Utilization of Evidence-Based Therapy for Acute Coronary Syndrome in High-Income and Low/Middle-Income Countries

2014 ◽  
Vol 113 (5) ◽  
pp. 793-797 ◽  
Author(s):  
Avi Shimony ◽  
Sonia M. Grandi ◽  
Louise Pilote ◽  
Lawrence Joseph ◽  
Jennifer O'Loughlin ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
High Income ◽  
Evidence Based ◽  
Middle Income ◽  
Middle Income Countries ◽  
Coronary Syndrome ◽  
Low Middle Income Countries ◽  
Evidence Based Therapy

Utilization of Evidence-Based Therapy for Acute Coronary Syndrome in High Income and Middle/Low Income Countries

2013 ◽  
Vol 29 (10) ◽  
pp. S297-S298
Author(s):  
A. Shimony ◽  
S.M. Grandi ◽  
L. Pilote ◽  
L. Joseph ◽  
J. O'Loughlin ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Low Income ◽  
High Income ◽  
Low Income Countries ◽  
Evidence Based ◽  
Coronary Syndrome ◽  
Evidence Based Therapy

Abstract WP418: A Systematic Comparison of Key Features of Ischaemic Stroke Prevention Guidelines in Low- and Middle-income vs High-income Countries

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Hernan O Bayona ◽  
Mayowa Owolabi ◽  
Wayne Feng ◽  
James R Sawers ◽  
Paul Olowoyo ◽  
...  
Keyword(s):  
Stroke Prevention ◽  
High Income ◽  
Evidence Based ◽  
Vascular Risk ◽  
Eligibility Criteria ◽  
Middle Income ◽  
Middle Income Countries ◽  
Prevention Guideline ◽  
Prevention Guidelines ◽  
Low And Middle Income

Introduction: Implementation of contextually appropriate, evidence-based, expert-recommended stroke prevention guideline is particularly important in Low- and Middle-Income Countries (LMICs), which bear disproportional larger burden of stroke while possessing fewer resources. Focus therefore, should be on approaches enabling healthcare systems to improve control of vascular risk factors. Objective: We aimed to compare important features of stroke prevention guidelines between LMICs and High Income Countries (HICs). Methods: We systematically searched PubMed, AJOL, SciELO, and LILACS databases for stroke prevention guidelines published between January 2005 and December 2015 by country. Primary search items included: “Stroke” and “Guidelines”. We critically appraised the articles for evidence level, issuance frequency and implementation aspects to clinical practice. Results: Among 45 stroke prevention guidelines published, 28 (62%) met eligibility criteria: 7 from LMICs (25%) and 21 from HICs (75%). LMIC-issued guidelines were less likely to have conflict of interest declarations (57% vs. 100%, p=0.01), involve high quality systematic reviews (57% vs. 95%, p= 0.03), had good dissemination channels (14% vs 71%, p=0.02). The patient views and preferences were the most significant stakeholder considerations in HICs (43%, p=0.04) compared with LMICs. Conclusion: The quality and quantity of stroke prevention guidelines in LMICs are less than those of HICs and need to be significantly improved upon.

scholarly journals Effective Strategies for Global Health Training Programs A Systematic Review of Training Outcomes in Low and Middle Income Countries

2016 ◽  
Vol 8 (11) ◽  
pp. 278 ◽  
Author(s):  
Aprill Z. Dawson ◽  
Rebekah J. Walker ◽  
Jennifer A. Campbell ◽  
Leonard E. Egede
Keyword(s):  
Medical Training ◽  
Skills Training ◽  
High Income ◽  
Training Methods ◽  
Middle Income ◽  
Training Outcomes ◽  
Effective Strategies ◽  
Middle Income Countries ◽  
Low Middle Income Countries ◽  
Low And Middle Income

<p><strong>INTRODUCTION: </strong>Low and middle-income countries face a continued burden of chronic illness and non-communicable diseases while continuing to show very low health worker utilization. With limited numbers of medical schools and a workforce shortage the poor health outcomes seen in many low and middle income countries are compounded by a lack of within country medical training.</p><p><strong>METHODS: </strong>Using a systematic approach, this paper reviews the existing literature on training outcomes in low and middle-income countries in order to identify effective strategies for implementation in the developing world. This review examined training provided by high-income countries to low- and middle-income countries.</p><p><strong>RESULTS: </strong>Based on article eligibility, 24 articles were found to meet criteria. Training methods found include workshops, e-learning modules, hands-on skills training, group discussion, video sessions, and role-plays. Of the studies with statistically significant results training times varied from one day to three years. Studies using both face-to-face and video found statistically significant results.</p><p><strong>DISCUSSION:</strong> Based on the results of this review, health professionals from high-income countries should be encouraged to travel to low- middle-income countries to assist with providing training to health providers in those countries.</p>

Globalization and Environment: An Asian Experience

2018 ◽  
Vol 09 (03) ◽  
pp. 1850010 ◽  
Author(s):  
Sudeshna Ghosh
Keyword(s):  
Granger Causality ◽  
Low Income ◽  
High Income ◽  
Low Income Countries ◽  
Environmental Damage ◽  
Empirical Observation ◽  
Middle Income ◽  
Middle Income Countries ◽  
Long Run ◽  
Low Middle Income Countries

This paper explores the causal association between globalization and carbon dioxide emanations in a panel set of 17 low- and low-middle-income countries and 12 upper-middle and high-income countries of Asia, respectively. The time series of observations run from 1974 to 2014. The Westerlund (2007) panel cointegration test reveals that there exists a long-run cointegrating relationship in both the panel set of observations between globalization and CO2 emissions. For the panel of upper-middle and high-income countries of Asia the long-run panel (heterogeneous elasticities) shows that globalization does not cause environmental damage, contrary to the observation based on lower- and lower-middle-income countries. The study is in conformity with the Environmental Kuznets Curve Hypothesis. The Granger causality between the variables is explored by utilizing the Dumitrescu and Hurlin (2012) Granger Causality tests. The empirical observation shows that globalization-led environmental causality is valid for lower- and lower-middle-income countries of Asia. So proper sustainable green and clean technology must be adopted for the low-income countries to stop the negation of the growth process in the near future.

scholarly journals COVID-19: An opportunity to strengthen Public Health Policy and Advocacy Efforts in LMIC (Low- Middle-Income Countries)

2021 ◽  
Author(s):  
Ponn P Mahayosnand ◽  
Saman Essa ◽  
ZM Sabra
Keyword(s):  
Public Health ◽  
Cost Effective ◽  
World Health ◽  
Evidence Based ◽  
Middle Income ◽  
Policy Problem ◽  
Middle Income Countries ◽  
Successful Case ◽  
Low Middle Income Countries ◽  
Public Health Practitioners

Similar to how physicians practice evidence-based medicine to treat individual patients, policymakers should govern the public's health according to evidence-based data. Initiated by the World Health Organization's directive to make COVID-19 research open and freely accessible, (1,2) multidisciplinary studies are still published daily. Collectively, policymakers worldwide have not used available data effectively to make noteworthy reductions in the pandemic that is now over a year old. This brief commentary introduces a policy problem, then shares 3 categories of successful case studies as possible solutions: [1] Low- and Middle-Income Countries (LMIC): Vietnam and Iran, (3,4) [2] public health practitioners: social workers in Africa and pharmacists in Zambia, (5,6) and [3] public health programs: a smoking cessation program and inmate health program. (7,8) Examples from LMIC were selected to demonstrate practical, cost-effective and duplicable methods. A collaborative multidisciplinary approach with community health partners is also proposed. (2,9)

scholarly journals Perceived helpfulness of treatment for generalized anxiety disorder: a World Mental Health Surveys report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Dan J. Stein ◽  
Alan E. Kazdin ◽  
Ayelet Meron Ruscio ◽  
Wai Tat Chiu ◽  
Nancy A. Sampson ◽  
...  
Keyword(s):  
Mental Health ◽  
Help Seeking ◽  
Health Surveys ◽  
High Income ◽  
Generalized Anxiety ◽  
Middle Income ◽  
Middle Income Countries ◽  
Dsm 5 ◽  
Low Middle Income Countries ◽  
Receive Treatment

Abstract Background Treatment guidelines for generalized anxiety disorder (GAD) are based on a relatively small number of randomized controlled trials and do not consider patient-centered perceptions of treatment helpfulness. We investigated the prevalence and predictors of patient-reported treatment helpfulness for DSM-5 GAD and its two main treatment pathways: encounter-level treatment helpfulness and persistence in help-seeking after prior unhelpful treatment. Methods Data came from community epidemiologic surveys in 23 countries in the WHO World Mental Health surveys. DSM-5 GAD was assessed with the fully structured WHO Composite International Diagnostic Interview Version 3.0. Respondents with a history of GAD were asked whether they ever received treatment and, if so, whether they ever considered this treatment helpful. Number of professionals seen before obtaining helpful treatment was also assessed. Parallel survival models estimated probability and predictors of a given treatment being perceived as helpful and of persisting in help-seeking after prior unhelpful treatment. Results The overall prevalence rate of GAD was 4.5%, with lower prevalence in low/middle-income countries (2.8%) than high-income countries (5.3%); 34.6% of respondents with lifetime GAD reported ever obtaining treatment for their GAD, with lower proportions in low/middle-income countries (19.2%) than high-income countries (38.4%); 3) 70% of those who received treatment perceived the treatment to be helpful, with prevalence comparable in low/middle-income countries and high-income countries. Survival analysis suggested that virtually all patients would have obtained helpful treatment if they had persisted in help-seeking with up to 10 professionals. However, we estimated that only 29.7% of patients would have persisted that long. Obtaining helpful treatment at the person-level was associated with treatment type, comorbid panic/agoraphobia, and childhood adversities, but most of these predictors were important because they predicted persistence rather than encounter-level treatment helpfulness. Conclusions The majority of individuals with GAD do not receive treatment. Most of those who receive treatment regard it as helpful, but receiving helpful treatment typically requires persistence in help-seeking. Future research should focus on ensuring that helpfulness is included as part of the evaluation. Clinicians need to emphasize the importance of persistence to patients beginning treatment.

scholarly journals Participation and Achievement in the Summer Paralympic Games: The Influence of Income, Sex, and Assistive Technology

2021 ◽  
Vol 13 (21) ◽  
pp. 11758
Author(s):  
Giulia Oggero ◽  
Louise Puli ◽  
Emma Maria Smith ◽  
Chapal Khasnabis
Keyword(s):  
Assistive Technology ◽  
Income Level ◽  
High Income ◽  
High Quality ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low Middle Income Countries ◽  
Significant Difference ◽  
Paralympic Games ◽  
Low And Middle Income

Global participation at the Paralympic Games has been steadily growing in the past 60 years. However, inequities in relation to geographic representation of Paralympians, sex representation, access to assistive technology, and medal success remain. The objectives of this research are to describe and compare trends in Paralympians’ participation and achievements in the Summer Paralympic Games by income level and sex, including in events requiring assistive products (wheelchairs, hand cycles/trikes, and prostheses). A retrospective secondary analysis of publicly available data was conducted. Participation, sex, and medal tally data were extracted from data available on the International Paralympic Committee website and archives. Data regarding income and population were collected from publicly available data available from the World Bank website. Participation in the Summer Paralympic Games differs significantly by income level (p = 0.000) with high- income countries sending, on average, more Paralympians than low- and middle-income countries. There is a significant difference between male and female participation (p = 0.00), with approximately 29% of all Paralympians being female. High-income countries demonstrate significantly higher achievement than low- and middle-income countries (p = 0.000), including in events requiring assistive products (p = 0.007). Despite growth in overall participation, low- and middle-income countries remain severely underrepresented in both participation and achievement at the Paralympic Games, especially in the events that require high quality assistive products to succeed. More equitable participation and achievement in the Paralympics may be supported by addressing the barriers for females, for people from low- and low-middle income countries, and for those without access to high quality assistive products required.

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