obstacles to health technology assessment within low- and middle-income countries and discuss mitigating strategies. The chapter concludes with recommendations for how countries can improve their priority-setting processes and how the global community can best support those efforts.

Some Conditions for Task Shifting in Low and Middle-Income Countries

2012 ◽  
Author(s):  
Joop de Jong ◽  
Mark Jordans ◽  
Ivan Komproe ◽  
Robert Macy ◽  
Aline & Herman Ndayisaba ◽  
...  
Keyword(s):  
Task Shifting ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income
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